Table 3.
Additional parameters in 160 children who drowned with cardiac arrest and hypothermia at drowning scene, at arrival of emergency medical service, and at arrival at emergency department, categorised by outcome. Number of children stated when fewer than total (160). Univariate analysis odds ratio are for having good outcome
| Total | No (%, 95% CI) or median (IQR) with good outcome | No (%, 95% CI) or median (IQR) with poor outcome | OR (95% CI) | P value | |
|---|---|---|---|---|---|
| No of children | 160 | 17 (11%, 6 to 15) | 143 (89%, 85 to 94) | — | — |
| Drowning event | |||||
| Median estimated duration of submersion (IQR): | |||||
| Minimal (min) | 13 (10-20), n=130 | 9 (5-10), n=14 | 15 (10-24), n=116 | 0.85 (0.75 to 0.96)* | 0.009 |
| Maximal (min) | 20 (15-40), n=105 | 13 (9-19), n=12 | 20 (15-43), n=93 | 0.89 (0.82 to 0.98)* | 0.02 |
| Basic life support at scene: | |||||
| Performed | 124/134 (93%) | 16 (94, 83 to 100) | 108/117 (92, 87 to 97) | — | 0.79 |
| Delayed: | |||||
| No delay | 100/124 (81%) | 14/16 (88, 71 to 100) | 86/108 (80, 72 to 87) | — | 0.46 |
| ≤10 min | 20/124 (16%) | 2/16 (13, 0 to 29) | 18/108 (17, 10 to 24) | ||
| >10 min | 4/124 (3%) | 0/16 (0, 0 to 17) | 4/108 (4, 0 to 7) | ||
| Emergency medical service | |||||
| Bag and mask ventilation | 159/159 (100%) | 17 (100, 84 to 100) | 142/142 (100, 98 to 100) | — | — |
| Endotracheal intubation | 133/153 (87%) | 11 (65, 42 to 87) | 122/136 (90, 85 to 95) | 0.25 (0.08 to 0.83) | 0.02 |
| Adrenaline | 124/139 (89%) | 9/15 (60, 35 to 85) | 115/124 (93, 88 to 97) | 0.12 (0.03 to 0.40) | 0.01 |
| Defibrillation | 18/120 (15%) | 0/14 (0, 0 to 19) | 18/106 (17, 10 to 24) | — | 0.13 |
| Emergency department | |||||
| Ongoing ALS at ED | 104 (65%) | 1 (1, 0 to 3) | 103 (99, 97 to 100) | 0.02 (0.00 to 0.19) | <0.001 |
| Median (IQR) initial core body temperature (°C) | 29.8 (28.0-31.9) | 29.0 (26.3-31.0) | 29.8 (28.0-32.0) | — | 0.39 |
| Median (IQR) initial GCS | 3 (3-3) | 4 (3-5) | 3 (3-3) | 0.19 (0.09 to 0.43)† | <0.001 |
| Initial blood gas analysis: | |||||
| Median (IQR) pH | 6.74 (6.53-6.90), n=135 | 6.90 (6.80-7.00), n=13 | 6.70 (6.50-6.87), n=122 | 0.56 (0.39 to 0.81)‡ | <0.001 |
| Median (IQR) negative BE (mmol/l) | 28 (23-31), n=106 | 22 (18-24), n=11 | 28 (24-32), n=95 | 0.80 (0.69 to 0.92) | <0.001 |
| Median (IQR) pCO2 (kPa) | 8.1 (4.8-14.0), n=126 | 7.6 (4.2-8.5), n=11 | 8.1 (4.9-15.0), n=115 | — | 0.08 |
| Median (IQR) total duration of ALS (min) | 45 (20-75) | 10 (5-15) | 50 (30-80) | 0.82 (0.74 to 0.92)* | <0.001 |
| Median (IQR) total doses of adrenaline | 3 (2-6), n=88 | 1 (0-3), n=13 | 4 (2-7), n=75 | 0.65 (0.47 to 0.89)§ | 0.01 |
| Extracorporeal life support | 12 (8%) | 0 (0, 0 to 22) | 12 (100, 78 to 100) | — | <0.001 |
IQR=interquartile range, ALS=advanced life support, ED=emergency department, GCS=Glasgow coma scale score, BE=base excess.
*Per 1 min increase.
†Per 1 decrease.
‡Per 0.1 decrease.
§Per dose.