Fatal heat stroke in a child entrapped in a confined space

Experimental and numerical investigation of thermal environment of the child trapped in a parked vehicle

Pediatric vehicular hyperthermia (PVH) has aroused wide public concern recently. High temperatures in closed vehicles with full sun exposure and no ventilation in summer seriously endanger children's lives. Aiming at this practical problem, this study first took the temperature of child's core body as a standard, and divided the hyperthermia into three stages: un-compensable heating (Tc > 37ºC), heat stroke (Tc > 40ºC) and critical thermal maximum (Tc > 42ºC). On this basis, two weeks of outdoor parking experiments during 10:00-18:00, using an equivalent size dummy were conducted to explore the influence of ambient temperature and solar irradiation on cabin temperature, humidity, and child's core body temperature. According to the experimental results, at an ambient temperature of 32.4ºC, the child in the cabin developed un-compensable heating within 72 min, suffered heat stroke within 129 min, and reached the critical thermal maximum within 151 min. Considering the limitations of the experiment, a numerical study was conducted to analyze the effects of ambient temperature, solar irradiation, and window radiation characteristics on cabin temperature and flow fields comprehensively. Simulation results were in good agreement with the experiments: even at low ambient temperature Ta = 23ºC or weak solar irradiation (ts = 18:00) condition, the temperature in a closed compartment could reach the "hazardous" level. This study can provide guidance for public to increase security and prevention awareness, and promote the development of relevant policies and technologies.

Review of washing machine-related deaths in South Korea

We reviewed data on washing machine-related deaths between 2008 and 2020 in South Korea to analyze the case characteristics, manners of death, and causes of death. Washing machine-related deaths are very rare, and only 23 incidents were identified over the study period. Of these cases, 19 (82.6%) were related to general pulsator-type top load washing machines; the other 4 (17.4%) were related to front-load washing machines. The pulsator-type top load washing machine-related deaths occurred in people aged between 40 and 93 years (mean age, 68 years), including 9 men (47.4%) and 10 women (52.6%). The manners of death among the incidents were suicide in 12 cases (63.2%), accident in 6 cases (31.6%), and unknown in 1 case (5.3%). A Medline search of the English literature currently does not yield results for washing machine-related suicidal deaths in adults. Of the 12 suicide cases, 4 were autopsied; suicidal death was determined by postmortem investigation or based on suicide notes. Washing machine-related suicidal deaths are presumed to have characteristics similar to those of bathtub suicidal deaths. The front-load washing machine-related deaths involved boys aged between 6 and 8 years, and all cases were concluded as accidents. The cause of death was hypoxia resulting from the children being accidentally trapped inside the washing machine while playing. Greater attention to vulnerable groups, especially children and older adults, is required to reduce the rate of washing machine-related accidental or suicidal deaths.

Evaluating the impact of solar radiation on pediatric heat balance within enclosed, hot vehicles

Pediatric deaths due to children being left in hot cars remain a significant yet preventable public health concern. The current study aims to demonstrate the influence of vehicle type, time of day, and solar exposure (sun or shade) on the energy balance and core temperature (T_c) of a hypothetical two-year old boy left in a vehicle on a hot day. Cabin temperatures and relative humidity were collected within six enclosed vehicles under sun or full shade in Tempe, Arizona. These variables and radiation estimates were used to estimate the human energy balance and final T_c across 76 measurement cycles lasting approximately 60minutes. Interior temperatures averaged 39.5°C and 47.6°C in the shade and sun, respectively, at steady-state. Based on the specific heat of a human body, the average T_c after 60 minutes in shaded or sun-exposed vehicles was estimated to reach 38.2±0.29°C and 39.1±0.41°C, respectively, with a significantly higher final T_c in sun-exposed vehicles across all days and in the shaded minivan. Extrapolation to 2 hours is estimated to result in heat injury in the sun. Results demonstrate the influence of radiation on a child's thermal balance in a hot and dry environment. In real-world situations, it is critical to acknowledge variability between children, the starting car environment, and climate (e.g., humid versus dry), and that a child left in any vehicle car can experience potentially lethal core temperatures if forgotten, as shown by vehicular heat stroke statistics. Findings may improve public messaging and reinforce the need for policy action and technological adoption to prevent injury and death.

Nondrowning Asphyxia in Veterinary Forensic Pathology: Suffocation, Strangulation, and Mechanical Asphyxia

Asphyxia in a forensic context refers to death by rapid cerebral anoxia or hypoxia due to accidental or nonaccidental injury. Death due to nondrowning asphyxia can occur with strangulation, suffocation, and mechanical asphyxia, each of which is categorized based on the mechanism of injury. Individuals dying due to various types of asphyxia may or may not have lesions, and even those lesions that are present may be due to other causes. The interpretation or opinion that death was due to asphyxia requires definitive and compelling evidence from the postmortem examination, death scene, and/or history. Beyond the postmortem examination, pathologists may be faced with questions of forensic importance that revolve around the behavioral and physiological responses in animals subjected to strangulation, suffocation, or mechanical asphyxia to determine if the animal suffered. While there is no prescriptive answer to these questions, it is apparent that, because of physiological and anatomical differences between humans and animals, for some mechanisms of asphyxia, consciousness is maintained for longer periods and the onset of death is later in animals than that described for people. Veterinary pathologists must be cognizant that direct extrapolation from the medical forensic literature to animals may be incorrect. This article reviews the terminology, classification, mechanisms, and lesions associated with asphyxial deaths in companion animals and highlights significant comparative differences of the response to various types of asphyxia in animals and people.