With the warm weather upon us here in the Northern Hemisphere it will soon be time for the pools to open. This episode is therefore incredibly timely, and focuses on the spectrum of submersion injuries and their management. Learn about drowning physiology, when to admit to the hospital, and how to assess the child who went under water unexpectedly but looks fine from this episode’s special co-host and producer, Joe Finney, MD a PGY-5 Pediatric Emergency Medicine and EMS fellow from Washington University in Saint Louis, MO. You can connect will Joe via email at

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A65. NICU, PICU AND CHRONIC VENTILATION. American Thoracic Society International Conference Meetings Abstracts American Thoracic Society International Conference Meetings Abstracts, 

Zuckerman GB, Gregory PM, Santos-Damiani SM. Predictors of Death and Neurologic Impairment in Pediatric Submersion Injuries: The Pediatric Risk of Mortality Score. Arch Pediatr Adolesc Med. 1998;152(2):134–140. doi:10.1001/archpedi.152.2.134

Watson RS, Cummings P, Quan L, Bratton S, Weiss NS. Cervical spine injuries among submersion victims. J Trauma. 2001 Oct;51(4):658-62. doi: 10.1097/00005373-200110000-00006. PMID: 11586155.

Gonzalez-Luis G, Pons M, Cambra FJ, Martin JM, Palomeque A. Use of the Pediatric Risk of Mortality Score as predictor of death and serious neurologic damage in children after submersion. Pediatr Emerg Care. 2001 Dec;17(6):405-9. doi: 10.1097/00006565-200112000-00002. PMID: 11753182.

Noel S. Zuckerbraun, Richard A. Saladino, Pediatric Drowning: Current Management Strategies for Immediate Care, Clinical Pediatric Emergency Medicine, Volume 6, Issue 1, 2005, Pages 49-56, ISSN 1522-8401, (

Szpilman D, Morgan PJ. Management for the Drowning Patient. Chest. 2020 Oct 14:S0012-3692(20)34896-0. doi: 10.1016/j.chest.2020.10.007. Epub ahead of print. PMID: 33065105.

Noonan L, Howrey R, Ginsburg CM. Freshwater submersion injuries in children: a retrospective review of seventy-five hospitalized patients. Pediatrics. 1996 Sep;98(3 Pt 1):368-71. PMID: 8784358.

Quan L, Kinder D. Pediatric submersions: prehospital predictors of outcome. Pediatrics. 1992 Dec;90(6):909-13. PMID: 1437433.

Szpilman D. Near-drowning and drowning classification: a proposal to stratify mortality based on the analysis of 1,831 cases. Chest. 1997 Sep;112(3):660-5. doi: 10.1378/chest.112.3.660. PMID: 9315798.

Best RR, Harris BHL, Walsh JL, Manfield T. Pediatric Drowning: A Standard Operating Procedure to Aid the Prehospital Management of Pediatric Cardiac Arrest Resulting From Submersion. Pediatr Emerg Care. 2020 Mar;36(3):143-146. doi: 10.1097/PEC.0000000000001169. PMID: 28486266.

Davey M, Callinan S, Nertney L. Identifying Risk Factors Associated with Fatal Drowning Accidents in the Paediatric Population: A Review of International Evidence. Cureus. 2019 Nov 19;11(11):e6201. doi: 10.7759/cureus.6201. PMID: 31890403; PMCID: PMC6919957.

Habib DM, Tecklenburg FW, Webb SA, Anas NG, Perkin RM. Prediction of childhood drowning and near-drowning morbidity and mortality. Pediatr Emerg Care. 1996 Aug;12(4):255-8. doi: 10.1097/00006565-199608000-00005. PMID: 8858647.

Son KL, Hwang SK, Choi HJ. Clinical features and prognostic factors in drowning children: a regional experience. Korean J Pediatr. 2016 May;59(5):212-7. doi: 10.3345/kjp.2016.59.5.212. Epub 2016 May 31. PMID: 27279885; PMCID: PMC4897156.

“Almost 800 Kids Drown Each Year; More than Half Are Under Age 5.” Safe Kids Worldwide, 29 June 2016,

“Drowning Prevention.”,

“WISQARS (Web-Based Injury Statistics Query and Reporting System)|Injury Center|CDC.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 1 July 2020, 

Idris AH, Berg RA, Bierens J, Bossaert L, Branche CM, Gabrielli A, Graves SA, Handley AJ, Hoelle R, Morley PT, Papa L, Pepe PE, Quan L, Szpilman D, Wigginton JG, Modell JH. Recommended guidelines for uniform reporting of data from drowning: the “Utstein style.”Circulation. 2003; 108:2565–2574. doi: 10.1161/01.CIR.0000099581.70012.68