METHODS: We conducted a retrospective case match analysis of drowning patients presenting to the EDs of Sunshine Coast Hospital and Health Service. Patients were matched for age, sex and severity of drowning injury. The primary outcome was in-hospital mortality. Secondary outcomes included positive pressure ventilation (PPV) by EMS and the ED, as well as admission to the Intensive Care Unit.
RESULTS: There were 108 patients in each group. Median (IQR) age was 22 (15-43) in the oxygen group and 23 (15-44) years in the non-oxygen group. There were 45 females in the oxygen group and 41 females in the non-oxygen group. Sixteen patients had suffered cardiac arrest and three patients respiratory arrest in each group. There were five deaths in each group. Initial oxygen saturation on arrival of EMS was identical in both groups 89.2% (±19.9) in the oxygen group versus 89.3% (±21.1) (P = 0.294) in the non-oxygen group. The oxygen group required PPV more frequently with EMS (19 vs 11, P < 0.01) and in the ED (19 vs 15, P < 0.01).
CONCLUSIONS: On scene treatment with oxygen by lifeguards did not improve oxygenation or outcomes in drowning patients.
方法:我们对向阳光海岸医院和健康服务的ED就诊的溺水患者进行了回顾性病例匹配分析。患者的年龄相匹配,溺水伤害的性别和严重程度。主要结果是院内死亡率。次要结果包括EMS和ED的正压通气(PPV),以及进入重症监护病房。
结果:每组108例患者。氧组的中位年龄(IQR)为22(15-43)岁,非氧组的中位年龄为23(15-44)岁。氧组女性45例,非氧组女性41例。每组16例患者心脏骤停,3例患者呼吸骤停。每组有5人死亡。在EMS到达时,两组的初始氧饱和度在氧气组中为89.2%(±19.9),在非氧气组中为89.3%(±21.1)(P=0.294)。EMS组(19vs11,P<0.01)和ED组(19vs15,P<0.01)更频繁地需要PPV。
结论:救生员现场吸氧治疗并不能改善溺水患者的氧合或预后。