Improving Lifejacket Wear Among Boaters on Lake Albert, Uganda
DrowningA cluster randomized trial will be conducted for six months. To avoid covariate imbalance at baseline, stratified permuted block randomization with a 1:1 allocation ratio will be done. At least 387 boaters across 7 clusters per arm will be interviewed post baseline to give a 90% power to detect the effect of the intervention if such effect exists. A mixed effects multi-level modeling at 5% alpha level will be done using logical model building procedures
Pathogens Responsible for Respiratory Infections Associated With Drowning in Seawater
DrowningLittle data is currently available on the type of pathogen responsible for respiratory infections following drowning. Many environmental germs present in seawater are described as difficult to culture on standard media but are potentially pathogenic. Even using specific culture media nearly 90% of the bacteria present in the water remain non-cultivable. The use of 16S and 18S rDNA amplification followed by high throughput sequencing on respiratory samples could allow us to objectify these bacteria potentially involved in the physiopathological process secondary to drowning and thus improve their overall management. Carrying out a bronchoalveolar lavage (BAL) within 24 hours after admission to intensive care with analysis on standard and specific culture media of environmental germs, carrying out antibiograms, DNA extraction, amplification by universal 16 and 18S rDNA primers followed by high flow sequencing and phylogenetic analysis of pathogens found. Comparison of these results with the same analyses performed on seawater samples taken near the drowning site and during a new AML at 72h for patients still intubated and showing signs of pneumonia in order to determine if the pathogens detected at the entrance persist and are present in the environment. AML at the patient's entrance, on day 3 and environmental sampling in the drowning environment within 24 hours. Standard and specific bacteriological analyses with molecular biology techniques (amplification 16 and 18S rDNA) carried out at Pr RUIMY's laboratory (Nice University Hospital) sequencing on INRA's Toulouse genomics platform. Phylogenetic data capture and analysis at IRCAN (Bioinformatics, Croce Olivier). Patient follow-up until resuscitation discharge.
Teaching Young Children Swim Survival Skills
DrowningThis study is designed to evaluate whether commercially-available swim self-rescue schools are effective to teach children ages 12-35 months to stay safely alive floating in the water without adult intervention. The investigators will measure children's water self-rescue skills at baseline and then they will engage in commercially-available training over the course of several sessions. The investigators will then measure their skills again. Assessments will be conducted using a standardized protocol with a certified lifeguard always within an arm's reach of the child. Parents will also complete a short survey concerning child and family demographics and child and family swim and lifeguard training experience.
Drowning in Denmark: A Six-year Registry-based Study of Fatal and Non-fatal Drowning
DrowningWithin a six-year period from 2016-2021, this retrospective cohort study aims to report: 1) the national incidence of non-fatal drowning accidents attended by the Danish Emergency Medical Services (EMS), 2) 48-hours and 30-day mortality, 3) Duration of hospitalization, 4) Neurological outcome at hospital discharge Furthermore, the investigators will follow the recommended guidelines for uniform reporting of data from drowning the "Utstein style" and investigate aspects associated with better outcome. Finally, the investigators wish to report spatial distribution of non-fatal drowning accidents. This can potentially result in recommendations towards certain educative, preventative, rescue, or treatment strategies to reduce OHCA from drowning.
Drowning-related OHCA in Denmark: A Six-year Registry-based Study
DrowningOut-Of-Hospital Cardiac ArrestWithin a six-year period from 2016-2021, this retrospective cohort study aims to: 1) report the national incidence of drowning related OHCA's among cases attended by the Danish Emergency Medical Services (EMS), 2) assess survival defined as return of spontaneous circulation (ROSC) on scene, by hospital admission and 30-day survival. Furthermore, aspects associated with better outcome are evaluated including actions taken by EMS-personnel and laypersons, geographical localization, type of activity, witnessed event, EMS response times, bystander CPR, initial rhythm, use of defibrillator, airway devices, pre-hospital medication, and patient demographics. This can potentially result in recommendations towards certain educative, preventative, rescue, or treatment strategies to reduce OHCA from drowning.
