Mehmet BOŞNAK, Gülseren BİLEN, Murat TUTANÇ, Ali KARAKUŞ, Cem ZEREN

ÇOCUK YOĞUN BAKIM ÜNİTESİNDE TAKİP EDİLEN SUDA BOĞULMA VE BOĞULAYAZMA OLGULARI

Amaç:Acil servisimize getirilen sudaboğulma ve boğulayazma vakalarınıdeğerlendirmek.Yöntemler:Çalışmaya 2002-2006 yılları arasındaacil servisimize boğulmanedeniyle getirilen, dosya bilgileritam, toplam 12 olgu alınmış-tır. Hastalar demografik ve kliniközelliklerine göre incelenmiştir.Bulgular:Olguların 10'u erkek, 2'si kadın,yaş dağılımı 1.5-9 yaş arasındaidi. Boğulma olaylarının%41.6'sı havuzda gerçekleş-mişti.Beş vakaya ilk 5 dakikada aileleritarafından müdahaleedilmişti. Yedisinde solunumsıkıntısı mevcut, 4'ünde ise solunumyoktu. Glasgow KomaSkalası ortalama 7 idi. Olgularıntümü hipotermikti. Dördündemetabolik asidoz, birindetrombositopeni vardı. Onolguda SO2%90'ın altında idi.Beş hastada pnomoni, 2 hastadapnömotoraks, 2 hastadakonvülsiyon oluştu. Onbirineantibiyoterapi, 4'üne ventilatördesteği, 2'sine antikonvülsanilaç, 2 hastaya kapalı tüp drenajıuygulandı. Vakaların 4'üöldü, 8'i şifa ile taburcu edildi.Sonuç:Suda boğulma çocukların sıkkarşılaştığı ve ölüm riski yüksekolan bir durumdur. Özellikleyerleşim bölgelerindeki su birikintisi,akarsu, yüzme havuzlarıve eğlence plajlarında gerekliolan boğulmayı önleyici güvenliktedbirleri alınmalıdır. Ayrıcaailelere temel ilk yardım eğitimiverilmesi hayat kurtarıcı birçaba olacaktır.

CASES OF DROWNING AND NEAR-DROWNING IN PEDIATRIC INTENSIVE CARE UNIT

ObjectiveEvaluation of drowning andnear-drowning cases taken toemergency room.Methods:A total of 12 drowning and neardrowningcases taken to theemergency room within 2003-2005time period were included in thestudy. Patients were analyzedaccording to demographic andclinical characteristics.Results:10 cases were males and 2 caseswere females, age distributionwas between 1.5-9. 41.6% ofdrownings had occurred ina pool. Five cases had beenintervened by their families infirst 5 minutes. Seven of the caseshad had respiratory distress,while breathing had stopped in 4cases. Mean Glasgow Coma Scaleaverage had been 7. All cases hadbeen hypothermic. Four patientshad been in metabolic acidosis,one had had thrombocytopenia.Ten patients’ SO2had beenbelow 90%. Five patients hadhad pneumonia; pneumothoraxhad occurred in 2 patients, andconvulsions had occurred in other2 patients. Antibioteraphy hadbeen given for 11 cases, ventilatorsupports had been applied for4 cases, anticonvulsant therapyhad been given for 2 cases and 2patients had undergone a closedtube drainage. Four cases haddied, 8 cases had been dischargedwith cure.Conclusion:Drowning is a high risk of deathin children, it is frequentlyencountered. Especially, securityprecautions should be providedfor settlements near ponds, rivers,swimming pools, or entertainmentbeaches in order to preventdrowning. In addition, basic firstaid training of families will be a alife-saving effort

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