Monday, March 13, 2017

Relationship between drowning location and outcome after drowning-associated out-of-hospital cardiac arrest: nationwide study


Title: Relationship between drowning location and outcome after drowning-associated out-of-hospital cardiac arrest: nationwide study
Authors: Jeong J, et al.
Journal: American Journal of Emergency Medicine, September 2016

Study Focus: This study examined the association between location and drowning-OHCA outcomes in South Korea

Study design

  • Cross-sectional study
  • Nationwide out-of-hospital cardiac arrest (OHCA) registry in South Korea
  • Analyzed drowning OHCA cases 2006-2013
  • Classified event locations
    1. Recreational public pools with lifeguards
    2. Recreational public beaches with lifeguards
    3. Natural freshwater locations without lifeguards
    4. Natural saltwater locations without lifeguards
  • Examined effects of the following on outcome:
    • age, sex
    • presence of witness, bystander CPR
    • EMS response time, EMS scene time, EMS transport time
    • Primary ECG at scene, prehospital defibrillation
    • Level of emergency department triage
  • The primary end point was survival-to-hospital discharge
  • Statistical models (2)
    1. Adjusted for confounding variables present before rescue (age, sex, witness)
    2. Adjusted for all potential confounders including prehospital variables and variables from Model 1
Results


Discussion
  • Model 1: Higher chance of survival for those who had drowning OHCA at supervised location
  • Model 2: No significant difference
  • Bystander CPR associated with location which likely accounts for difference in outcome of models
This study is nice for a couple of reasons: (1) it uses a nationwide database with fairly good drowning data and (2) it analyzes a country with national safety laws pertaining to lifeguards for all public bodies of water. This allows for a nice comparison given the lower variability of coverage than we would see in the US. The authors do mention, however, that they don't specifically evaluated the pools and beaches adherence to the national safety laws.

Bottom Line: In this single-nation study, drowning OHCA in bodies of water with lifeguards was found to have a higher survival to discharge than those without lifeguards.


Reference
Jeong J, Hong KJ, Shin SD, Ro YS, Song KJ, Lee EJ, Lee YJ, Ahn KO.
Relationship between drowning location and outcome after drowning-associated
out-of-hospital cardiac arrest: nationwide study. Am J Emerg Med. 2016

Sep;34(9):1799-803.

1 comment:

  1. Very awesome!!! When I seek for this I found this website at the top of all blogs in search engine. lie detector test

    ReplyDelete