Accidental mechanical asphyxia at work site by mud

Sand, gravel or dirt aspirations are rare but potentially lethal incidents in emergency medicine. Most of the cases reported share the common mechanism of being buried accidentally under sand, dirt, or gravel masses at construction sites, as the result of the collapse of sand tunnels, sand castles and sand piles or in the course of a vehicle accident. Accidental aspirations, notably those of children being buried under sand masses, survived after successful bronchoscopy and postural drainage are reported. Although extensive deep aspiration of sand, gravel, or dirt is a very rare incident, its consequences may be severe ranging from the necessity of immediate intensive care to death. The fatalities due to sand aspiration reported so far were ascribed to extraneous causes. We report a rare case, where husband and wife, who were manual laborers, slipped and got accidentally buried together in the mud while working at the site and died due to suffocation involving two different mechanisms.