Thursday, September 27, 2012

Resuscitation June 2012

Today I present two articles from the June 2012 issue of Resuscitation, primarily to highlight the impressive efforts of the European and Scandanavian drowning research community.  Continually, they have provided high quality epidemiological data particularly in regards to cold water submersion.

The first article by Wanscher et al, describes the treatment course and outcomes of a very unique and interesting study population.  They report on a tragic but enlightening event which can only be described as an accidental case-control study, in which 15 individuals submerged in cold water after their boat capsized.  Of these 15, 1 died from drowning during the event, 7 survived with spontaneous circulation, and 7 survived after prolonged resuscitation.  This report takes you through their inpatient evolution, beginning with an the impressively fast initiation of ECMO and ending with decryption of their long term neurocognitive outcomes.  Definitely an interesting read, more on ECMO in the future.

The next article by Claesson et al, attempts to characterize every documented drowning case responded to by its national EMS system over a 15 year span.  While the article does a good job of using what data is available to subcategorize cases based on environmental and demographical aspects, what I like most about it is its ability to show the importance of working toward the establishment of a national drowning registry to include both fatal and non-fatal incidents so that the highest quality data can be obtained.

The final article is an Editorial from the same issue which highlights some of the important points from the previously mentioned articles.  Definitely some interesting and unique data on cold water submersion survival.

Outcome of accidental hypothermia with or without circulatory arrest, Experience from the Danish Præstø Fjord boating accident (Wanscher et al; Resuscitation, 2012)

Characteristics of lifesaving from drowning as reported by the Swedish Fire and Rescue Services 1996-2010. (Claesson; Resuscitation, 2012)

Drowning: more hope for patients, less hope for guidelines (Deakin; Resuscitation, 2012)