ROCHESTER, Minn. -- As summer begins, researchers in the current issue of Mayo Clinic Proceedings offer a strong reminder that parents should supervise children playing in sand. The authors write about two instances where children were killed after being buried in sand: one in a sandbox and the other at a construction site.
"Greater awareness by public health and safety officials at beaches, sandboxes, sandpiles and natural play areas may prevent potentially lethal accidents," the authors write in the June issue of Mayo Clinic Proceedings.
The two accidental deaths of boys who were trapped under sand are the first documented instances of deaths from respiratory asphyxia where the sand compressed their lungs and chests, the authors say. Only 15 accidental burials resulting in eight deaths have been reported in medical literature, the authors said. In all but one, the details of the death include the victims breathing sand into the lungs.
In the two accidents studied by the authors, the weight of the sand compressed their chests and was too heavy for the youths to get out of the sand or ventilate their lungs adequately. Neither of the 10-year-old boys who died had sand in the mouth, pharynx, trachea or bronchi.
One 10-year-old died when the tunnel he was digging in his sandbox collapsed on him. He was buried for about 10 minutes before he was pulled from the sand. In the second case, the 10-year-old boy was buried in wet sand at a construction site after a 30-foot pile of sand collapsed and avalanched on him and two others. Two other boys playing at the site were not hurt: one was not buried and the other was partially buried, but his head and chest were clear. It took about 60 minutes for rescuers to find the third boy under 12 feet of sand.
In their report, the authors write that their work should remind health care professionals to actively warn parents and children about the dangers involved with sand. Parents should supervise children playing in the sand, the authors say.
"When witnesses are at the scene, and there is early extrication and appropriate airway management, odds of survival are greater," the authors write.
Authors of the report are: Abdalla Zarroug, M.D., Penny Stavlo, David Rodeberg, M.D., and Christopher Moir, M.D., all of Mayo Clinic, and Greg Kays, M.D., of Fairview Red Wing Medical Center, in Red Wing, Minn.
Jay Grosfeld, M.D., surgeon-in-chief at Riley Children's Hospital in Indianapolis, writes in an accompanying editorial that the report contains important safety messages.
"Safety precautions at potentially dangerous construction sites and industrial sand storage facilities should be instituted as part of an accident-prevention program with appropriate inspections to ensure compliance," says Dr. Grosfeld.
He also notes that young children need to be supervised. "If either of the two reported events had been observed, the chance of prompt extrication and survival would have been better," he says.
###A peer-review journal, Mayo Clinic Proceedings publishes original articles and reviews dealing with clinical and laboratory medicine, clinical research, basic science research and clinical epidemiology. Mayo Clinic Proceedings is published monthly by Mayo Foundation for Education and Research as part of its commitment to the medical education of physicians. The journal has been published for more than 75 years and has a circulation of 130,000 nationally and internationally. A copy of the article will be available online at http://www.mayo.edu/proceedings.
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