ABSTRACT
Purpose@#Despite the well-known mortality of pediatric drowning, there is a paucity of evidence on the implications of an initial evaluation on the relevant outcome of drowning. This study aimed to investigate the association of initial clinical findings with outcome of children undergoing drowning. @*Methods@#This retrospective study was conducted using the medical records of 56 children undergoing drowning who visited 3 Korean academic hospitals from January 2000 through May 2020. We analyzed information regarding the prehospital resuscitation, drowning time, a 4-tiered chest radiographic grade, and the baseline characteristics. The grade was defined based on the findings of initial chest radiographs. The poor outcomes were defined as the need for intensive care unit care or death aftercare. We analyzed the association of the prehospital resuscitation, submersion time, and the radiographic grade with the poor outcomes using binary logistic regression. @*Results@#Among the 56 children, 31 (55.4%) were aged 1-4 years. Prehospital resuscitation and 1-5 minutes of submersion time were noted in the 25 (44.6%) and 30 children (53.6%), respectively. The chest radiographic grades 1 through 4 accounted for 17 (30.4%), 20 (35.7%), 12 (21.4%), and 3 children (5.4%), respectively. Poor outcomes occurred in 17 children (30.4%), including 3 deaths (5.4%). The association with the poor outcomes was noted in the submersion time of longer than 5 minutes (adjusted odds ratio, 21.49; 95% confidence interval, 1.11-415.73; compared with < 1 minute) while not in the submersion time and chest radiographic grade. @*Conclusion@#This study confirms that submersion time is an outcome predictor of drowning.
ABSTRACT
This study is to prepare promotional strategies of establishment of the Korea Poison Center based on the chemicals and chemical products and the database (DB) construction status of Chemical Accident Emergency Respond Information System (CEIS) and the DB needs survey of the lay person. The methods of CEIS DB construction and hazard classification are; first, the researchers required material safety data sheet from the manufacturer/distributor and verified its composition/information on ingredients. Second, the researchers conducted the hazard classification of the chemical products by the mixtures classification according to the United Nations Globally Harmonized System of Classification and Labelling of Chemicals (GHS, 3rd edition) guidelines based on the verified composition/information on ingredients. The emergency measures information was established by the Emergency Department healthcare professionals. Health hazards are classified by using 13 reference databases, which include European Chemical Substances Information System (IUCLID) and IARC, and 4 reference books like Emergency Management Guides(ERG). As the result of analyzing the DB construction status of chemical products, it showed in the order of, 180 for vehicle products (15.0%), 162 for printing products (14.0%), 129 for paint (11.0%) and 120 for adhesives (10.0%). Currently in 2013, emergency respond information was established for a total of 2,400 chemicals (includes 1200 chemical products). As the result for conducting a needs survey for the establishment of emergency respond information targeting on the general public and professionals, it showed the highest level of demand for the establishment of emergency respond information on 'household products (2.87 points)' for both lay person and experts. As the result of analyzing the Q&A of the lay person until March 2013, through CEIS, it showed the highest inquiry on disinfectant and germicide products with 11 issues (27.5%). World Health Organization recommends to provide emergency consultation and information on poisoning accidents and operate a 24 hour national poison center able to perform the research functions for every nation. However, there is no such national poison center in Korea, and it can be said fundamental reform of the national poison management system and establishment of national poison center is urgent, considering the fact social demand and citizens from recent consecutive chemical poisoning accidents are increasing.