Pediatric Submersion Injury Prognosis - Medical Algorithm

Orlowski reported a prognostic score for cases of pediatric drowning and near-drowning.

Patient population:

(1) 93 cases from Australia, India, California and Ohio

(2) patients <= 20 years of age

(3) included both salt water and fresh water submersions (including pools, lakes, streams, fish tanks, buckets, bathtubs and toilets)

Parameters used for prognostic score:

(1) age of child

(2) duration of submersion

(3) interval between rescue and initiation of resuscitation (mouth to mouth, or cardiopulmonary resuscitation)

(4) presence of coma on admission to hospital

(5) arterial blood pH

Parameter	Finding	Points
age	< 3 years	1
	>= 3 years	0
maximum submersion time (estimated)	> 5 minutes	1
	<= 5 minutes	0
length of time before resuscitation attempted after rescue	>= 10 minutes	1
	< 10 minutes	0
status on admission to hospital	comatose	1
	noncomatose	0
arterial blood pH	<= 7.1	1
	> 7.1	0

prognostic score =

= SUM(points for 5 parameters)

Interpretation:

• minimum score: 0

• maximum score: 5

• The early initiation of resuscitative efforts was the most important single factor affecting survival.

Score	Survival
<= 2	90%
>= 3	5%

To read more or access our algorithms and calculators, please log in or register.

Prognostic Score of Orlowski in Pediatric Submersion Victims