Abstract
Among 17 children with near-drowning seen in a 6 year period at an urban Pediatric center, 10 involved bath tub accidents (average age 1.2 yrs.). The most important determinant of outcome was their condition on admission. All of 6 children who were alert and breathing did well on minimal therapy (O2 and NaHCO3) with an average of 2.8 hosoital days. Four apneic comatose patients required in addition, steroids, blood transfusion, tracheal intubation and mechanical ventilation, and were hospitalized an average of 14 daysi 3/4 died. Among those in whom studies were obtained less than 2 hours after the accident, findings were as follows: acidosis (mean pH 7.0) in S cases; hypercapnia (mean pCO2 62) in 4 cases; a-A gradient (mean pO2 91) in 3 cases (all receiving O2); and mild hyponatremia (mean Na 132) in 6 cases.
In 9/10 cases the child was unattended in the bath tub. Social Service was consulted in 7/10 cases, and formal child neglect forms were filed in 6 cases. Two cases had been previously reported for neglect. One mother was under psychiatric care. In 3 cases severe social disorganization was evident. In 5 cases the parents were unaware of the hazard of leaving infants unattended in the bath tub. Prevention of bath tub near-drowning will require a more active effort by health professionals to educate such high risk families about this danger.
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Palmer, J., Schidlow, D. & Huang, N. BATH TUB NEAR-DROWNING AS A MANIFESTATION OF THE CHILD NEGLECT SYNDROME: CLINICAL, BIOCHEMICAL AND SOCIAL ASPECTS. Pediatr Res 11, 577 (1977). https://doi.org/10.1203/00006450-197704000-01241
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DOI: https://doi.org/10.1203/00006450-197704000-01241