อ.พญ. มนจ ฑา เอ ยมอ ดมกาล ภาคว ชาก มารเวชศาสตร ศ นย การแพทย สมเด จพระเทพร ตนราชส ดาฯ คณะแพทยศาสตร มหาว ทยาล ยศร นคร นทรว โรฒ

Size: px

Start display at page:

Download "อ.พญ. มนจ ฑา เอ ยมอ ดมกาล ภาคว ชาก มารเวชศาสตร ศ นย การแพทย สมเด จพระเทพร ตนราชส ดาฯ คณะแพทยศาสตร มหาว ทยาล ยศร นคร นทรว โรฒ"

Emery Lucas
5 years ago
Views:

1 อ.พญ. มนจ ฑา เอ ยมอ ดมกาล ภาคว ชาก มารเวชศาสตร ศ นย การแพทย สมเด จพระเทพร ตนราชส ดาฯ คณะแพทยศาสตร มหาว ทยาล ยศร นคร นทรว โรฒ

3 372,000 people die from drowning every year Drowning is the leading cause of dead in under 14 s (48/85 countries). Peak drowning rate are among children Highest rate in 1-4yrs,follow by 5-9 yrs

5 WHO:Key facts on drowning 2014

6 Infants and young children Lack of adequate and close supervision Lack of barriers low awareness of water dangers Poor swimming skill

7 Drowning can occur during a brief lapse of supervision, not complete lack of attention. After drowning 2 mins Lose conciousness 4-6 mins Irreversible brain damage 10 mins die Survivors are discovered in 2 mins. Wintermute GJ,Amer J Dis Child 1990

8 496 of drowning deaths, age< 14 yrs 10% completely unsupervised 79% of unsupervised were 5-14 yrs A national study of childhood drowning and related attitudes and behaviors.us

9 2004 A national study of childhood drowning and related attitudes and behaviors.us

10 Never leave a young child unsupervised, even for a moment. Never allow children to swim without adult supervision. Maintain continuous visual and auditory contact Not engaged in distracting behaviors Keep the children within arm s reach

11 4-sided fencing pool Decrease pool immersion injuries in young children more than 50% (2000,Cochrane data base review) Queensland,Australia : The barrier-isolation legislation reduces drowning rates in young children by more than 30%.(Pearn et al, 2008)

12 80% of drowning children < 5 yrs happened within 20 m around the resident.(bangladish National Survey) Only 10 cm of water can kill them.

16 Association between swimming lessons and drowning in 1-4 yrs Characteristic Case (N=61) Controls (N=134) P value Adjusted OR (95%CI) formal ( ) no 59(97) 99(74) yes 2(3) 35(26) Informal instruction Never/rarely 25(42) 42(35) Every/most 35(58) 78(65) 0.24

17 Adjusted OR 0.36, 95% CI

20 16% of drowning death had strong or average swimming skill. (2009,Canadian Red Cross) 17% of the victims had received swimming instruction. (1989, Hassall IB. Aust Pediatr J.)

22 Support swimming lessons for 4yrs and older. No recommendation the aged for learning watersurvival skills. Need more study for types of swim instruction and water-survival skillls. 2010,Weiss J, Pediatrics

23 Adolescents High risk behavior Consuming alcohol while engaging with water 2014: WHO: Global report on drowning

24 Impair judgment Impair physiologic effect Swimming skill Orientation (Smith GS, JAMA 2001.)

25 30-70% of swimming & boating victims had alcohol in blood. ( Driscoll TR,2004 Inj Prev.) Increase risk 16-fold when the BAC >100 mg/dl. (Smith GS,2001 JAMA)

26 PFDs decrease drowning morbidity &mortality.(2003,browne ML. Public Health Rep.) 9 % of 510 victims were wearing a PFDs. (2008, US Coast Guard)

28 Air-filled swimming aids are TOYS.

30 Bystander resuscitation can improve survival rate (> 70%)and neurological outcome. Start with C-A-B rather than A-B-CHandsonly CPR is not appropriate. Heimlich maneuver is not recommend. Marc D. Berg et al. Circulation. 2010

31 Once someone start to drown : the outcome always fatal

5/13/ National Drowning Prevention Symposium, Pittsburgh, April Linda Quan Monday Plenary Presentation 1

5/13/ National Drowning Prevention Symposium, Pittsburgh, April Linda Quan Monday Plenary Presentation 1 Drowning in Open Water Recreational settings Linda Quan, MD Seattle Children s Hospital Professor, Pediatrics University of Washington School of Medicine, Seattle, WA 1 Open Water Drowning Who drowns in