• Child behaviour
• mental health
• paediatrics
• self-harm
• self-injurious behaviour
• suicide

In this edition of the journal Deasy et al1 share some unique and original insights into hanging in children (see page 411). These were only possible because of the use of an electronic database (VACAR), which has been backdated to include paper records from previous years in respect of out-of-hospital cardiac arrest. It includes hospital outcome to the level of detail of the paediatric cerebral performance category scale. The researchers were also able to validate their data against a national coroner information system. Comparable databases do not exist in Britain and so this analysis could not have been done here.

Hanging was the fourth most common cause of out-of-hospital cardiac arrest and 91% were intentional, hence occurring during waking hours. The only survivors were when the event was witnessed and bystander resuscitation was prompt. Out …