10-YEAR REVIEW OF PEDIATRIC BATHTUB NEAR-DROWNINGS - EVALUATION FOR CHILD-ABUSE AND NEGLECT

Study objective: To evaluate the risk factors associated with bathtub submersion injury and their relationship to child abuse and neglect. Design: Retrospective chart review. Setting: An urban children's hospital. Participants: Any child sustaining a bathtub near-drowning over the 10-year period from 1982 to 1992. Interventions: None. Results: Twenty-one patients were treated for bathtub near-drownings during the 10-year period, accounting for 24% of all submersion injuries. A significant number (67%) had historic and/or physical findings suspicious for abuse or neglect, including incompatible history for the injury, other physical injuries, previous child abuse reports, psychiatric history of the caretaker, and/or psychosocial concerns noted in the chart. The mortality rate of 42% was significant. No demographic characteristics identified the children at risk. Conclusion: Many children who are injured in the bathtub suffer from abuse or neglect. Medical evaluation should include social work consultation and a search for other accompanying injuries.