title: Drowning Injuries: Analysis of a Decennial Air Medical Rescue Center Experience.
abstract: OBJECTIVE
  Drowning is one of the leading injury death causes in younger children. Common intensive care measures seem not to improve neurologic outcome, and early prognostic options appear partially unreliable. Therefore, we evaluated a cohort of drowning patients cotreated by a helicopter emergency medical service regarding typical incident constellations, early and subsequent prognostic options, and relevant interventions.
  
  
  METHODS
  All patients prehospitally cotreated by helicopter emergency medical service "Christoph 4" in primary missions because of drowning incidents during a 10-year period were evaluated. Patient, prehospital, and clinical data were recorded retrospectively; correlations and prognostic values were evaluated with appropriate statistical tests.
  
  
  RESULTS
  Fifty-one patients were included. Various examination results (several vital, neurologic, and laboratory parameters) and sufficient prehospital first aid measures were significantly correlated with the final outcome (P < .05, respectively). Aspartate aminotransferase and alanine aminotransferase values precisely discriminated between the final outcome groups (P = .001 and area under the receiver operating characteristic curve = 1.0 in both cases).
  
  
  CONCLUSIONS
  Aspartate aminotransferase and alanine aminotransferase values were the most useful predictors of outcome in our study. Sufficient prehospital first aid measures were correlated with improved outcome. Regular first aider training is recommended.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, Germany; Helicopter Emergency Medical Service, Hannover Medical School, Hannover, Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Schumacher
authors.affiliation: Trauma Department, Urban Hospital, Hildesheim, Germany.
authors.forename: Eckhard
authors.initials: E
authors.lastname: Mössinger
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: William
authors.initials: W
authors.lastname: Min
authors.affiliation: Helicopter Emergency Medical Service, Hannover Medical School, Hannover, Germany; Department of Trauma and Reconstructive Surgery, University Medical Center Aachen, Aachen, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Hildebrand
authors.affiliation: Helicopter Emergency Medical Service, Hannover Medical School, Hannover, Germany; Department for Trauma, Hand and Reconstructive Surgery, University Medical Center Marburg, Marburg, Germany. Electronic address: michaelfrink@web.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Frink
mesh_terms: D000293:Adolescent; D000328:Adult; D017732:Air Ambulances / Q000706:statistics & numerical data*; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D004332:Drowning / Q000453:epidemiology* / Q000517:prevention & control; D004632:Emergency Medical Services / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D018635:Rescue Work / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase