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015 Epidemiology and clinical characteristics of fatal and nonfatal drowning patients presenting to a Mid-Atlantic Urban pediatric emergency department from 2018 to 2020
  1. Katherine Macmillan1,
  2. Andrea Gielen2,
  3. Ellen McDonald2,
  4. Katherine Hoops1,
  5. Sapna Kudchadkar1,
  6. Isam Nasr1,
  7. Leticia Ryan1
  1. 1Johns Hopkins, Baltimore, USA
  2. 2Bloomberg School of Public Health, Baltimore, USA


Statement of Purpose To address current gaps in drowning research and inform local prevention efforts, our objective is to describe the epidemiology and clinical characteristics of pediatric drowning patients. In addition to an updated description of epidemiological patterns of injury, a more in-depth understanding of current clinical presentations and management is warranted to better characterize severity for nonfatal cases.

Methods/Approach A retrospective descriptive chart review of pediatric patients evaluated in a mid-Atlantic urban pediatric emergency department from January 2018 to December 2020.

Results 57 patients aged 0–18 years were identified. Patients 1–4 years of age represented 53% of those identified. Similar numbers of African American (N=24, 42%) and Caucasian (N=22, 38%) patients presented for evaluation following drowning. Although the majority of events were unintentional, one event was a self-injury with drowning as the mechanism of suicide attempt. More than half of the patients required CPR (N=32, 56%) and/or admission (N=32, 56%). The majority of patients survived (N=54, 95%) despite need for high level of intervention. Many patients (77%) had chest x-rays obtained, and of those, 59% were abnormal. About 70% of events occurred Friday through Saturday (N=40), in a pool (N=40), and during the summer (N=41).

Conclusions Drowning can be an intentional or unintentional source of injury in pediatric patients. Among the patients who presented to the emergency department after a drowning event, most received CPR and/or were admitted. In this study population, weekends, outdoor pools, and summer season are potential high yield targets for drowning prevention efforts.

Significance This study presents some epidemiological and clinical patterns that are helpful to inform prevention approaches. It is worth noting that rates of pediatric suicidal ideation and attempts have risen due to stressors related to COVID-19, and recognizing that drowning can be a mechanism of self-injury is important.

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