Lethal head entrapment - A problem characteristic of early childhood

Abstract

Accidental deaths in infancy and early childhood often result from young childrens’ lack of understanding of the dangers of certain situations and their physical inability to extricate themselves from potentially lethal circumstances. Two cases are reported to demonstrate an age-related susceptibility in the young to lethal head entrapment. Case 1: a 5-month-old girl smothered when she slipped down in her stroller, trapping her head beneath the frame and forcing her face into the soft material of the base. Case 2: a 14-month-old boy was hanged while exploring a filing cabinet when his head became caught between two lower drawers. Additional mental and physical characteristics that predispose young children and infants to lethal head entrapment include an inability to effectively problem solve once confronted with a hazardous situation, and relatively large heads and weak neck musculature. Because of these features lethal head entrapment represents a particular circumstance that may predispose to accidental asphyxial deaths in the very young. A combination of careful death scene and autopsy evaluations will be required to confirm the alleged circumstances of death in these cases, including mortuary re-enactments and assessment of the deceased infant’s level of physical maturity and mobility.