Cartoons Kill: A new high-risk patient for critical illness & death

This past month, the BMJ published an impressive retrospective review that analyzed nearly 80 years of data to find that animated characters in children’s films are in fact at a very high-risk for death when compared to characters in adult dramas.

Films ranged from 1937 (Snow White) to 2013 (Frozen) and were compared against the two highest gossing dramatic films in that same year. The authors found that nearly two thirds of the children’s animated films contained an on-screen death of an important character compared to only half in adult dramas.

Fatalities were most commonly the result of:

Defenestration/falls (11%)

Animal attacks (11%)

Drowning (6.7%)

Gunshot wounds (6.7%)

Other mystical causes (6.7%)

Other high-risk animated characters include the parents of the protagonist (17.8% mortality) and nemeses (28.9% mortality). Median survival time was approximately 90 minutes (much less than the usual ED LOS!)

Notable early on-screen deaths included Nemo’s mother being eaten by a barracuda 4 minutes into Finding Nemo, Tarzan’s parents being killed by a leopard 4 minutes into Tarzan, and Cecil Gaines’ father being shot in front of him 6 minutes into The Butler.

The author’s intention was to point out the psychological impact of death on young children, but I think the authors also highlight an important, high-risk patient population that could present to your ED.

Bottom Line: Animated characters should be aggressively resuscitated and strongly considered for admission to a higher level of care should they present to your ED, as they appear to be at high-risk for death and rapid decompensation.

May all of you have a happy and safe 2015!

Reference

1. Colman I, Kingsbury M, Weeks M, et al. CARTOONS KILL: casualties in animated recreational theater in an objective observational new study of kids' introduction to loss of life. BMJ. 2014;349:g7184.

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