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[西班牙加利西亚儿童溺水事件的触发因素、后果及卫生系统应对情况的描述性分析。一项为期17年的回顾性研究。]

[Descriptive analysis of triggers, outcomes and the response of the health systems of child drowning in Galicia (Spain). A 17-year retrospective study.].

作者信息

Sánchez-Lloria Patricia, Barcala-Furelos Roberto, Otero-Agra Martín, Aranda-García Silvia, Cosido-Cobos Óscar, Blanco-Prieto Jorge, Muñoz-Barús Ignacio, Rodríguez-Núñez Antonio

机构信息

Servicio Médico de Emergencias, Fundación Pública Urxencias Sanitarias de Galicia 061, Cultura. A Estrada (Pontevedra). España.

Grupo de Investigación REMOSS, Facultad de Educación y Ciencias del Deporte, Universidad de Vigo. A Xunqueira (Pontevedra). España.

出版信息

Rev Esp Salud Publica. 2022 Jun 22;96:e202206048.

Abstract

OBJECTIVE

Drowning is one of major public health problem in childhood. The aim of this paper was to describe the characteristics, locations, interventions and outcomes of child drowning in Galicia over 17 years.

METHODS

Retrospective study of 100% of data of drowning amongst children aged 0-14 in the 2004-2020 period who were attended by the 061 emergency services in Galicia (Spain) was made. The characteristics of the incident, the victim's profile, location, type of medical care given and whether the victim survived or died were analysed using the Chi Square test to compare relative frequencies, and Odds Ratio to estimate the risk.

RESULTS

During the period under study, 100 child drownings were recorded. In 55%, the main cause was lack of supervision. Young children (aged 0-4) primarily drowned in pools, and pre-teens and teenagers (aged 10-14) in the sea. In 42% of the incidents, bystanders performed CPR (37% included ventilation). Emergency services took 12 minutes on average to arrive at the scene. 6% died in situ and of the rest, were taken to hospital and admitted in 47% PICU, 26% ward, 8% discharged from Accident and Emergency (43% with pulmonary oedema, 41% with supplemental oxygen, 13% with IMV/NIMV [invasive mechanical ventilation/non-invasive]). Pneumonia was the most common complication and survival to discharge was 77%.

CONCLUSIONS

Small children usually drown in pools and water facilities because of lack of supervision, whereas adolescents usually drown in the sea. CPR started by bystanders and the fast response of emergency services contributed to a high rate of survival. A large amount of data was lost during the process: accurate, standardized coding of drowning is necessary.

摘要

目的

溺水是儿童期主要的公共卫生问题之一。本文旨在描述加利西亚地区17年间儿童溺水事件的特征、地点、干预措施及结果。

方法

对2004年至2020年期间西班牙加利西亚地区061紧急服务部门接诊的0至14岁儿童溺水数据进行100%回顾性研究。使用卡方检验比较相对频率,并用优势比估计风险,分析事件特征、受害者情况、地点、所提供的医疗护理类型以及受害者的存活或死亡情况。

结果

在研究期间,共记录了100例儿童溺水事件。55%的主要原因是缺乏监管。幼儿(0至4岁)主要在游泳池溺水,青少年(10至14岁)主要在海里溺水。42%的事件中,旁观者进行了心肺复苏(37%包括通气)。紧急服务部门平均用时12分钟到达现场。6%当场死亡,其余被送往医院,47%入住重症监护病房,26%入住普通病房,8%从急诊出院(43%有肺水肿,41%吸氧,13%进行有创机械通气/无创通气)。肺炎是最常见的并发症,出院存活率为77%。

结论

幼儿通常因缺乏监管在游泳池和水上设施溺水,而青少年通常在海里溺水。旁观者进行的心肺复苏和紧急服务部门的快速响应促成了高存活率。在此过程中丢失了大量数据:有必要对溺水进行准确、标准化编码。

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