1/9. The 1999 annual report of the Regional Infant and child mortality review Committee.The 1999 Annual Report of the Regional Infant and child mortality review Committee (RICMRC) is presented. Our Regional (Minnehaha, Lincoln, and Turner Counties) incidence for sudden infant death (SIDS) continues to significantly exceed the national rate. In this study, SIDS is strongly associated with prone sleeping and sleeping on soft surfaces or bedding. The back-to-sleep campaign that has been an important part of lowering the national SIDS rate appears to have been less successful in our region. The Regional Infant child mortality review Committee therefore has elected to serve not only as a data collection committee, but has also actively engaged in community education programs directed towards providing a safer environment for our children.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
2/9. sudden infant death: lingual thyroglossal duct cyst versus environmental factors.An 8-month-old female baby was found collapsed in the prone position 30 min after being positioned under soft-bedding. She was taken to the emergency room with cardiopulmonary arrest. Her heartbeat was recovered after resuscitation and continued for 20 h under artificial respiration, at which point the child died. At autopsy, the child showed no significant pathological abnormalities apart from a thyroglossal duct cyst of 2.0 cm diameter, therefore, it seemed that the cyst, which was close to the epiglottis, had caused asphyxia through airways occlusion. However, the child had shown no respiratory problems before death, and the risk of airway occlusion as a result of lingual cysts is more likely in a supine rather than a prone position. A small amount of evidence suggested that the child died as a result of suffocation from being covered by soft-bedding, which could have caused fatal asphyxia; it is also possible that a hypoxic state induced by airway obstruction might have been enhanced by being covered with bedding. It seemed reasonable to assume that death was caused by a combination of the lingual thyroglossal duct cysts and asphyxia caused by being covered in bedding, though the main factor appeared to be the large cyst.- - - - - - - - - - ranking = 4keywords = environment (Clic here for more details about this article) |
3/9. The fallacy of the simultaneous sudden infant death syndrome in twins.The likelihood of twin infants dying suddenly and simultaneously of SIDS, a natural disorder, defies credibility. However, injuries associated with environmental hazards provide possible mechanisms of sudden death. A search for hazards in the homes of 13 pairs of healthy twins who died together of no apparent cause formed the basis of this study. Ten of the 13 sets were certified by medical examiners as simultaneous twin SIDS. The findings in this study suggest that all 13 sets died from injuries, either unintentional or otherwise, and that these deaths could have been prevented.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
4/9. sudden infant death. Overheating and cot death.Four risk factors for overheating were sought in the histories of 34 cot-death victims in Oxford and Scarborough. 19 babies were unusually hot or sweating when found dead; 14 died in an unusually warm environment; 17 had evidence of a terminal infective illness; and 24 were excessively clothed or overwrapped. 3 babies had all four risk factors, 8 had three, 17 had two, and 4 had one risk factor. Only 2 had no risk factor; both had had very low birthweights. In 6 of 15 babies (40%) whose rectal temperature was recorded after death the temperature was above 37 degrees C, the highest being 42 degrees C. If parents could be educated to anticipate the dangerous situations preceding febrile apnoea, many cot deaths could probably be avoided.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
5/9. Unexpected infant death in association with suspended rocking cradles.We report on the deaths of two infants aged 10 1/2 and 11 weeks who were found face down in the angle between the base and side of their frame-suspended rocking cradles. Locking pins designed to prevent tilting of the cradles were not in place in either case. Investigation of the two cradles associated with the infant deaths and six other similar rocking cradles available for purchase in south australia revealed either marked angles of tilt or inadequate or nonchildproof locking devices in all cases. A study of live control infants placed in similar situations demonstrated support for the possibility of positional asphyxia. We consider that these cases represent another potentially lethal sleeping environment for infants and emphasize the importance of death scene examination in all cases of unexpected infant death.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
6/9. Apparent life threatening events and infant holding practices.Two 4 week old infants are reported who suffered apparent life threatening events (ALTE) while being cradled in adult arms. The events, which could be reproduced under controlled circumstances, were not associated with any struggling by the infants. Alteration of infant holding practices in both cases resulted in cessation of the events. A case of cardiorespiratory arrest during breast feeding in an 8 week old infant that was unnoticed by her mother is also described. These cases suggest that certain infants may not respond normally to airway occlusion while being held or nursed, and show that careful study of the events surrounding ALTE may reveal contributing environmental factors. If ALTE occur around feeding time, observation of how caretakers place the infant during and after feeding may be informative.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
7/9. Simultaneous death of twins. An environmental hazard or SIDS?The sudden and simultaneous death of twin infants is described. The search for hazards in the home and the postmortem investigation provided an insight into the possible mechanism of death. Instead of a diagnosis of simultaneous sudden infant death syndrome (SIDS), the infants were determined to be victims of a combination of several environmental factors that led suddenly to death. Strong circumstancial evidence of nonnatural (accidental) death included sublethal levels of carbon monoxide (CO), overwrapping, and mechanical obstruction of upper airways. The literature concerning the phenomenon of simultaneous twin death is also reviewed.- - - - - - - - - - ranking = 5keywords = environment (Clic here for more details about this article) |
8/9. Accidental bed deaths in infants due to unsafe sleeping situations.Sixteen accidental deaths of infants occcurred in Wayne County (Detroit) during 1974-1975 as a result of unsafe sleeping environments. Thirteen of these deaths resulted from different modes of asphyxia, two were due to falls, and one drowned. Differential diagnoses are pointed out. It is estimated that over 600 infants die each year in the united states due to unsafe sleeping conditions. Despite the magnitude and importance of this problem, little has been provided to the public in the form of preventive education. Federal regulations, passed in 1974, control the manufacture of new cribs but do not affect the existing unsafe cribs. Suggestions for the prevention of such fatal accidents are outlined, including a safety check list for infant beds. The cooperation of all health professions is required to educate the public of these dangers to their infants.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
9/9. Cockroach: the omnivorous scavenger. Potential misinterpretation of postmortem injuries.Interpretation of postmortem injuries, including their differentiation from those produced antemortem, may be difficult even for experienced forensic pathologists. A variety of animals or insects residing in the death environment may alter the appearance of the deceased. Dictyoptera blattaria (the cockroach) is common in the residential setting. Three cases of sudden and unexpected infant death are presented in which postmortem injuries inflicted by cockroaches initially raised concern of nonaccidental injury. The true nature of the lesions was not recognized by the people at the death scene and, in one case, observation of neck injuries raised suspicion of possible strangulation. In another, the lesions were thought to be burns of different ages. cockroaches are omnivorous scavengers that devour keratin. They will bite human flesh in both the living and dead with resultant injury. Recognition of cockroach bites will help in the evaluation of injuries discovered during child death investigations.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |