Bamber Andrew R, Pryce Jeremy W, Ashworth Michael T, Sebire Neil J
Camelia Botnar Laboratories, Department of Histopathology, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, WC1N 3JH, UK,
Forensic Sci Med Pathol. 2014 Sep;10(3):363-70. doi: 10.1007/s12024-014-9569-0. Epub 2014 Jun 4.
To investigate the demographics, circumstances and autopsy findings in infants and children dying following immersion.
A retrospective review of a pediatric autopsy database at a specialist center over a 16-year period (1995-2010) was undertaken to identify deaths between 7 days and 16 years of age in whom death occurred following immersion.
28 infants and children died following immersion during the study period. 82 % were aged <4 years, with peak age of death between 1 and 2 years. Immersion occurred at home in a bath or private pool in 70 % of cases. There was a lack of direct supervision in all but two cases where the information was recorded (91 %); one of these cases occurred in a public swimming lesson, and in the other the carer was incapacitated. Autopsy findings were non-specific. Facial or subconjunctival petechial hemorrhages were a feature of 18 % of cases. There was increased lung weight, or histological pulmonary edema/intra-alveolar hemorrhage in all but one case.
The data suggest that the majority of pediatric immersion-related deaths were potentially preventable with appropriate supervision. The findings strongly support the role of education regarding adequate carer supervision of infants and children while bathing, particularly in children with underlying conditions such as epilepsy. As private pools and "hot tubs" become more common in the UK and other jurisdictions, specific recommendations such as fencing pools will need to be included in advice to carers. So-called 'dry drowning" appears to be an uncommon mechanism of death in this age group.
调查溺水后死亡的婴幼儿及儿童的人口统计学特征、具体情况和尸检结果。
对某专科中心16年期间（1995 - 2010年）的儿科尸检数据库进行回顾性研究，以确定7天至16岁因溺水死亡的病例。
研究期间有28名婴幼儿及儿童溺水后死亡。82%的死者年龄小于4岁，死亡高峰年龄在1至2岁之间。70%的溺水事件发生在家中的浴缸或私人泳池。除两例记录了相关信息的情况外，其他所有病例（91%）均缺乏直接监管；其中一例发生在公共游泳课上，另一例是照顾者丧失了行为能力。尸检结果无特异性。18%的病例有面部或结膜下瘀点性出血。除一例病例外，其他所有病例均有肺重量增加或组织学上的肺水肿/肺泡内出血。
数据表明，通过适当监管，大多数与儿童溺水相关的死亡是可以预防的。研究结果有力地支持了对照顾者进行教育的作用，即在给婴幼儿洗澡时要进行充分监管，尤其是对于患有癫痫等潜在疾病的儿童。随着私人泳池和“热水浴缸”在英国及其他地区越来越普遍，向照顾者提供的建议中应纳入诸如泳池围栏等具体建议。所谓的“干性溺水”在这个年龄组似乎是一种不常见的死亡机制。
