PROGNOSTIC FACTORS IN PEDIATRIC CASES OF DROWNING AND NEAR-DROWNING

Ninety-three cases of drowning or near-drowning in the pediatric age group between 1972 and 1976 were reviewed. A scoring system for prognostic factors was developed using one point for each of five unfavorable factors involved in the drowning or near-drowning of each patient. The prognostic factors were 1) age less than three years; 2) maximum submersion time estimated longer than five minutes; 3) resuscitation not attempted for at least ten minutes after rescue; 4) patient in coma on admission to hospital, and 5) arterial blood pH of ≤ 7.10. This scoring system significantly predicted the eventual outcome of patients who had experienced the postsubmersion syndrome. Patients with scores of ≤ 2 had a 90% chance of full recovery; those with scores of ≥ 3 had only a 5% probability of survival. The early institution of resuscitative efforts was the single most important factor influencing survival. © 1979 American College of Emergency Physicians.