Heat related Hyperthermia Injuries in Pediatric and Veterinary Cases

International Online Pediatrics Journal Case Study Int Onli Pediatr Jour (IOPJ) 2024 | Volume 1 | Issue 1 Heat related Hyperthermia Injuries in Pediatric and Veterinary Cases Nojaye Talebzadeh CHS Citation: Nojaye Talebzadeh. Heat related Hyperthermia Injuries in Pediatric and Veterinary Cases. Int Onli Pediatr Jour. 2024;1(1):1-4. Received Date: 23 June, 2024; Accepted Date: 25 June, 2024; Published Date: 27 June, 2024 *Corresponding author: Nojaye Talebzadeh. CHS Copyright: © Nojaye Talebzadeh, Open Access 2024. This article, published in Int Onli Pediatr Jour (IOPJ) (Attribution 4.0 International), as described by http:// creativecommons.org/licenses/by/4.0/. ABSTRACT The incidence of heatstroke in children has been reported to be between 29 to 37 children per year from 2018 to present. The incidence is higher in case of animals and pets, with 163 animals in 2023 that succumbed to hyperthermia after being left in the cars. Most hypotheses suggest memory lapse, fatigue, stress, and habit changes could be the underlying cause of such events. It is necessary to examine four types of vehicles commonly used in the United States, and evaluate the internal temperature rise at different times of the day. This sample of increased temperature in these vehicles demonstrates the importance of prevention and proactive planning in car manufacturing. In addition, we will further examine new bills being introduced to prevent child and pet deaths. Keywords: Hyperthermia; Pediatric; Car; Family pets; Children; Prevention INTRODUCTION According to National Weather Service data, the incidence of heat stroke has ranged between 23 to 50 deaths per year in the United States since 1998.[1] These incidences have risen even more, to approximately 150 deaths per year in case of family pets.[2] There have been significant attempts by news outlets and social media to reduce the hyperthermia related death. However this has not reduced the risk significantly. The incidence is more common in children younger than 3 years old. It has been shown that the hyperthermia occurs in all seasons although more common in June to August.[3] Physiologic response to heat has been evaluated. With rise in temperatures the homeostatic mechanisms cannot balance the internal temperatures to proper physiologic range. Heat reduces the water and minerals necessary to maintain cellular physiologic functions. Heat exhaustion presents as thirst, dizziness, fainting, weakness and finally to confusion, convulsion, coma and eventually death. These studies have revealed that the temperature rise in vehicles is very rapid.[4] It has been shown that sun rays pass through the windshield and are absorbed by dark surfaces of the car. This absorption leads to infrared light trapped by the interior and leads to rapid increase in temperatures.[5] Significant work in vehicle materials is being conducted. Studies have shown that certain materials in the interior of new vehicles produce volatile molecules, such as benzene content at 50 milliliter per square feet. This is not harmful to humans or pets however with rise in temperature this concentration may raise to 2000 to 4000 milliliter per square feet. At that International Online Pediatrics Journal Case Study Int Onli Pediatr Jour (IOPJ) 2024 | Volume 1 | Issue 1 level, passengers experience headaches, dizziness, drowsiness, confusion and eventually loss of consciousness.[6] This can lead to convulsions and death. Studies of material used in interiors, which include type of glass, plastic, carbon fiber and other materials, have ramifications in infra-red-light absorption and rise in temperature. The interior temperature can be reduced from 140 degrees to 89 degrees Fahrenheit with use of new material such as Cross-Linked Polyethylene Sheet and vehicle air ventilation designs.[5] This study aims at looking at temperature rise in four types of vehicles commonly used in the United States namely, large SUV, small SUV, Sedans, and small vehicles. The temperature is evaluated at different times of the day and rise is assessed based on type of vehicle and speed of rise in temperature. Study design: Four vehicles with different sizes were selected. These were based on common vehicles seen on the road today. They included a large and small sport utility vehicle, a large sedan and small compact car. The experiment was conducted at 8 AM, 12 PM and 3 PM. The exterior temperature was measured and recorded, and the vehicle doors left open until the interior temperature matched the exterior temperature. Subsequently the thermometer was placed in the middle of the back seat and measurements were obtained at 0,15,30, 45 and 60 minutes and recorded (Table 1). Table 1: The temperature and time data for 4 types of vehicles. Time Minutes 8AM 12PM 3PM External Temp 72.2oF External Temp 80.0oF External Temp 82.0oF Small SUV 15 67.5 87.1 126.3 Small SUV 30 66.4 91.2 131.3 Small SUV 45 66.4 95.2 134.2 Small SUV 60 67.6 100 138.1 Large SUV 15 72 85.1 130.6 Large SUV 30 72 88 134.1 Large SUV 45 72.3 89.4 135.3 Large SUV 60 73 91.2 135.1 Small Sedan 15 68.4 93.4 115.3 Small Sedan 30 68 97.3 120 Small Sedan 45 68.9 116.1 141.3 Small Sedan 60 70.2 130.1 145.6 Large Sedan 15 67.5 87.4 104.7 Large Sedan 30 67.8 90.3 107.7 Large Sedan 45 67.5 96.4 115.2 Large Sedan 60 68.5 116.2 120.5 Data Analysis: The data suggests that in the morning due to colder temperatures, the temperature inside the cars in general are cooler than outside. There is a noticeable drop in temperature in all cars most likely due to the colder interior of the vehicles International Online Pediatrics Journal Case Study Int Onli Pediatr Jour (IOPJ) 2024 | Volume 1 | Issue 1 that regulates the internal temperature. However, by 12PM the average increase in internal temperature is 8,11.7,19.28 and 28.9 degrees Fahrenheit in 15-minute increments. The maximum internal temperature of the car was increased to levels close to 130.1 degrees Fahrenheit in one vehicle. The 3 pm temperature externally started at 820 Fahrenheit however, again the internal temperature rise was more significant at 42.2, 41.3, 49.5 and 53.0-degrees Fahrenheit. The maximum temperature reached at 3 PM in one vehicle was 145.6 degrees in one hour. DISCUSSION Deaths from hyperthermia is a preventable tragedy that can be avoided having a good understanding of the etiology and taking proactive steps to prevent it. Various etiologies have been hypothesized as the underlying cause of hyperthermia related deaths. “Forgotten baby syndrome” is one of the major contributors of this event.