A family had a traumatic experience when an innocent game turned into a nightmare for a few days. Fortunately, they received timely and precise treatment, which may not be possible in all cases. The victim was a 10-year, 7-month-old male child who was rushed to our emergency room after an alleged accidental hanging incident followed by multiple seizures with altered sensorium. According to the parents, the child was pretending to be a puppy on straps, holding a synthetic "DUPATTA" around his neck that was suspended from the window rail. The child was unattended for a mere five to 10 minutes and was found unresponsive when discovered.
Dr Md Nawad Azam, well-known Pediatric Intensive Specialist, Rainbow Children's Hospital, Hebbal, said, "The child was given antiseizure medications and intubated followed by bag and tube ventilation due to prolonged seizures and abnormal breathing. He was then shifted to PICU for intensive care and further evaluation and management. The child had reached our hospital within three hours of the incident, where a CT scan of the brain and neck was done to rule out any acute injuries to the neck bones and brain. He required 36 hours of ventilator support, antiseizure medication, and neurological monitoring. After nearly 48 hours, he regained consciousness and responded to his parents."
Accidental hanging is a potentially preventable cause of death and morbidity in children. Complete hanging implies that the entire body is suspended off the ground, although children often have partial or incomplete hanging, which means that some parts of their bodies are in contact with the ground. There is limited data available in India regarding the prevalence of accidental hanging in children, but some studies report that 7-8% of deaths are due to accidental hanging.
Dr Azam said, "Accidental hanging or strangulation can lead to obstruction of the windpipe, major neck vessels, and pressure on the carotid sinus, leading to sudden loss of consciousness. A cut-off in blood supply to the brain for 10 to 20 seconds can lead to unresponsiveness, brain hypoxia, and seizures.”
Dr Prabhjot Kaur (Pediatric Neurologist, Rainbow Children’s Hospital, Marathahalli) said, “Brain hypoxia can lead to permanent brain damage, and may even turn life-threatening in a few minutes in some cases. Even if a child survives, they may develop complications such as permanent brain injury leading to recurrent seizures, neurological deficits, and vegetative states. Some children can develop vision issues due to bleeding inside the eye."
Dr Md Nawad Azam said, "Prevention is the only assured method of avoiding these issues, and parental awareness is crucial. For infants and toddlers, parents should ensure that loose cords, clothing, and swinging cords are secured and out of reach. They should also avoid placing them in areas where they can become tangled or caught on furniture. Parents should supervise both outdoor and indoor activities. Older children and adolescents should be educated regarding the hazards of strangulation and choking. We suggest that all parents learn basic CPR (cardiopulmonary resuscitation). In case of inadvertent hanging, parents should ensure the child is breathing and immediately take the child to the nearest hospital for further care."
Dr. M D NAWAD AZAM
MBBS, MD Pediatrics, Fellowship Pediatric critical Care (IDPCCM), PGPN (Boston University)
Consultant-Paediatric Intensivist
Rainbow Children’s Hospital, Hebbal
This article was published in association with Rainbow Children’s Hospital and not by TNM Editorial.