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Pathophysiology of Hyperthermia
Although vehicular entrapment quickly results in hyperthermia in victims of all ages, children are especially vulnerable to the effects of heat stroke. Compared to adults, they have a more susceptible surface area that can absorb heat and immature thermoregulation. Additionally, young children strapped into a car seat are both developmentally and physically unable to extricate themselves from a vehicle, remove clothing to help manage heat or drink fluids to manage dehydration.
Heat stroke is the most severe form of heat illness. It usually consists of a core body temperature greater than or equal to 104˚ F and neurologic dysfunction, such as disorientation, delirium, seizures, or coma. The pathophysiology of heat stroke in children relates to the duration of exposure to heat. At the onset of heat stress, cardiac output increases and circulation is shunted peripherally to vasodilate skin and muscle to facilitate heat loss. Hyperthermia develops as the child is unable to dissipate heat with prolonged exposure and can no longer maintain a normal core body temperature. As it progresses, dehydration and electrolyte abnormalities develop, particularly hypernatremia (KZ note: dangerously high sodium levels) due to water loss and hypocalcemia (KZ note: dangerously low calcium levels) due to skeletal muscle degradation. These electrolyte abnormalities affect cardiac contractility and conduction (KZ note: this means the ability of the heart to beat properly), and impede the childs ability to maintain an elevated cardiac output (KZ note: children are dependent on heart rate to keep their blood pressure in the proper range, unlike adults who have a more complicated mechanism to regulate blood pressure.) In the presence of dehydration and vasodilation, this drop in cardiac output leads to hypotension (KZ note: this means dangerous collapse of the blood pressure regulatory and compensatory mechanisms).
As the duration of exposure increases, endothelial damage (KZ note: damage inside the blood vessels) occurs to the microvasculature and children may develop cutaneous signs of coagulopathy (KZ note: dangerous disorder of proper blood clotting), including petechiae and purpura. Terminal hyperthermia results in cardiac arrhythmias and deep gasping.6-8 In a series of autopsies of children who died from vehicular hyperthermia, the most consistent finding was intrathoracic petechiae (KZ: small pinpoint hemorrhages inside the lungs), presumed to be due to deep gasping. Although victims of heat stroke may progress to cerebral edema (KZ note: serious swelling of the brain), multiorgan hemorrhage, and necrosis or rhabdomyolysis (KZ note: sudden onset breakdown of muscle tissue producing by products that can clog the kidneys), these injuries are not believed to be present during acute heat stroke.
"They lose water and losing water, dehydration, actually brings about the imbalance of what metabolises and minerals in the body."
He added that once the sodium and potassium levels in the body increase, it is considered fatal.
"Another problem with hyperthermia is that in our muscles we have a special protein responsible for the muscle contraction. It's called myosin but in very high temperature it comes down to another protein called globine, forming the substance myoglobine which paralyses the muscles. So eventually it's muscle paralysis involving the entire body."
So before being dehydrated, baby Jaedon's muscles would have been paralysed throughout his entire body and according Dr. Alexandrov, his diaphragm would have become paralysed and it would have then blocked respiration. The same would have occurred for his heart muscles.
"So eventually the clinical picture of people dying of this condition is they become kind of dormant, then semi-conscious, unconscious, then comatosed and during this period, because of the muscular problems, they develop seizures which basically aggravate the whole situation and the final stage is death."
From Dr. Alexandrov's past experiences, the length of time for someone to die from hyperthermia would be approximately one hour.
That's what I don't understand. I think the point I was making in this thread (which I've made elsewhere before) is related to this concept that it is "understandable' and "conceivable" that a parent would do this.
It makes me curious about how we can set up situations in society that can be abused by men and women who don't want to be in a relationship or tied to a person with whom they had a child. (Not necessarily this case)
Ex. A man marries a woman and she has a baby and after a while he wants out. But he realizes that he's going to be chained to this woman for the next 18 years because of the baby and perhaps even longer.
So he babysits the baby and "forgets" to take the baby in from the car. OMG dead baby. He's traumatized and the devastation breaks them up.
Perhaps it's just the fact that we're hearing about the issues more and more in the news. But here's an example of the penalty for this crime
http://www.ny-criminal-defense-lawye...nd-degree.html
Would 1-3 years be dropped into parole?
There's an old Quincy episode where my hero busted a lawyer trying to do exactly this same thing. (I know I know television SPOILER) Basically the lawyer waited for someone to cross a crosswalk. Prior to this he pulled up next to a bus stop and made sure everyone was seeing him sloppy drunk. Then he ran the guy over and killed him and kept drinking so that his BAC was super high. This was back in the 80s when the penalties were not as stiff for drinking and driving and he knew he'd get parole.
http://www.imdb.com/title/tt0681764/
So he used the system to get away with murder. If penalties in these cases are not harsh, aren't we setting up a system that makes it easy to murder little kids and get away with it?
(And no I'm not saying that's all that's happening)
I still can't grasp how a grown adult watching a baby could leave a child inside a car on a hot day. It's all over the news everywhere.
ETA: this article was JUST published on June 3rd of this year. I had read it when a friend posted it on Facebook, and thought of it immediately when the Cooper Harris story hit the news.
This is not "science" but it's a blog post written for Salon by a mom who left her 4 year old in the car while she ran in a store for a moment, and was prosecuted:
http://www.salon.com/2014/06/03/the_day_i_left_my_son_in_the_car/
He was not injured or harmed in any way, but the trial and her side of the case are interesting.
I was sympathetic to her. I saw her side of the story. I understand why she did what she did that day.
She could have been the parent and told her son NO at any point: NO You can't come to the store. Once at the store NO you can't stay in the car. NO headphones if you insist on staying in the car. This wasn't a dire emergency run to a pharmacy for some necessary medication, there was no exigent circumstance for her to leave her child in the car - it was for headphones you can buy at the airport for crying out loud. I'm sorry I have no sympathy or patience with this woman, this whole piece is a long, overwrought tale of over-indulgent parenting, self-pity and blame-evasion. She broke the damned law but appears to think she is so special and her circumstances were so special she should get away with it.
Greenpalm: I was sympathetic to her. I saw her side of the story. I understand why she did what she did that day.
Greenpalm, I often feel the way you expressed yourself in this post -- I try to understand the perspective of all involved parties and I can get easily (emotionally) involved.
Here is my concern -- when we let our feelings prevent us from holding people accountable, it opens up a huge can of worms; it's a slippery slope. I agree with Nancy above -- ultimately it's Mom's responsibility to make sure the law is followed and that there is NO room for error/accidents, etc, involving your children. Her child was safe BUT many things COULD have still happened. The car could have been stolen with him in it; he could have been kidnapped; he could have decided to get out and wander in to the store & been hit by a car -- any number of things COULD have happened; thankfully it didn't; but she still left her child alone in the car.
We need to charge parents when they break the law and let the investigative chips fall where they may -- our emotions in cases like these are better suited for education/prevention -- and in the case of an arrested parent, it can be helpful for LE & courts to perhaps be sympathetic to a mother like this during bond hearings and sentencing phase. We can't let our understanding get in the way of our judgment, and we can't give a "pass" to those who plan to use past cases and our emotions against us when they want to hurt their children.
Heres a timeline of Jacobs experience:
At 1 minute, the temperature was 92 degrees in the car, and 88 outside.
6 minutes 100 degrees in the car, and Jacob begins to sweat.
10 minutes 105 degrees, and Jacob is sweating through his shirt.
....
30 minutes almost 125 degrees Fahrenheit. Jacobs shirt is completely drenched in sweat. Jacob has a heart rate of 140, the beginning of a heatstroke.