title: Indoor versus outdoor childhood submersion injury in a densely populated city.
abstract: OBJECTIVE
  To review the outcome of childhood submersion injury (SI).
  
  
  METHODS
  We reviewed discharge data of all children with SI who were hospitalized in a university teaching hospital between January 2002 and January 2008.
  
  
  RESULTS
  There were 15 admissions (8 males and 7 females). Outdoor SI (n = 10) were more common than indoor SI (n = 5) and 7 cases occurred in public swimming pools with life guard service. There were significant differences between the two types of SI. Indoor SI more likely occurred in the Chinese mainland. The victims were generally younger, more likely to have low Glasgow Coma Scale (GCS), asystole and intubation at the emergency department (ED). They were more likely to require intensive care, ventilatory support, neurological imaging and had worse neurological sequlae of death or hypoxic-ischaemic encephalopathy (HIE).
  
  
  CONCLUSIONS
  Indoor SI was associated with worse prognosis. All patients with GCS of 3 at ED and required intensive care support were either dead or incapacitated. Low GCS, pulselessness and intubation at the ED and seizures are also associated with adverse outcomes. Describing the mode of paediatric SI in a city where SI rarely occurs serves to heighten public awareness especially of home safety in the prevention of SI.
authors.affiliation: Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. ehon@cuhk.edu.hk
authors.forename: Kam-Lun Ellis
authors.initials: KL
authors.lastname: Hon
authors.forename: Ting-Fan
authors.initials: TF
authors.lastname: Leung
authors.forename: Sze-Yan Jennette
authors.initials: SY
authors.lastname: Chan
authors.forename: Kam-Lau
authors.initials: KL
authors.lastname: Cheung
authors.forename: Pak-Cheung
authors.initials: PC
authors.lastname: Ng
mesh_terms: D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D004332:Drowning / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D007101:Immersion / Q000009:adverse effects*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015701:Near Drowning / Q000453:epidemiology*; D012189:Retrospective Studies; D013551:Swimming Pools