Resuscitating drowned children

The World Health Organization published its global report on drowning in November 2014, reporting a staggering 372 000 deaths a year from all types of water immersion. Worldwide, drowning is in the top 10 causes of death in children and young people, particularly in males and those aged under 5. An estimated 21 children and young adults are drowned every hour.1 Other public health matters have had disproportionately greater attention, despite the numbers of deaths from drowning being equivalent to two thirds of global deaths from malnutrition and over one half of deaths from malaria.

The linked paper by Kieboom and colleagues (doi:10.1136/bmj.h418) looked at the outcomes of 160 Dutch children after cardiac arrest from drowning who were hypothermic at presentation to the emergency department.2 The authors analysed records from 1993 to 2012. Children who had been involved in traffic or boating incidents were excluded as injuries could have contributed to their arrest independently of drowning and also because air pockets could not be excluded. The duration of bystander cardiopulmonary resuscitation was not included in this study as emergency medical services reached patients within 15 minutes of being dispatched.

Of the children receiving prolonged resuscitation …