Drowning ; epidemiology ; prevention & control ; Humans

Drowning is a leading cause of accidental injury in children and has a great impact on family and society. The prevention and treatment of drowning is of great importance for reducing mortality rate. This consensus reviews the literature on the epidemiology, rescue, resuscitation, and acute clinical management and prevention of drowning. The panel determines the score of available evidence according to the criteria of Oxford Centre for Evidence-Based Medicine and then makes recommendations on evidence based on such criteria, so as to provide a basis for further reducing the mortality and disability rates caused by drowning.
Child ; Consensus ; Drowning/prevention & control* ; Humans ; Resuscitation

OBJECTIVEThe main causes of death in children aged 0 - 4 were accidental suffocation and drowning which had a significant relation with parents' lack of prevention knowledge and effective measures. By comparing parents' acknowledge and behavior in preventing accidental suffocation and drowning and the mortality rate of accidental suffocation and drowning after intervening with those before the intervening, evaluation was made on intervening efficacy of health education.

METHODSSix counties in north Jiangsu were involved in the survey. Two townships drawn from each county were divided into the intervened group and the controlled group. Health education was carried out in the intervened group for one year in 2000. Twenty to 30 parents of infants and children aged 1 - 4 drawn randomly from every township in the intervened group were taken as investigation subjects before and after intervening, and a questionnaire was made for them to answer. Meanwhile, the mortality rates of accidental suffocation and drowning were measured.

RESULTSFollowed by health education for a year, the parents' opinion about whether unintentional injury can be avoided or not has changed from 18.8% to 20.5% to 1.8% - 2.9%, and parents' knowledge about how to give first aid in spot has increased from 11.1% - 13.5% to 41.1% - 56.8%. The parents' behavior that not sleeping with their infants in the same beds and not tying infants in a candle with blanket, and setting up fence beside pools and rivers has increased by 75.7%, 61.5% and 61.2%, respectively, while their relative knowledge has increased by 212.7% and 194.3%. In the intervened group, the mortality rates of infants' accidental suffocation per 100,000 has fallen from 487.8 to 71.2, dropped by 85.4%; and the mortality rates of drowning in children aged 1 - 4 per 100,000 has fallen from 60.0 to 36.2, dropped by 39.7%. In comparison, in the controlled group, the mortality rates of infants' accidental suffocation per 100,000 has fallen from 344.1 to 276.4, dropped by 19.7%; and the mortality rates of drowning in children aged 1 - 4 per 100,000 has increased by 26.3%, from 51.7 to 65.3.

CONCLUSIONHealth education to parents is an effective intervening measure for prevention of accidental suffocation and drowning. The goal of health education should be to change inadequate behavior and dangerous environment in which unintentional injury is easily happened. The intervening measures that not sleeping with their infants in the same beds and not tying infants in a candle with blanket, and putting up fence beside pools and rivers are feasible and practicable.

Accident Prevention ; Asphyxia ; prevention & control ; Child, Preschool ; China ; Drowning ; prevention & control ; Female ; Health Education ; Humans ; Infant ; Male ; Parenting ; Parents ; education ; Suburban Population ; Surveys and Questionnaires ; Treatment Outcome

PURPOSE: The incidence and severity of injuries differs between each region of Korea due to socioeconomic differences. The comparative analysis between national injury data and the evaluation of regional epidemiologic characteristics is useful in establishing an injury prevention strategy for a regional community. This study was conducted in order to provide basic data for the establishment of an injury prevention strategy by priority through comparison between national injury data collected by National Emergency Department Information System (NEDIS) and injury data from regional emergency centers located in small cities, in Korea. METHODS: The study subjects were the injury patients who visited a total of 117 regional, specialized and local emergency centers from April 2009 to March 2010, as well as those who visited Konkuk University Chungju Hospital during the same period. We collected national data from the Injury Surveillance Report published by Korea Centers for Disease Control and Prevention and compared these with study hospital data collected by our own injury registration system to include gender, ratio, age, and mechanism and severity of patient injury. RESULTS: Of 3,931,573 patients who visited 117 emergency centers and 23,671 patients who visited the study hospital during the study year, the number of injury patients was 786,006 (20.0%) versus 6,177 (26.1%), respectively. 485,521 (62.0%) of the nation-wide subjects versus 4,046 (65.5%) of the study hospital subjects were male, and 298,197 (38.0%) of the nation-wide subjects versus 2,128 (34.5%) of the study hospital subjects were female. The comparison by age of the injury subjects was as follows: below 9 years (22.4% versus 16.8%), twenties (14.5% versus 16.3%) and forties (14.5% versus 15.2%). In the comparison of injury mechanism, blunt injury was higher (20.4%) in nation-wide subjects followed by slip injury (20.0%) and transport accident (19.0%). Transport accidents produced the highest cause of injury (26.0%) in the study subjects followed by slip injury (20.1%) and bunt injury (16.1%). In the severity comparison, 641,344(81.6%) versus 4797(77.8%) were mild injury patients, 139,260(17.7%) versus 1299(21.1%) were severely injured, and 3114 (0.4%) versus 69(1.1%) were fatal injuries. The causes of severe injury nation-wide included intoxication (46.3%), falls (34.8%) and machine accidents (33.3%) versus machine (46.0%), asphyxia (44.4%), intoxication (39.3%) in the study hospital, and the causes of fatal injuries nation-wide were intoxication (5.2%), drowning (4.3%), and asphyxia (4.2%), versus drowning (11.1%), asphyxia (5.6%) and intoxication (4.9%) in the study hospital. CONCLUSION: Through the comparison between study hospital with national injury data, we found that the percentage of severe and fatally injured patients was higher in the nationally with transportation related accidents being highest in terms of mechanism. The construction of a regional injury data system with ongoing comparison with national injury data may be useful in the establishment of a regional injury intervention strategy by priority.
Accident Prevention ; Asphyxia ; Centers for Disease Control and Prevention (U.S.) ; Drowning ; Emergencies ; Female ; Humans ; Incidence ; Information Systems ; Korea ; Male ; Population Surveillance ; Transportation ; Wounds, Nonpenetrating

OBJECTIVETo find out the risk factors of drowning among children aged 1 and 14 in rural areas and to provide evidence for prevention and to reduce such incidents.

METHODS20 towns being selected as a cluster sampling study and screened out 133 drowning children aged 1-14 from Jan. 1, 2002 to Dec. 31, 2004 were screened. 1:2 matched case-control method was conducted. Data was analyzed with conditional univariate and multivariate logistic regression analysis.

RESULTSResults showed that falling into water took the leading type of drowning among children from the rural areas. The component of drowning displayed that boys was higher than girls. The majority occurred. during the warmer months, in summer and autumn. The places where drowning occurred was mainly at incidence site. Results from single and multiple factors analysis identified four major risk factors as: alcoholic drinking of his/her mother, lack of emergency treatment in the village, the child care-taker did not know what to do when drowning was occurring, the child usually played beside the water site. Factors preventing from drowning were: swimming training, the child caretaker keeping an eye on the child when he/she was swimming, the health condition of the caretaker and the communication with the parents.

CONCLUSIONThe risk factors of drowning among children aged 1-14 in rural areas were caused by multiple factors. Prevention and control program on drowning should be focusing on supervision, safety water, safety education and teaching swimming.

Adolescent ; Case-Control Studies ; Child ; Child, Preschool ; China ; epidemiology ; Drowning ; epidemiology ; prevention & control ; Female ; Humans ; Infant ; Male ; Risk Factors ; Rural Health