[7] It was in the 1990s that airbags became a standard for safety in vehicles. This followed by recommendations to place children in back seats to prevent airbag injuries. The intent of the law was to improve child safety however, a secondary effect was an increase in hyperthermia related deaths.[8,9] Studies have looked at psychologic factors contributing to Forgotten baby syndrome. Habit being an automatic process has been one contributing factor. Habits in our daily activity are usually being conducted without any input. Our daily routines are mostly automatic functioning and any change in our routine may psychologically be forgotten. This unintentional phenomenon is one of the major contributors to the tragedy. Other conditions such as stress and fatigue could also be contributing to temporary memory impairment.[10,11] Other possibilities are described as “Capacity-resource theory”. Under this theory, there is decreased attention under stressful conditions. The Habits are not affected by stress and therefore mistakes could occur.[12] The continued education of the parents is essential in prevention of injuries. Those include every concept, such as always looking at the back seat, leaving toys or diapers in the front seat, asking care providers to call the parents' cells if a child does not arrive on time and never leaving children or pets alone at any time. Our data suggested that the interior of the small sedan with dark exterior and interior absorbed more heat and temperatures rose the highest at 145.6 degrees Fahrenheit. There are significant studies being done to reduce the heat generated in vehicles by designing better ventilation of vehicles during inactivity and use of better materials to reduce absorption of radiation from sunlight. Studies have shown that using Cross Linked Polyethylene Sheets (XLPE Sheets) reduces interior temperatures from 143.60F to 89.60F.[13] This study suggests that manufacturers could proactively design interiors with materials that prevent rapid rise in interior temperature. In addition to parental education, preventive technology exists today that could help reduce infant and pet death today. Companies like Hyundai have taken the lead to create an ultrasound detection mechanism in the car to detect motions in the back seat. This allows the car to alert the drivers and prevent fatal accidents. However, there is a push back by some reporting that only 6 percent of car buyers have infants and young children. The ability of existing technology must become the standard in car manufacturing to prevent such events. This requires us to encourage our legislators to pass laws that require all car manufacturers to proactively use these technologies in all cars. This technology could be simply activated and deactivated as part of software programming if the owners have young children or pets in the car and to address concerns of opposing the technology. Bills such as one introduced by Senator Roger Wicker from International Online Pediatrics Journal Case Study Int Onli Pediatr Jour (IOPJ) 2024 | Volume 1 | Issue 1 Mississippi aim at requiring manufacturers introduce systems to prevent hyperthermia related deaths. We should advocate our congress and governors to pass such laws to help curb these tragic incident. REFERENCES 1. Children,pets and vehicles. National Weather Service. Accessed 2024. 2. Willians B. Report: Heat-related deaths of dogs and cats double from last year; PETA declares crisis. PETA. 2023. 3. https://www.peta.org/media/news-releases/report-heat-related-deaths-of-dogs-an d-cats-double-from-last-yearpeta-declares-crisis/ 4. Null J. Heatstroke deaths of children in vehicles. No heat stroke. 2018. 5. McLaren C, Null J, Quinn J. Heat stress from enclosed vehicle: moderate ambient temperatures cause significant temperature rise in enclosed vehicles. Pediatrics. 1995;72(1,2):12-17. 6. Balakrishnan S, Paul J, Mahibalu K. Analysis of temperature rise in a car parked under sunlight, its effects and possible solutions. Int J Auto Eng; 2021;(1):1-15. 7. Egeghy P, Tornero-velez R, Rappaport SM. Environmental and biological monitoring of Benzene during selfservice automobile refueling. Envir health Perp. 2000;108(12):1195-1202. 8. Ho K, Minhas R, Young E. Pediatric hyperthermia related deaths while entrapped and unattended inside vehicles: The Canadian experience and anticipatory guidance for prevention. Paed Child Health. 2020;25(3):144-148. 9. Bae JY, Anderson E, Silver D. Child passenger safety laws in the United States, 1978-2010: Policy diffusion in the absence of strong federal intervention. Soc Sci Med. 2014;100:30-37. 10. Patterson J. “The engineering behind automotive airbags”. Illumin Mag. 2000. 11. Graybiel AM. Habits, rituals and the evaluative brain. Annu Rev Neurosci. 2008;31:359-87. 12. Kahneman D. Attention and Effort. Englewood Cliffs, NJ: Prentice-Hall, 1973. 13. Bargh JA. Attention and automaticity in the processing of self-relevant information. J Pers Soc Psychol. 1982; 43(3):425. 14. Balakrishnan S, Paul J, Mahibalu AK. Analysis of temperature rise in a car parked under sunlight, its effects and possible solutions. Int J Auto Eng. 2020;1(1):1-15. 15. https://www.nbcnews.com/news/us-news/technology-save-kids-hot-cars-exists-s o-why-isn-t-n1038281