One of the most difficult decisions that challenges the emergency clinician is determining when resuscitative efforts may be successful and when efforts may be futile. Accurate prediction of a neurologically good or poor outcome is essential for guiding clinical decision making. Some of these decisions will be made in the ED, some much later in the ICU. Unfortunately, the quality of information regarding a specific drowning event, especially true submersion time and quality of resuscitation efforts in the field, may be lacking in the immediate moments upon arrival to the ED. Most of the studies focused on predictors of good versus poor neurologic outcome are single-institution studies with small numbers. To date, no multicenter studies addressing factors which may predict pediatric drowning outcomes have been performed.
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