Making Waves: Understanding Previous Local Drowning Data to Inform Future Prevention

Victoria Thompson, DO
Micaela Parson, MS4
Brit Anderson, MD
Kerry Caperell, MD, MBA, MSC

Drowning is a leading cause of injury-related death in the pediatric population. The circumstances surrounding drownings are varied, impacting primary prevention. The purpose of this study was to evaluate pediatric drownings seen in a pediatric emergency department (ED) and drowning-related deaths in the metro area surrounding a pediatric trauma center, to determine annual injury rates and describe injury characteristics.

Retrospective chart review was completed for patients <18 years old who lived in the metro area of this land-locked state and were seen at a pediatric ED with a chief complaint, or ICD-10 code, related to drowning from 1/2016-1/2022. Coroner’s data with the same inclusion criteria completed the dataset, and duplicates were excluded. We extracted demographic information, relevant past medical history, disposition, location of residence, and water source. Injury rates were calculated using census data. Descriptive statistics, chi-square, and mapping software were used for analysis. Injury rates are expressed as injuries per 100,000 children per year.

219 patient encounters met inclusion criteria. The mean age was 4.2 years (SD 3.7), 55.7% male, 69.4% white, 20.1% Black, 6.9% Hispanic ethnicity. The majority (61.2%) occurred in the summer and nearly half on the weekend (43.8%). 14.2% of patients had a diagnosed neurologic/neurodevelopmental condition, while only 1.4% and 0.5% had a documented psychiatric and cardiac history, respectively. Pools were the most common site (71.2%), followed by bathtubs (20.6%) and open water (5.9%). Evaluation of disposition showed that 54.7% went home from the ED, 25.1% were admitted to the medical-surgical floor, 12.3% were admitted to the pediatric intensive care unit (PICU), and 6.9% died. Of the children that died or were admitted to the PICU, 26.2% had a previous neurologic/ neurodevelopmental diagnosis. The overall injury rate for the included region ranged from 9.6-15.5 during the study period. 2022 had the highest injury rate at 15.5.

Drownings in our metro area are more common in pools, during the summer, and disproportionally on weekends. A considerable number of children had a previous neurologic/neurodevelopmental diagnosis. Along with mapping, this critical information will be used to target finite resources for local primary injury prevention. This methodology could be employed to inform injury prevention in other locations.

1. Describe how local data sources can be used to describe injury epidemiology.
2. Examine characteristics associated with pediatric drowning and consider targeted injury prevention strategies.
3. Evaluate geographic distribution of pediatric drownings to target injury prevention.