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Dr.I.B.

GD Surya Putra P, SpF


Department of Forensic Medicine
Faculty of Medicine, Gadjah Mada University
 Definition of asphyxia
 Causes of asphyxia
 Phase of asphyxia
 Appearence /clasiccal signs of autopsy
 Types of asphyxia
 Term “asphyxia” mean “lack of oxygen”
 Etymologically the word means “absence of
pulsation”
 A condition where the cells or organs did not
receive oxygen.
 The condition can be partial (hypoxia) or total
(anoxia).
There are three causes of asphyxia :
1. Natural disease

2. Trauma (mechanical)

3. Toxic conditions
 Dyspneu
 Convulsion
 Apneu
 paralyse
1. CYANOSIS
2. PETECHIAE HAEMORRHAGES
3. VISCERAL CONGESTION
4. FLUIDITY OF BLOOD
 Mean “dark blue”
 The colour of soft tissue or skin change to blue
or purple. And usually we look In the lip and
under the nail.
 However becomes observable until at least 5 g
of reduced hemoglobin per 100 ml.
 Pinpoint hemorrhages produced by ruptured
of small vessels, predominantly small venules.
 Size from a tent of millimetre to about two
millimetre.
 Rupture is caused by sudden over distention or
increases in intravascular pressure.
 It is classically seen in the conjunctivae and
sclerae (strangulation).
 It often known as ’tardiev spot’
 It is due to obstructed venous return and
capillovenous congestion.
 There is dilatation of the vessels and stasis of
blood.
 It is due to increased activity of fibrinolysin.
Can be group into three categories:
1. Suffocation

2. Strangulation

3. Chemical asphyxia
There are six general forms :
1. Entrapment/environmental suffocation

2. Smothering

3. Choking

4. Mechanical asphyxia

5. Mechanical asphyxia combined with


smothering
6. Suffocating gases
 It is caused by inadequate or gross deficiency
of oxygen in the environment.
 But it is not due to by suffocating gases.
 In this case volume of oxygen was 9.6%
 It caused by fungus-like organisms ( for
enviromental)
 These death are almost accidental in nature.
 It is caused by the
mechanical obstruction or
occlusion of the external
airways, i.e., the nose and
mouth.
 These death are usually
either homicide or suicide,
very rarely accident.
 It is caused by obstruction
within the air passages.
 The manner of death can be
natural, homicide, or accident.
 The diagnosis of choking death
is made at autopsy when the
airways is found occluded.
 If the material in oro-pharynx is
choking, if laryngo-pharyngx is
called Gagging.
 This condition, if there is pressure on the
outside of the body prevents respiration.
 Divided into three types :
1. Traumatic asphyxia
2. Positional asphyxia
3. Riot-crush or “human pile “ death
Traumatic asphyxia:
 It occurs when a heavy weight
press down on individual’s chest
or upper abdomen.
Positional asphyxia :
 It occurs when the position of
the bodies trapped in restricted
space.
Riot-crush :
 It occurs in riots, when the chest
is compressed by stampeding
people piling on top each other.
 It is a combination of both these entities.
 An accidental form is overlay, where an infant
is placed in bed for the night with either an
adult or a larger child.
 This condition is caused by inert gases such as
carbon dioxide and methane.
 The gases makes reduction of atmospheric
oxygen.
 It is characterized by closure of the blood vessel
and air passages of the neck as a result of
external pressure on the neck.
 They are three forms :
1. Hanging
2. Ligature strangulation
3. Manual strangulation
 In hanging, there is compression or constriction
of the neck structure by noose or other
constricting band tightened by the weight of
the body.
 There may be either complete or incomplete
suspension of the body.
 Commonly, hanging is suicide. Accidental
hanging is uncommon and homicidal hanging
very rare.
HOMICIDE : SUICIDE :

 Complete supension :  The distance between


the distance between foot and floor is near
foot an floor is far  Victim : just one wound
 Victim : there is in the neck
another wounds  Scene: Tidy
 Scene : Untidy
 The pressure on the neck is
applied by a constricting
band that tightened by a force
other than the body weight.
 All cases are homicides.
 It is produced by pressure
of the hand, forearm, or
other limb against the neck,
compressing the internal
structures of the neck.
 All cases are homicide.
 Principally caused by hanging
 Transitory anoxia is intentionally induced to
enhance sexual arousement produced by
masturbation.
 Loss of control, and accidental death occur.
 Such deaths are rare, with the victim always a
male, only a few cases involving female.
 Typically found in a private area, sometimes
wearing female clothing, erotic literature,
sexual paraphernalia, and mirror
 This condition occur due to chemical
substance.
 In chemical asphyxiants, the most common
encountered by medical examiner is carbon
monoxide, and cyanide.
THANK YOU

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