Sudden deaths from positional asphyxia

Chmieliauskas, Sigitas; Mundinas, Eimantas; Fomin, Dmitrij; Andriuškevičiūtė, Gerda; Laima, Sigitas; Jurolaic, Eleonora; Stasiuniene, Jurgita; Jasulaitis, Algimantas

doi:10.1097/md.0000000000011041

Cited by 13 publications

(6 citation statements)

References 34 publications

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“…The leading cause of death among the fatalities discovered from 1993 to 2018 was asphyxia (Table 4). Asphyxia is the lack of oxygen or excess carbon dioxide in the body due to irregular or disturbed respirations (asphyxia, 2003) The body's position during restraint or compression from the adults' weight on the victim's face, neck, chest, or back may contribute to asphyxiation (Chmieliauskas et al, 2018;Paterson et al, 2003). The next most common cause of death was cardiac arrhythmia (heart rhythm difficulties).…”

Section: Immediate Cause Of Deathmentioning

confidence: 99%

A 26-Year Study of Restraint Fatalities Among Children and Adolescents in the United States: A Failure of Organizational Structures and Processes

Nunno

McCabe

Izzo

et al. 2021

Child Youth Care Forum

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Background Physical and mechanical restraints used in treatment, care, education, and corrections programs for children are high-risk interventions primarily due to their adverse physical, emotional, and fatal consequences. Objective This study explores the conditions and circumstances of restraint-related fatalities in the United States by asking (1) Who are the children that died due to physical restraint? and (2) How did they die? Method The study employs internet search systems to discover and compile information about restraint-related fatalities of children and youth up to 18 years of age from reputable journalism sources, advocacy groups, activists, and governmental and non-governmental agencies. The child cohort from a published study of restraint fatalities in the United States from 1993 to 2003 is combined with restraint fatalities from 2004 to 2018. This study’s scope has expanded to include restraint deaths in community schools, as well as undiscovered restraint deaths from 1993 to 2003 not in the 2006 study. Results Seventy-nine restraint-related fatalities occurred over the 26-year period from across a spectrum of children’s out-of-home child welfare, corrections, mental health and disability services. The research provides a data snapshot and examples of how fatalities unfold and their consequences for staff and agencies. Practice recommendations are offered to increase safety and transparency. Conclusions The study postulates that restraint fatalities result from a confluence of medical, psychological, and organizational causes; such as cultures prioritizing control, ignoring risk, using dangerous techniques, as well as agencies that lack structures, processes, procedures, and resources to promote learning and to ensure physical and psychological safety.

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Section: Immediate Cause Of Deathmentioning

confidence: 99%

A 26-Year Study of Restraint Fatalities Among Children and Adolescents in the United States: A Failure of Organizational Structures and Processes

Nunno

McCabe

Izzo

et al. 2021

Child Youth Care Forum

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“…(1) In the city-setting, hazards may include revolving doors,(4) weight lifting apparatus,(5) or as we have described here, donation bins. Additionally, compression asphyxia may result from sustained external chest compression due to the weight of another individual(6) or from the weight and positioning of one’s own body, as described in cases of positional asphyxia (7).…”

Section: Discussionmentioning

confidence: 99%

Deaths Associated With Community Donation Bins: A Ten-Year Retrospective Review Describing Five Cases in British Columbia and Ontario

Hickey

Dmetrichuk

Morin

et al. 2020

Academic Forensic Pathology

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Introduction: Community donation bins have become more common in the urban setting over the past several years. Many nonprofit organizations use these sturdy metal enclosures for unobserved collection of various donated items such as clothing, books, and household items. Although the donated items are often of low individual value, donation bins may become a target of individuals in low socioeconomic situations seeking desired items for personal use or resale, or for personal shelter within the bin. Methods: To identify donation bin-associated deaths, we reviewed cases taken under the jurisdiction of the coroner for investigation in the provinces of British Columbia and Ontario, Canada, over the years 2009 to 2019. Results: We present the circumstances and postmortem findings of five deaths that occurred in British Columbia and Ontario (Canada) between 2009 and 2019, wherein the decedents were each believed to have been reaching into donation bins and became caught within the door mechanism and died as a consequence of compression asphyxia involving the chest and/or neck. Discussion: Donation bins have the potential for harm when individuals attempt to access the bin contents through the entry portal. We advocate for greater attention and changes in the placement location and/or design of these potentially dangerous devices.

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“…This results in a decrease in cerebral perfusion and a likely syncopal episode. Studies report that greater than 20% of circulating blood volume can be confined to the lower extremities, resulting in an equal decrease in cardiac output due to a relative hypovolemia [12]. Therefore, a victim who is left hanging in their harness and unable to provide muscle contractions is much more susceptible to the effects of venous pooling than one who is able to move spontaneously.…”

Section: Pathogenesismentioning

confidence: 99%

Suspension Trauma: A Clinical Review

Weber

McGahan²,

Kaufmann

et al. 2020

Cureus

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Suspension trauma is a potentially dangerous outcome of the body's normal physiological response to motionless vertical suspension from a rope. All who use a safety harness are at risk, and the growing need for occupational work at extreme heights in addition to the interest in caving and mountaineering worldwide has led to an increased number of individuals wearing protective harnesses for work and recreation. It has been described as the cause of death in many climbing incidents and has been demonstrated in multiple studies for improvement of employee fall protection.Although suspension trauma is potentially life-threatening, there is a lack of scientific data to define an exact mechanism of injury, and there is little conclusive evidence about the proper management of victims. This has led to controversy surrounding the topic of postsuspension management. The discussion of suspension trauma has historically been led by nonmedical experts, but the recent push for more evidence-based research has created a better understanding of the condition. Further investigation of the pathophysiological mechanism of suspension trauma and more complete collection of data from individual cases will increase our understanding of the topic and lead to better decision making in the management of victims.

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Sudden deaths from positional asphyxia

Cited by 13 publications

References 34 publications

A 26-Year Study of Restraint Fatalities Among Children and Adolescents in the United States: A Failure of Organizational Structures and Processes

A 26-Year Study of Restraint Fatalities Among Children and Adolescents in the United States: A Failure of Organizational Structures and Processes

Deaths Associated With Community Donation Bins: A Ten-Year Retrospective Review Describing Five Cases in British Columbia and Ontario

Suspension Trauma: A Clinical Review

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