Association between Response time and Mortality in Drowning Patients in Thailand

1. Association between Response time and Mortality in Drowning Patients in Thailand Mr.Phichet Nongchang Dr PH 567110001-5 Faculty of Public Health, Khon Kaen University

2. BACKGROUND Drowning is defined as the process of experiencing respiratory impairment from submersion/immersion in liquid

3. BACKGROUND • Drowning is a leading cause of accidental • death worldwide • Injuries account for nearly 10% of total • global mortality. Drowning is the 3rd leading • cause of unintentional injury death, • accounting for 7% of all injury-related deaths, • low- and middle-income countries account • for 96% of unintentional drowning deaths • (WHO)

4. BACKGROUND • In Thailand 2008, drowning was • the second cause of death in injuries • (4,065 cases) • Emergency medical services (EMS) • Response time effected improving • patient outcomes. • It is not yet clear for Thailand

5. OBJECTIVE To determine association between response times and mortality in drowning patients in Thailand

6. MATERIALS AND METHODS • Cross sectional analytical • Thailand EMS database. • National Institute for Emergency Medicine (NIEM) • Across country (except Bangkok) • 2011-2012

7. Study Outcome • The primary outcome: • mortality of drowning on emergent patients (out-of-hospital) • Independent variables: • response time • Scene time, Transport time • CPR, Gender, Age, Region

8. Statistical Analysis • Statistical analysis by Stataversion 12.0 • Descriptive statistics (frequency and percentage) • multiple logistic regression • Odds Ratios, 95% Confidence • Intervals, and p-value.

9. RESOULT Total number of ALS service case (n = 437,770) Exclude with other case (435,723) Drowning Patients (n= 2,047) Excluded with Urgent, Non-urgent and other (792) Emergent of Drowning Patients (Red Code) (n=1,255)

10. Demographic Characteristics

11. Demographic Characteristics

12. Demographic Characteristics

13. Demographic Characteristics

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15. DISSCUSSION • This study did not show significant • increase in mortality of drowning • patients form increase response times • OR adj = 1.01 • 95 % CI (0.99 - 1.03) P-value=0.255

16. DISSCUSSION • Response times association survival in • out-of-hospital cardiac arrest (OHCA) • by drowning • Response times affected patient • mortality and associated with • higher mortality rates • response times no associated mortality • with in Acute Heart Failure Patients

17. DISSCUSSION • Did not demonstrated association between • scene time and transport times and mortality • Transportation time correlate with • mortality in Acute Heart Failure Patients • No association between transport interval • and outcome OHCA • Cardiopulmonary resuscitation (CPR) • associated mortality in drowning patients

18. CONCLUSIONS • The study could not demonstrate that Response times association • mortality in emergent drowning • Patients in Thailand • Further study should be conducted to the pre-hospital factors effect survival of drowning, and the effectiveness of CPR for drowning survival

19. THANK YOUfor your attention