Suction entrapment of an upper limb in a swimming pool

A 4-year-old boy was referred to the emergency unit of a tertiary hospital after suction entrapment of his arm in a swimming pool while he was bathing under maternal supervision. Water depth was 40 cm and his head was not submerged. Pool technicians were unable to switch off the suction system, so the pipe had to be removed by emergency personnel to enable the patient’s transfer to hospital. An interval of 2.5 h passed between the accident and the emergency unit admission. In the emergency unit, after cutting off the industrial material, his right upper limb was extricated (Fig. 1). Initially, poor distal perfusion and bluish skin were observed, although he had intact radial pulse (Fig. 2). After the limb release, the patient made a full recovery. No evidence of bone damage was detected on X-ray of the upper extremity. The child was admitted to hospital for 24h for monitoring and to ensure proper pain treatment. He had neither compartment syndrome nor further complications. Suction entrapment occurs when a swimmer, usually a small child, is trapped by the suction forces created by the water rushing out of the drain at the bottom of the pool. In some cases swimmers have been trapped underwater until drowning occurred and in others they have suffered serious injuries to various parts of their bodies (limbs, hair, thorax and even evisceration). According to the US Consumer Product Safety Commission there were 39 victims of suction entrapment between 2008 and 2012, therefore, suction entrapment in swimming pools, the mechanism of which has led children to severe injuries, represents a known and important risk to infants and children. Clinicians and parents should keep in mind that these accidents might occur so it is important to emphasize primary prevention. First of all, doctors and parents should be informed of the potential