He Siran, Lunnen Jeffrey C, Zia Nukhba, Khan Uzma, Shamim Khusro, Hyder Adnan A
BMC Emerg Med. 2015;15 Suppl 2(Suppl 2):S4. doi: 10.1186/1471-227X-15-S2-S4. Epub 2015 Dec 11.
Drowning is a heavy burden on the health systems of many countries, including Pakistan. To date, no effective large-scale surveillance has been in place to estimate rates of drowning and near-drowning in Pakistan. The Pakistan National Emergency Department Surveillance (Pak-NEDS) study aimed to fill this gap.
Patients who presented with a complaint of "near-drowning" were analyzed to explore patterns of true near-drowning (unintentional) and intentional injuries that led to the "near-drowning" complaint. Bivariate analysis was done to establish patterns among patients treated in emergency departments, including socio-demographic information, injury-related information, accompanying injuries, and emergency department resource utilization.
A total of 133 patients (0.2% of all injury patients) with "near-drowning" as presenting complaints were recorded by the Pak-NEDS system. True near-drowning (50.0%) and intentional injuries that led to "near-drowning" complaints (50.0%) differed in nature of injuries. The highest proportion of true near-drowning incidents occurred among patients aged between 25-44 years (47.5%), and among males (77.5%). True near-drowning patients usually had other accompanying complaints, such as lower limb injury (40.0%). Very few patients were transported by ambulance (5.0%), and triage was done for 15% of patients. Eleven (27.5%) true near-drowning patients received cardiopulmonary resuscitation.
There was major under-reporting of drowning and near-drowning cases in the surveillance study. The etiology of near-drowning cases should be further studied. Patients who experienced non-fatal drownings were more commonly sent for medical care due to other accompanying conditions, rather than near-drowning event itself. There is also need for recognizing true near-drowning incidents. The results of this study provide information on data source selection, site location, emergency care standardization, and multi-sector collaboration for future drowning prevention studies.
溺水给包括巴基斯坦在内的许多国家的卫生系统带来了沉重负担。迄今为止，巴基斯坦尚未开展有效的大规模监测来估计溺水和近乎溺水的发生率。巴基斯坦国家急诊科监测（Pak-NEDS）研究旨在填补这一空白。
对主诉为“近乎溺水”的患者进行分析，以探究真正的近乎溺水（意外）和导致“近乎溺水”主诉的故意伤害的模式。进行双变量分析以确定急诊科治疗患者之间的模式，包括社会人口统计学信息、伤害相关信息、伴随伤害以及急诊科资源利用情况。
Pak-NEDS系统记录了总共133例以“近乎溺水”为主诉的患者（占所有受伤患者的0.2%）。真正的近乎溺水（50.0%）和导致“近乎溺水”主诉的故意伤害（50.0%）在伤害性质上有所不同。真正的近乎溺水事件发生率最高的是年龄在25至44岁之间的患者（47.5%），以及男性患者（77.5%）。真正的近乎溺水患者通常还有其他伴随主诉，如下肢受伤（40.0%）。很少有患者通过救护车运送（5.0%），15%的患者进行了分诊。11例（27.5%）真正的近乎溺水患者接受了心肺复苏。
监测研究中溺水和近乎溺水病例存在大量漏报情况。近乎溺水病例的病因应进一步研究。经历非致命溺水的患者因其他伴随情况而非近乎溺水事件本身更常被送去就医。还需要识别真正的近乎溺水事件。本研究结果为未来溺水预防研究的数据源选择、地点定位、急诊护理标准化和多部门合作提供了信息。
