Introduction

This chapter covers a very eclectic range of situations, from sleeping accidents in infants, to trauma from vehicle crashes, drug misadventure, animal attacks, and iatrogenic errors. Despite the differences in many of the topics the common theme is that unexpected death occurred due to unnatural and non-inflicted causes. Accidents, or non-intentional injuries, are responsible for many deaths in the young with varying susceptibilities at different ages. For example, only 3–5% of deaths in infants are due to accidents compared to 71% in those aged 15–19 years.

Variations in age-related death rates are due to fundamental differences in mobility and activities in the two age groups. While toddlers and young children are at less risk due to their relative immobility, problems occur with exploratory behavior, inability to perceive potential danger, inability to problem solve once confronted with a hazardous situation, and their immature anatomical and physical characteristics. Adolescents and young adults tend to engage in increased risk-taking activities. In the United States in 1987 as many as 25,814 of 54,239 deaths in those aged from 1 to 24 years were accidental, and in the state of California a decade later 636 fatal accidents occurred in children under 4 years of age (Table 2.1).

In the United States in 2006 the top five causes of fatal unintentional injuries in those aged 15–24 years were vehicle accidents (66.2%), poisoning (18.1%), drowning (3.8%), “other land transport” (1.7%), and falls (1.5%).