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R T Shepherd

Publications and source records attributed to R T Shepherd.

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England

Accidental self-strangulation in a young child--a case report and review.

The accidental self-strangulation of a child of 3 years is described. This is an unusual occurrence and has, in this case, resulted from a particular group of circumstances. The features of the case are presented and asphyxial deaths in young children are reviewed. The dangers of loose wires, cords or other potential ligatures in or adjacent to sleeping or play areas is emphasized. That a relatively small amount of force is required to asphyxiate a child appears to be confirmed by this case.

Accidents, Home

Mechanism of sudden death associated with volatile substance abuse.

1. Sudden death is a recognized hazard of volatile substance abuse and may occur during exposure or in the subsequent hours. Intoxication may also lead to indirect deaths due to trauma. 2. Specific post-mortem features have not as yet been identified either macroscopically or microscopically in VSA-related deaths. Toxicological examination for volatile substances of all unnatural teenage deaths is strongly recommended. 3. Four mechanisms for acute, direct VSA-related deaths are discussed, viz anoxia, vagal inhibition, respiratory depression and cardiac arrhythmia. Of these, cardiac arrhythmia due to 'sensitization' of the heart to adrenaline is probably the most common and is well documented in experimental conditions. 4. Deaths from cardiac arrhythmia during or soon after VSA are unpredictable, unpreventable and resuscitation is rarely successful. Previous uneventful sessions of abuse provide no protection from this mode of death.

Arrhythmias, Cardiac