Tuesday, 17 October 2017


Swiping the screen of my phone, I leaned back to thoroughly digest the article. It was an autopsy case report sent by one of my teachers to sharpen my "research intellect". As I read through, I was deeply unsettled. Indeed it was a sad tale.

The case of  three boys; two brothers and a neighbour, aged 3, 5 and 7years who had been declared missing and later found dead in the boot/trunk of a car belonging to
one of the families. It seemed that in the course of playing they had entered the boot of the car and closed themselves in.
When their absence was noticed, alarm was raised and search started. The same car was driven round the neighbourhood, no one thinking to check the boot of the car till the following morning when the owner opened the trunk to wash his car.
Their lifeless bodies were found. Unable to get out, the boys had apparently suffocated and died.
An autopsy was requested and the cause of death was found to be: Enclosure asphyxia.
What a sad  reality!!! One can't begin to imagine the agony of the affected parents, the emotional trauma. We pray that the souls of the boys find rest in Lord's bosom.

Enclosure asphyxia is suffocation that occurs in confined/enclosed spaces as a result of decreased oxygen supply to the body and could result in death. These confined spaces range from the boot/trunk of vehicles to closed cabinets and wardrobes, parked cars with closed doors and windows amongst others.
Children by their very nature are at risk. According to Prof Nzegwu et al, the average child has an uncontained desire to explore his environment. As parents and guardians,  we can relate to this. The average child can barely stay still, ambling about in various directions irrespective of the inherent danger whether it's a kettle of boiling water, a pan of frying oil or electricity.

What happens when one is trapped in an enclosed space:
Ordinarily, the concentration of oxygen in atmospheric air is approximately 21%. When one is trapped in an enclosed space, the concentration of oxygen begins to decrease with associated increase in levels of carbon dioxide and other gases. These gases are trapped as there's no space for ventilation: carbon dioxide and other gases cannot effectively diffuse out and there's little/ no incoming oxygen.  As a result of decreased oxygen supply to the brain, concentration, thinking and decision making are impaired. As this condition progresses, the person becomes unconscious and may eventually lead to death, if not rescued. Quite tragic!!!

How do we prevent "play accidents" and incidents as the one cited above?
Prof Nzegwu et al in their publication went on to recommend,  "child education in homes and schools inorder to enlighten parents and children of the possibility and grave danger of such entrapment and the need to avoid exploring enclosures". A prominent danger is that no one may remember to look in such ?? Unlikely places.
In addition to the advice above, I say we as parents, guardians and teachers should redefine the rules of play in our homes and schools. There should be set boundaries and education on home safety practices.

These home safety practices include:
-Teach children the rules of play------- avoid heights and enclosed spaces.
-Keep medicines out of reach of children
-Keep children out of the kitchen and away from sharp objects/ fire
-Keep detergents and harmful liquids in well labelled containers and out of reach of children
-Restrict access to electrical gadgets
-Ensure spills are wiped off the floor as soon as they occur
-Be conscious of children's play areas and location
- Remember, the boot/trunk of any vehicle can be a child's potential hide-out... Always check.
The list continues and should be adapted to our domestic settings. The need to regularly have discussions on safety with our children/wards at home and in schools cannot be overemphasized.

I like to particularly point out a recurrent oversight. That of leaving our children in parked cars with doors and windows tightly shut for safety's sake as we dash out to run "a quick errand". Unfortunately, cases have occurred where the caregiver returned to find the unconscious or lifeless body (ies) of the child(ren).
Please, rather than leave children in the car, take them along or leave them in the care of a responsible adult... inorder to avoid stories that break the heart.

Above all, watch (be cautious), teach (talk to them) and pray that God keeps them safe at all times. I always say, we can't be everywhere with our children but God can. In his care, their safety is always assured.

E don do as e dey my mouth.  As my people say,  e kwughi ekwu mere okenye, anughi anu mere nwata which literally means,  one can only advice, it's in the hands of the listener to implement.
Do Stay Safe, Live and Love Healthy With Dr IB

References: 1) Nzegwu Martin A., Olusina Francis D.B., Ukekwe Ikechukwu and Nzegwu Victor. Enclosure asphyxia as a cause of death in 3 Nigerian children trapped at the boot of car- Case reports and review of literature.
2) www.eiga.org/index.php?
Reviewed by: Drs Nwachukwu Paul and Ukeje Chibuko.

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