Drowning is defined as death within 24 hours of a submersion accident.1 It is the third most common cause of accidental death in children in the United States.2 More than 8,000 children die every year from drowning, and many more delayed deaths (more than 24 hours after the accident) occur from causes related to the accident. Drowning is clearly a major cause of mortality among children, but the data that have been published about morbidity among survivors of submersion accidents (near-drowning victims) are less conclusive.
In this issue of the Journal (see p 1006), Frates reports the results of his retrospective analysis of the records of 42 pediatric near-drowning victims, to determine whether specific early neurologic signs could accurately predict outcome. The finding of fixed and dilated pupils when the patient first reached the emergency room discriminated perfectly between good and bad outcome. He has concisely reviewed the