title: Pattern of presenting complaints recorded as near-drowning events in emergency departments: a national surveillance study from Pakistan.
abstract: BACKGROUND
  Drowning is a heavy burden on the health systems of many countries, including Pakistan. To date, no effective large-scale surveillance has been in place to estimate rates of drowning and near-drowning in Pakistan. The Pakistan National Emergency Department Surveillance (Pak-NEDS) study aimed to fill this gap.
  
  
  METHODS
  Patients who presented with a complaint of "near-drowning" were analyzed to explore patterns of true near-drowning (unintentional) and intentional injuries that led to the "near-drowning" complaint. Bivariate analysis was done to establish patterns among patients treated in emergency departments, including socio-demographic information, injury-related information, accompanying injuries, and emergency department resource utilization.
  
  
  RESULTS
  A total of 133 patients (0.2% of all injury patients) with "near-drowning" as presenting complaints were recorded by the Pak-NEDS system. True near-drowning (50.0%) and intentional injuries that led to "near-drowning" complaints (50.0%) differed in nature of injuries. The highest proportion of true near-drowning incidents occurred among patients aged between 25-44 years (47.5%), and among males (77.5%). True near-drowning patients usually had other accompanying complaints, such as lower limb injury (40.0%). Very few patients were transported by ambulance (5.0%), and triage was done for 15% of patients. Eleven (27.5%) true near-drowning patients received cardiopulmonary resuscitation.
  
  
  CONCLUSIONS
  There was major under-reporting of drowning and near-drowning cases in the surveillance study. The etiology of near-drowning cases should be further studied. Patients who experienced non-fatal drownings were more commonly sent for medical care due to other accompanying conditions, rather than near-drowning event itself. There is also need for recognizing true near-drowning incidents. The results of this study provide information on data source selection, site location, emergency care standardization, and multi-sector collaboration for future drowning prevention studies.
authors.forename: Siran
authors.initials: S
authors.lastname: He
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Lunnen
authors.forename: Nukhba
authors.initials: N
authors.lastname: Zia
authors.forename: Uzma
authors.initials: U
authors.lastname: Khan
authors.forename: Khusro
authors.initials: K
authors.lastname: Shamim
authors.forename: Adnan A
authors.initials: AA
authors.lastname: Hyder
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015701:Near Drowning / Q000453:epidemiology*; D010154:Pakistan / Q000453:epidemiology; D011159:Population Surveillance; D017678:Sex Distribution; D012959:Socioeconomic Factors; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult