William The Coroner’s Forensic Files

Monday, 17, October, 2011

Asphyxia

Filed under: Forensics,Teaching — williamthecoroner @ 12:00

I know, you were waiting breathlessly for this one…

Asphyxia

I. Introduction
A. Anoxia vs. ischemia
B. Neck compression
1. Hanging
2. Ligature strangulation
3. Manual
C. Smothering
1. Burking
2. Pillow
3. Grain elevators
D. Choking
1. Bolus of food
2. Young or incapacitated
E. Positional (mechanical asphyxia)
1. Unable to make respiratory movements
2. Crushing of chest
3. Crucifixion
F. Poisonous environments
1. Manure pits, coal mines, gas ovens
2. Near dry ice
3. Freezers
H. Chemical asphyxia
1. CO
2. CN

II. Anoxia vs. ischemia
A. Anoxia lack of oxygen
B. Ischemia lack of blood flow
C. Ischemia worse
1. Re-perfusion injury
2. Lack of metabolic substrates
3. “Starve and strangle”

III. Cervical Compression
A. Hanging
1. Pressures
a. Venous 5#
b. Carotids 12#
c. Airway 40#
d. Vertebrals 65#
e. “Vascular hanging” impede outflow
f. Tardieu spots

Asphyxia p. 2

2. Suspension is not necessary
a. Complete noose
b. U-shaped
c. Chair or bet

3. “hangman’s fracture”
a. Short drop
b. Long drop
c. Cruel ones (piano wire)

IV. Strangulation
A. Ligature
1. below larynx
2. Homicidal, accidental suicidal
3. Spanish windlass
4. Belt as control

B. Manual
1. Pattern injuries, ♀ by ♂

V. Smothering
A. Block off air with soft object
1. Pillow over face
2. Final exit suicide.
3. Avalanche

B. Torn frenulum
Broken teeth

VI. Choking
A. Café coronary
B. Victims
1. Impaired. Alcohol.
2. Young
3. No teeth.

VII. Positional asphyxia
A. Pressure on chest
B. Industrial accidents
C. Crucifixion

Asphyxia p. 3

VIII. Exclusion of oxygen
A. Gases
1. Manure pit
2. Hiding in ice cream truck
3. CO2 heavier than air
4. Canary in coal mine

B. Dangerous environments
1. Refrigerators

IX. Chemical asphyxia
A. CN
1. Poison electron transport chain.
2. Cyanide is natural.

B. CO
1. Irrevocably bind to hemoglobin
2. Smoke, auto exhaust, smoker
a. Smoke inhalation 90% in healthy
b. Fatal 40-90 depending on disease
c. Car 40-60%
d. Smokers 10%
e. Non-smokers 1-5%
f. Don’t put gurney behind the ambulance

X. Drowning
A. Sweet water

B. Salt water

C. Retardation of decomposition

D. Diatoms

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