Citation

Rehn M, Davies G, Foster E, Lockey DJ. Pediatr. Emerg. Care 2016; ePub(ePub): ePub.

Affiliation

From the *London's Air Ambulance, Barts Health Trust, London, United Kingdom; †The Norwegian Air Ambulance Foundation, Drøbak, Norway; and ‡Field of Prehospital Critical Care, University of Stavanger, Stavanger, Norway.

Copyright

(Copyright © 2016, Lippincott Williams and Wilkins)

DOI

10.1097/PEC.0000000000000860

PMID

28850052

Abstract

OBJECTIVES: Hanging may inflict laryngotracheal injuries and increase the potential for difficult airway management. We describe the management of pediatric hangings attended by an urban physician-led prehospital trauma service to provide information on a clinical situation encountered infrequently by most acute care clinicians.

METHODS: Retrospective trauma registry-based observational study of all children younger than 16 years attended with hanging as mechanism of injury in the period between 2000 and 2014.

RESULTS: Twenty-three thousand one hundred thirty patients were attended; 2415 (10%) of which were children. Of these, 32 cases (<1%) were pediatric hanging (1 case excluded due to missing data). There were 22 (71%) boys and 9 (29%) girls. Median age was 13 years. There was suicidal intent in 23 (74%) cases, and in 8 (26%) cases, hanging was accidental. There were 17 (55%) deaths, of which 14 (82%) were suicides.The doctor-paramedic team intubated 25 (80%) patients, with a 100% success rate. One (3%) patient was managed with a supraglottic airway device, and 5 (16%) patients did not require any advanced airway management.

CONCLUSIONS: Pediatric hanging is rare, but has a high mortality rate. Attempted suicide is the leading cause of hangings in children and preventive measures should target psychiatric morbidity. Despite concerns about airway edema or laryngeal injury, experienced doctor-paramedic teams had no failed airway attempts.

Language: en