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Fatal heat stroke in children found in parked cars: autopsy findings


A common and unfortunate cause for heat stroke-related deaths in children is entrapment in closed vehicles. The aim of this study was to analyze the pathological consequences of such grave events. Autopsy reports of all children that were brought to a national forensic medicine center after being found dead in closed vehicles over a 21-year period (1995–2015) were reviewed. Data extracted were the circumstances of the events, child age, sex, height and weight, time, date and duration of entrapment, and environmental temperatures at the time of entrapment and the autopsy findings. Eight deceased children were brought to the forensic medicine center for autopsy, and seven families consented to the procedure. Autopsy findings included diffuse petechiae and hemorrhages of serosal membranes (n = 7/7) and lung congestion (n = 3/7).

Conclusion: Typical autopsy findings following classical heat stroke in children include diffuse petechiae and hemorrhages and lung involvement. These findings are similar to those reported in adults that had died following exertional heat stroke—a very different mechanism of heat accumulation. Prevention of future events can possibly be obtained by public education on the rapid heating of closed vehicles, the vulnerability of children to heat, and the caregiver role in child entrapment.

What is Known:
A common and unfortunate cause for heat stroke-related deaths in children is entrapment in closed vehicles. The pathological consequences of such grave events have not been previously reported.
What is New:
This study is the first to describe autopsy findings from children who were found dead in parked cars.
Autopsy findings included diffuse petechiae hemorrhages of serosal membranes and lung congestion.
These findings are identical to those seen in adults following exertional heat stroke.

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Classical heat stroke


Exertional heat stroke


Israel National Center of Forensic Medicine


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Author contributions

Berliz Adato, Yuval Heled, and Yoram Epstein conceived the study and participated in study design, acquisition, and interpretation of data. Hadas Gips participated in acquisition and interpretation of data. Gal Dubnov-Raz participated in interpretation and analysis of data and initial drafting of the article. All authors revised the manuscript critically for important intellectual content and gave final approval of the version to be published.

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Correspondence to Gal Dubnov-Raz.

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No funding was obtained for this study.

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All authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Communicated by Mario Bianchetti

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Adato, B., Dubnov-Raz, G., Gips, H. et al. Fatal heat stroke in children found in parked cars: autopsy findings. Eur J Pediatr 175, 1249–1252 (2016).

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  • Automobile
  • Autopsy
  • Death
  • Heat stroke
  • Pediatrics