P3.L226: A retrospective study of drowning victims presenting to a pediatric emergency department

Background: Drowning is the leading cause of death in children ages 1 to 4 and is the second leading cause of unintentional injury related death in adolescents ages 5 to 14 in the United States. Prior works have reported that rates of drowning death vary with age, sex, and race. In addition, age has been found to be an important determinant of drowning location, with infants being more likely to drown in bathtubs and buckets, preschool-aged children being more likely to drown in swimming pools and older children and adolescents being more likely to drown in natural bodies of water.
This study aims to describe encounters for patients 0-17 who present to a single tertiary-care, academic emergency department from November 2012 to June 2023 after a drowning event to identify possible risk factors for these events to help target future intervention.

Methods: We performed a retrospective chart review for a single tertiary-care, academic emergency department from November 2012 to June 2023, including patients age 0-17 presenting after a drowning event. Data collected included both patient specific information, as well as details of the drowning or submersion event.

Results: We identified 161 children presenting for care after a drowning event. The median age for patients was 4.0 years, and a greater proportion were male (53.4%). When a location was listed, drownings most often occurred around the home (16.1%), at a natural body of water (16.1%), or at a hotel pool/spa (14.9%). Saturday was the most common day for drowning events to occur (28.0%). For the majority of patients (59.0%), a parent/guardian/family member was identified as being the supervisor at the time of the drowning event. The rescuer was most often a parent/guardian/family member (49.1%), followed by a bystander (15.5%). Hospital length of stay varied drastically, ranging from 0.7 - 1361.8 hours, with less than half (39.8%) of patients discharging to home from the Emergency Department.

Conclusion: Similar to prior studies, our results found that young children, as well as males are at highest risk for drowning events. With regards to event details, we identified natural bodies of water, specifically Lake Michigan, as a common location for drowning events. In addition, our findings highlighted the dangers of hotel pools/spas that do not have lifeguards on duty and are frequently locations for parties/gatherings where supervisors may easily become distracted. Results from this project may be used to shape future drowning prevention efforts and lead to improved water safety in our community.