Clinical trial NCT06327893: Patients Treated by the Danish Emergency Medical Services Following Non-drowning Water Rescues From 2016 to 2023
Official title: Patients Treated by the Danish Emergency Medical Services Following Non-drowning Water Rescues From 2016 to 2023: A Danish Registry-based Study From 2016 to 2023
Study type: OBSERVATIONAL
Overall status: NOT_YET_RECRUITING
Conditions: Drowning
Drowning, Near
Submersion
Submersion - Accidental
Submersion or Drowning Due to Being Washed Overboard
Submersion or Drowning Due to Being Thrown Overboard
Submersion or Drowning Due to Ship Sinking, Water Skier Injured
Submersion or Drowning Due to Boat Submerging, Swimmer Injured
Submersion or Drowning Due to Boat Overturning, Swimmer Injured
Submersion or Drowning Due to Boat Submerging, Water Skier Injured
Submersion or Drowning Due to Fall From Gangplank, Swimmer Injured
Submersion or Drowning Due to Ship Sinking, Docker or Stevedore Injured
Submersion or Drowning Due to Fall Overboard, Docker or Stevedore Injured
Keywords: Water rescue
Aquatic rescue
Danish Prehospital Drowning Data
Danish Drowning Formula
Emergency Medical Service (EMS)
Cohort
Registry
Utstein
Epidemiology
Lead sponsor: Prehospital Center, Region Zealand
Sponsor class: OTHER
First posted: 2024-03-25
Enrollment: 3000
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients treated by the Danish EMS following an aquatic rescue are identified from the Danish Prehospital Electronic Medical Record using the Danish Drowning Formula and extensive manual validation.

We used the WHO definition of drowning supported by the "Clarification and Categorisation of Non-fatal Drowning" statement to differentiate between drowning and non-drowning aquatic rescues.

Brief summary: Since 2015, all Danish prehospital EMS have used the nationwide Prehospital Electronic Medical Record (PEMR). In 2023, the investigators developed the Danish Drowning Formula (DDF), a text-search algorithm designed to search the unstructured text fields in the electronic medical records with comprehensive search criteria to identify all potential water-related incidents. This protocol describes the first study to analyse the prehospital data from a nationwide Danish cohort of patients treated by the EMS from 2016 to 2023 following non-drowning aquatic rescues.

Detailed description: Purpose The purpose of this study is to establish recommendations towards specific educational, preventative, or rescue strategies to reduce the number of aquatic rescues in Denmark (e.g., campaigns targeting high-risk groups, or fencing, allocating rescue equipment, or establishing lifeguard stations in high-risk areas). This may not only enhance prevention of aquatic rescues but also decrease the mortality and the total number of drowning incidents in Denmark.

Objectives The primary objective is to estimate the yearly incidence of patients treated by the Danish EMS following a non-drowning aquatic rescue from 2016 to 2023 and calculate the aquatic rescue to drowning ratio. The secondary objectives are to characterise the rescues (e.g., lay rescuer or professional rescuer, use of equipment) and to report the spatial distribution.

Study design This study is a nationwide registry-based study with data from the Danish nationwide PEMR from 2016 to 2023.

Methods Since 2015, all Danish prehospital EMS have used the nationwide Prehospital Electronic Medical Record (PEMR). In 2023, the investigators developed the Danish Drowning Formula (DDF), a text-search algorithm designed to search the unstructured text fields in the electronic medical records with comprehensive search criteria to identify all potential water-related incidents. This study will be the first to analyse the prehospital data from a nationwide Danish cohort of patients treated by the EMS from 2016 to 2023 following non-drowning aquatic rescues.

Eligibility criteria: Inclusion Criteria:

* All the patients registered in the Danish Prehospital Electronic Medical Record from 2016-2023 will be screened by the Danish Drowning Formula and the medical records containing one or more trigger words will be extracted for manual validation.
* All records where the patient was immersed or submersed in liquid but did not experience mild, moderate, or severe respiratory impairment following the drowning process will be included.

Exclusion Criteria:

* All records where the patient was immersed or submersed in liquid and did experience mild, moderate, or severe respiratory impairment following the drowning process).
* All records where the patient was not immersed or submersed in liquid.

Primary outcomes:
measure: The annual incidence.
timeFrame: From 2016 to 2023.
measure: The annual incidence rate.
timeFrame: From 2016 to 2023.
Secondary outcomes:
measure: The spatial distribution of aquatic rescues on a map of Denmark.
timeFrame: From 2016-2023.
Other outcomes:
Locations:
city: Næstved
country: Denmark
facility: Prehospital Center
state: Region Zealand
Study officials:
affiliation: Prehospital Center, Region Zealand
name: Helle Collatz Christensen, Ass. Prof.
role: STUDY_DIRECTOR
References:
citation: Breindahl N, Wolthers SA, Jensen TW, Holgersen MG, Blomberg SNF, Steinmetz J, Christensen HC; Danish Cardiac Arrest Group. Danish Drowning Formula for identification of out-of-hospital cardiac arrest from drowning. Am J Emerg Med. 2023 Nov;73:55-62. doi: 10.1016/j.ajem.2023.08.024. Epub 2023 Aug 15.