title: Cervical spine injuries among submersion victims.
abstract: BACKGROUND
  Submersion victims are frequently considered at high risk for cervical spine (C-spine) injury regardless of whether they sustain a traumatic injury. We hypothesized that C-spine injury is unlikely in submersion victims who do not sustain high-impact injuries.
  
  
  METHODS
  The study was a cohort study of all people who submerged between January 1974 and July 1996 and received medical care or were seen by the medical examiner in King, Pierce, and Snohomish counties in Washington State.
  
  
  RESULTS
  Eleven (0.5%) of 2,244 submersion victims had C-spine injuries. All 11 had submerged in open bodies of water; had clinical signs of serious injury; and had a history of diving, motorized vehicle crash, or fall from height. No C-spine injuries occurred in 880 low-impact submersions.
  
  
  CONCLUSIONS
  Submersion victims are at risk for C-spine injury only if they have also sustained a traumatic injury. Routine C-spine immobilization does not appear to be warranted solely on the basis of a history of submersion.
authors.affiliation: Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, Washington, USA. watsonrs@anes.upmc.edu
authors.forename: R S
authors.initials: RS
authors.lastname: Watson
authors.forename: P
authors.initials: P
authors.lastname: Cummings
authors.forename: L
authors.initials: L
authors.lastname: Quan
authors.forename: S
authors.initials: S
authors.lastname: Bratton
authors.forename: N S
authors.initials: NS
authors.lastname: Weiss
mesh_terms: D000293:Adolescent; D000328:Adult; D001494:Baths; D002574:Cervical Vertebrae / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D004242:Diving / Q000293:injuries; D004332:Drowning / Q000453:epidemiology*; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D007101:Immersion / Q000009:adverse effects*; D007223:Infant; D008297:Male; D015701:Near Drowning / Q000453:epidemiology* / Q000628:therapy; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D016103:Spinal Fractures / Q000453:epidemiology* / Q000628:therapy; D013550:Swimming / Q000293:injuries; D014861:Washington / Q000453:epidemiology