Strangulation injury from indigenous rocking cradle

Anthropo-Mechanical Cradles: A Multidisciplinary Review

Domestic cradles are beds that are movable but non-mobile for babies up to five months of age. The "anthropo-mechanical" cradle simulates the physiological movement of the human body. The article reviews scientific literature discussing the impacts of swinging on infants, provides classifications of all currently used cradles due to how the child moves, and briefly describes modern technologies within cradle automation. This made it possible to calculate and propose safe motion parameters within mechatronic cradles. The main conclusions of the article are as follows: (1) the scientific literature reports the beneficial effects of harmonic movement on a child, (2) motion analyses substantiating the classifications of all cradles into six types (tilting, yawing, hammock, Sarong, swing, and surging cradle; the classification criterion included the nature of the cradle movement in relation to the planes and anatomical axes of the child's body), (3) modern technologies allowing for the use of movement with thoughtful parameters, thus, safer for a child, (4) movement within the parameters similar to the motion and speed passively performed by the child in the womb while a mother is walking was considered beneficial and safe, and (5) the use of advanced technology allows for the possibility to devise and create an automatic mechatronic cradle with a child-safe motion. Future innovative anthropo-mechanical cradles that follow physiological human motion parameters can be used safely, with a vertical amplitude ranging from -13 to + 15 mm and a frequency of up to 2 Hz.

Accidental hanging injuries in children: recognition and management

Accidental hanging is rare in childhood but is often fatal. Window blind cords pose a particular and unique risk to young children in the UK, accounting for one to two deaths annually. These accidents are frequently associated with non-adherence to the safety instructions provided by the manufacturers. Early discovery of the child and initiation of effective cardiopulmonary resuscitation at the site of the incident are likely to improve the outcome. Prolonged suspension, children who are pulseless at first contact by the emergency paramedic responder, and patients with prolonged periods of remaining in asystole before return of spontaneous circulation after starting cardiopulmonary resuscitation are unlikely to have intact neurological survival. Management in the hospital includes early airway protection by intubation, maintenance of normal oxygen saturation, normothermia, active control of clinical and sub-clinical seizures, and strict electrolyte and glucose regulation. Child safeguarding concerns should be considered when children have asphyxial injuries, and other signs of child physical abuse should be actively looked for. There is a need for stronger legislation in the UK to prevent some of these accidents, especially those relating to window blind cords.

Accidental strangulation in children by the automatic closing of a car window

Among the main causes of death in our country are car accidents, drowning and accidental burns. Strangulation is a potentially fatal injury and an important cause of homicide and suicide among adults and adolescents. In children, its occurrence is usually accidental. However, in recent years, several cases of accidental strangulation in children around the world have been reported. A 2-year-old male patient was strangled in a car window. The patient was admitted to the pediatric intensive care unit with a Glasgow Coma Scale score of 8 and presented with progressive worsening of respiratory dysfunction and torpor. The patient also presented acute respiratory distress syndrome, acute pulmonary edema and shock. He was managed with protective mechanical ventilation, vasoactive drugs and antibiotic therapy. He was discharged from the intensive care unit without neurological or pulmonary sequelae. After 12 days of hospitalization, he was discharged from the hospital, and his state was very good. The incidence of automobile window strangulation is rare but of high morbidity and mortality due to the resulting choking mechanism. Fortunately, newer cars have devices that stop the automatic closing of the windows if resistance is encountered. However, considering the severity of complications strangulated patients experience, the intensive neuro-ventilatory and hemodynamic management of the pathologies involved is important to reduce morbidity and mortality, as is the need to implement new campaigns for the education of parents and caregivers of children, aiming to avoid easily preventable accidents and to optimize safety mechanisms in cars with electric windows.

An unusual cause of accidental hanging in a toddler

Accidental hanging in children, although uncommon, has been reported worldwide. We report a case of a toddler who was brought to our hospital with an alleged history of hanging with his head trapped in-between the railings of a balcony. He became unconscious and developed seizures secondary to asphyxial injury and survived. Hanging is an important cause of homicidal and suicidal injury in adults, but in children, it is usually accidental, leading to death because of asphyxia as a result of partial or complete hanging. There is paucity of data in Indian literature regarding accidental hanging injuries in children. According to available data from western countries, strangulation ranks fourth among the causes of unintentional injury in children younger than 1 year after roadside accidents, drowning, and burns. The unique mode of hanging in this child has prompted us to report this case.