Ten-year review of pediatric bathtub near-drownings: evaluation for child abuse and neglect.

STUDY OBJECTIVE

To evaluate the risk factors associated with bathtub submersion injury and their relationship to child abuse and neglect.

DESIGN

Retrospective chart review.

SETTING

An urban children's hospital.

PARTICIPANTS

Any child sustaining a bathtub near-drowning over the 10-year period from 1982 to 1992.

INTERVENTIONS

None.

RESULTS

Twenty-one patients were treated for bathtub near-drownings during the 10-year period, accounting for 24% of all submersion injuries. A significant number (67%) had historic and/or physical findings suspicious for abuse or neglect, including incompatible history for the injury, other physical injuries, previous child abuse reports, psychiatric history of the caretaker, and/or psychosocial concerns noted in the chart. The mortality rate of 42% was significant. No demographic characteristics identified the children at risk.

CONCLUSION

Many children who are injured in the bathtub suffer from abuse or neglect. Medical evaluation should include social work consultation and a search for other accompanying injuries.