From the Emergency Associates for Medicine and University of South Florida College of Medicine, Tampa, FL, USA
Correspondence
Address reprint requests to Dr Causey, Department of Emergency Medicine, Children's Hospital of The King's Daughters, 601 Children's Ln, Norfolk, VA 23507.
From the Emergency Associates for Medicine and University of South Florida College of Medicine, Tampa, FL, USA
Correspondence
Address reprint requests to Dr Causey, Department of Emergency Medicine, Children's Hospital of The King's Daughters, 601 Children's Ln, Norfolk, VA 23507.
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Abstract
To determine if routine, noninvasive parameters could be measured which predict early (4–6 hour) discharge from the emergency department (ED) in mildly symptomatic and asymptomatic victims of childhood near-drowning, a retrospective cohort study was undertaken. Patients with fresh water near-drowning were studied over a 3-year period who presented with Glascow Come Scale (GCS) ≥13 and required no advanced life support prior to or ≤4 hours after ED presentation. Three groups of patients were found: 39 patients (81%) had normal pulmonary examination (PEx) and normal room air oxygen saturation (RASaO2) by 4 to 6 hours and did not deteriorate during the hospital admission (<24 hours); 5 patients (10%) had normal PEx by 4 to 6 hours and RASaO2 by 8 to 12 hours and did not deteriorate during hospitalization (<24 hours). Four patients (8%) were hospitalized for more than 24 hours. No patient with normal RASaO2 at 6 hours deteriorated while in the hospital (Cl 92.3–100%). Children who present to the ED with GCS ≥13 and have normal PEx/respiratory effort and RA-SaO2 more than 95% at 4 to 6 hours after ED presentation can be safely discharged home.
