Difference between revisions of "Asphyxial deaths"

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==Hanging==
Classic:
*V-shaped furrow on the neck.
*V "open" at the point of suspension.
==Drowning==
Classic:
*Autopsy is often negative, i.e. there is no anatomical cause of death.
Drowning is difficult to prove on autopsy.<ref name=pmid16378701>{{cite journal |author=Piette MH, De Letter EA |title=Drowning: still a difficult autopsy diagnosis |journal=Forensic Sci. Int. |volume=163 |issue=1-2 |pages=1–9 |year=2006 |month=November |pmid=16378701 |doi=10.1016/j.forsciint.2004.10.027 |url=}}</ref>  The diagnosis is often based on circumstance, i.e. the scene.
===Macroscopic===
External:
*Plume of froth at the mouth/nostrils (fresh drowning only).<ref name=pmid16378701/>
Internal:
*Lung emphysema.
*Froth in the trachea.
*Patlauf spots<ref name=pmid12134758>{{cite journal |author=Bohnert M, Ropohl D, Pollak S |title=[Forensic medicine significance of the fluid content of the sphenoid sinuses] |language=German |journal=Arch Kriminol |volume=209 |issue=5-6 |pages=158–64 |year=2002 |pmid=12134758 |doi= |url=}}</ref> -- ???
===Micro/Lab===
There are a few tests of debated value:<ref name=pmid16378701/>
*Diffusion of particulates into the blood (left ventricle) from the water.
**Diatom test.
*Haemodilution.
**Mostly useless - CPR interferes with it, not reliable if there putrefaction or autolysis.
*Transport of aveolar element into blood circulation.
==Carbon monoxide==
Carbon monoxide (CO) is a common way to commit suicide.
Pathophysiology:
*CO binds to haemoglobin -- prevents oxygen from binding there.
Findings:
*Salmon pink skin.
*CO level (blood test) elevated (???).
==Manual strangulation==
Features:<ref name=Ref_HoFP>{{Ref HoFP|155}}</ref>
*Petechiac of sclerae (white part of eye) & conjunctivae (cover sclerae); present ~ 90% of the time.
*Hyoid bone fracture.
*Thyroid cartilage fracture.
*Haemorrhage in strap muscles of the neck.


==See also==
==See also==

Revision as of 04:46, 12 September 2010

This article deals with asphyxial deaths, where "asphyxia" is used in the conventional context, i.e. it is not used appropriately when considered from the perspective of its etymology (as pointed-out by Knight).[1]

Asphyxia is, etymologically, lacking pulsation; in common usage it is essentially hypoxia (blood lacking oxygen)[2] and anoxia (tissues lacking oxygen).[3]

Overview

DiMaio classification:[4]

 
 
 
 
 
 
 
 
 
 
 
Asphyxia
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Strangulation
 
 
 
 
Chemical
 
 
 
 
 
 
Suffocation
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Hanging
 
Ligature
 
Manual
 
 
 
Mechanical
 
Choking
 
Smothering
 
Environmental
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Positional
 
 
 
Overlay
 
 
 
 
 
 
 
 
 
 

Hanging

Classic:

  • V-shaped furrow on the neck.
  • V "open" at the point of suspension.

Drowning

Classic:

  • Autopsy is often negative, i.e. there is no anatomical cause of death.

Drowning is difficult to prove on autopsy.[5] The diagnosis is often based on circumstance, i.e. the scene.

Macroscopic

External:

  • Plume of froth at the mouth/nostrils (fresh drowning only).[5]

Internal:

  • Lung emphysema.
  • Froth in the trachea.
  • Patlauf spots[6] -- ???

Micro/Lab

There are a few tests of debated value:[5]

  • Diffusion of particulates into the blood (left ventricle) from the water.
    • Diatom test.
  • Haemodilution.
    • Mostly useless - CPR interferes with it, not reliable if there putrefaction or autolysis.
  • Transport of aveolar element into blood circulation.

Carbon monoxide

Carbon monoxide (CO) is a common way to commit suicide.

Pathophysiology:

  • CO binds to haemoglobin -- prevents oxygen from binding there.

Findings:

  • Salmon pink skin.
  • CO level (blood test) elevated (???).

Manual strangulation

Features:[7]

  • Petechiac of sclerae (white part of eye) & conjunctivae (cover sclerae); present ~ 90% of the time.
  • Hyoid bone fracture.
  • Thyroid cartilage fracture.
  • Haemorrhage in strap muscles of the neck.

See also

References

  1. ↑ Saukko, Pekka; Knight, Bernard (2004). Knight's Forensic Pathology (3rd ed.). A Hodder Arnold Publication. pp. 352. ISBN 978-0340760444.
  2. ↑ URL: http://dictionary.reference.com/browse/hypoxia. Accessed on: 12 September 2010.
  3. ↑ URL: http://dictionary.reference.com/browse/anoxia. Access ed on: 12 September 2010.
  4. ↑ DiMaio, Vincent J.M.; Dana, Suzanna E. (2006). Handbook of Forensic Pathology (2nd ed.). CRC Press. pp. 155-64. ISBN 978-0849392870.
  5. ↑ 5.0 5.1 5.2 Piette MH, De Letter EA (November 2006). "Drowning: still a difficult autopsy diagnosis". Forensic Sci. Int. 163 (1-2): 1–9. doi:10.1016/j.forsciint.2004.10.027. PMID 16378701.
  6. ↑ Bohnert M, Ropohl D, Pollak S (2002). "[Forensic medicine significance of the fluid content of the sphenoid sinuses]" (in German). Arch Kriminol 209 (5-6): 158–64. PMID 12134758.
  7. ↑ DiMaio, Vincent J.M.; Dana, Suzanna E. (2006). Handbook of Forensic Pathology (2nd ed.). CRC Press. pp. 155. ISBN 978-0849392870.
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