7- Drowning _Immersion_ by ewghwehws

VIEWS: 16 PAGES: 18

									7- Drowning (Immersion):
It is a form of violent asphyxia in which death
results from submersion of mouth and nostrils of a
living person under water


• Classification (types) of drowning:
1- Typical (wet) drowning:
2- Dry drowning.
3- Secondary drowning (Near-
 drowning).
Physiopathological changes:

• In fresh water   hypervolemia 
 hypoxia and potassium excess.


• In salt water  pulmonary edema 
 hypovolemia and circulatory shock.
 Dry drowning:
Water in the larynx      laryngeal spasm   
 asphyxia

Near-drowning (2nd drowning syndrome):
glistening pleural surface of a lung
PM picture of drowning:

• These are signs of asphyxia unless death
    occurred from
1- shock,
2- syncope,
3- concussion.
     External appearances
1. Signs of immersion:
These are found in any body found dead in
   water (whatever the cause of death).
• Coolness of the body.
• Goose-skin the skin is wrinkled.
• Washerwoman-skin: the skin is sodden.
• Peeling of the epidermis in the form of
   gloves and stockings.
• Hypostasis
2- Sure external signs:

A-Froth:
(Fine – White – Odorless _ increase)

B-Cadaveric spasm
of the hands on weeds, mud, sand, etc.
     Internal appearances

• Voluminous lungs with indentation marks
  of ribs on their lateral surfaces.
• Respiratory passages contain froth (having
  the same characters of that found
  externally at the mouth and nostrils),
• foreign material ( weeds, mud, sand,.).
A normal pink aerated appearance with
     ,minimal anthracotic pigmentation
Diffuse alveolar damage in which the lung
       is diffusely firm and rubbery
Diatoms:
• These are microscopic, unicellular algae,
  found in fresh as well as salt water.
• When a live person is drowned in water,
  they penetrate his alveolar membrane and
  pass with the circulation to distant organs.
• But when a dead body is thrown into
  water, the absence of beating heart
  prevents circulation of diatoms to distant
  organs.
some of the plant material in the
water was aspirated into a bronchus .
The medico-legal (ML) importance of diatoms:


 • 1- Sure signs of drowning,
 • 2- Could still be identified in putrefied
   bodies,
 • 3- Could give an evidence of the site of
   drowning (fresh or salt water species).
How to know that death was due
to drowning:
1-Froth at mouth and nostrils: fine, white,
    abundant.
2.Cadaveric spasm on weeds, mud or sand.
3.Lungs: voluminous, edematous with
    indentation marks of the ribs.
4.Froth in the air passages.
5. Diatoms in the tissues.
In putrefied bodies:

• Only diatoms could be identified

								
To top