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Robin A. Helmuth, MD
Methodist Hospital of Indiana, Inc Indianapolis

JAMA. 1990;264(11):1407.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The recent Brief Report by Jumbelic and Chambliss¹ provided some alarming statistics concerning drowning deaths in toddlers. However, my attention was caught by the photograph in Fig 2, labeled "Infant with head down in an empty 5-gallon plastic industrial bucket." I could not help but notice the presence of livor mortis on the midback and the legs as well as the prominent blanching of the presacral area, buttocks, and both heels. Livor mortis is "the reddish-purple discoloration found in dependent areas of the body due to accumulation of blood in the small vessels of the dependent areas secondary to gravity."² Blanching is due to external pressure on dependent areas during this process. The external pressure compresses the soft tissue, which prevents the accumulation of blood, thus producing the pale or blanched areas.

With these facts in mind, one could postulate at least two different scenarios. . . . [Full Text PDF of this Article]

Footnotes
Edited by Drummond Rennie, MD, Deputy Editor (West), and Don Riesenberg, MD. Senior Editor.

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