Accidental Hypothermia in Drowning-related OHCA
HypothermiaAccidental3 moreThis study aims to report mortality and neurological outcome 180 days after drowning incident in patients with accidental hypothermia vs normothermia following drowning-related OHCA in Denmark during a six-year period from 2016-2021.
Environmental and Behavioral Risk Factors for Childhood Drowning
DrowningThis study will examine the relationship between swimming lessons, swimming ability, and other risk factors or protective factors, and the risk of drowning among children. The study's primary focus is on children between 1 and 4 years of age, with a secondary focus on older children up to 19 years of age. Drowning is the second leading cause of accidental death among children under 5 years of age, with drowning rates peaking among 1- to 2- year-olds. The study will examine the circumstances of cases of children between 1 and 19 years of age who have drowned in a body of water where swimming ability might have been a risk factor, such as a pool, Jacuzzi, hot tub, pond, lake, river, canal quarry, irrigation ditch, dam, or ocean. (Drowning is defined as death from asphyxia while submerged, or within 24 hours of the submersion.) The victims' parents or guardians will be interviewed about their child's general health, temperament, motor development, swimming ability, history of swimming lessons, and exposure to water. In addition, they will be asked about environmental factors related to the child's drowning, such as if a lifeguard was present or if, in the case of a pool drowning, there was a fence around the pool. They will be asked about parental norms regarding child supervision and pool-provider advice regarding swimming instruction. Parents of older children will be asked about their child's risk-taking and sensation-seeking behaviors. Information on additional risk factors, such as the remoteness of the site of the drowning and the victim's blood alcohol level will also be obtained. The above information will be compared with similar information gathered from parents of control subjects-that is, children who are the same age as the victims and who live in the same geographic area. For adolescent cases, information about swimming in unguarded sites or drinking alcoholic beverages while in or around water will be obtained from direct interviews with adolescents, as parents may not have accurate information in these areas. The information gained from this study will provide guidance for the development of interventions to prevent childhood drowning.
Observational Study of Drowning Patient's Emergency Care in Its Pre-hospital Phase.
DrowningAccording to the 9th edition of "NOYADES" survey, 1480 drownings accidents occurred in France in 2021, of which 146 (i.e. nearly 10%), were in the Var department. These patient's care involve in first place the Emergency Medical Service (EMS). To date, there is no recommendation from French or European academic societies of emergency medicine formalising pre-hospital care of these patients (except for the specific case of cardiac arrest). This absence of recommendation therefore favours heterogeneity of practices.
Expanded Access Protocol: Umbilical Cord Blood Infusions for Children With Brain Injuries
Cerebral PalsyHydrocephalus4 moreThe purpose of this protocol is to enable access to intravenous infusions of banked autologous (a person's own) or sibling umbilical cord blood (CB) for children with various brain disorders. This is an expanded access protocol intended for patients who are unable to participate in a clinical trial involving their own or their sibling's cord blood. Children with cerebral palsy, congenital hydrocephalus, apraxia, stroke, hypoxic brain injury and related conditions will be eligible if they have normal immune function and do not qualify for, have previously participated in, or are unable to participate in an active cell therapy clinical trial at Duke Medicine. For the purpose of this protocol the term children refers to patients less than 26 years of age. The cord blood is thawed and then administered as an intravenous infusion. Recipients do not receive chemotherapy or immunosuppression. The mechanism of action is through paracrine signaling of cord blood monocytes inducing endogenous cells to repair existing damage.
Pulse Oximetry in Healthy SubjEcts ImmergeD in OceaN.
DrowningDrowning is the 3rd leading cause of accidental death in the world. One of the tools used by lifeguards to help ER assess gravity, is pulse oximetry. Its measure is variable even in optimal condition and its accuracy can be altered by factors specific to the patient and by environmental factors. The conditions gathered during a drowning rescue are thus propitious to a misleading evaluation. Assessing its reliability and looking for influencing factors of the measure of pulse oximetry could help for pre-hospital care management.