Firearm Injuries

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					Unnatural Causes of Death
         Omar Ali AL-Romaih
       Mazen Othman AL-hozime

        prof . Aiman Zaher
 Definition of un-natural causes of death
 Firearm and explosive injuries
 Drug abuse and poising
 Unnatural sexual offences
 Injury due to heat , cold
  and electricity
 Wound injures
 Asphyxia
 Drowning
 Summary
   Definition of Unnatural Causes of Death
 deaths caused by criminals or violence by:
 humans (self or non) as suicide, homicide by any
  methods as Hanging , drug abuse..
 Also animals as( fishes, dogs) .
    Characters of firearm injuries
   Loss of substance

   Presence of inlet
    and/or exit

   Powder marks

   Beveling of flat bones
Firearm Distance

                   star-shaped laceration
Close discharge of 12-bore
shotgun to chest.

  Medium-distance discharge of
  12-bore shotgun.
Differences between inlet & exit
-Powder marks

-Beveling of
flat bones
 Terrorism and warfare lead to many deaths from
  explosive devices.

 When explosion occurs, chemical , gas , heat
  generation .

 minimum pressure about 700 kilopascals need
  for tissue damage.

 all types of injury(abrasions , bruises,
   lacerations ,burns )due to collapse of structure .

                                                        Multiple abrasions and lacerations
                                                        by terrorist bomb
Drug abuse and poisoning
   Drug paraphernalia
 any equipment, product, or material that is
  modified for making, using, or concealing
  illegal drug such as cocaine , heroin and
    Skin popping
 Skin popping is a method of administration for the use of
  recreational drugs by injecting or placing the substance or
  drug under the skin. It can include subcutaneous
  placement or intradermal placement
 The result of “skin popping”
 Multiple injection site
     Causes Methanol intoxication
 Accidental overdose can be seen in children.
 Alcoholic persons commonly consume methanol as a substitute for
 In the industrial setting, inhalation of methanol fumes is a risk.
 Rape : is unlawful sexual intercourse by a man with a
 woman, by force and against her will.

   -victim of rape and strangulation.
   -bleeding from perineum and
   soling of skin
Injury due to Heat , Cold
      and Electricity
    Heat injury(Hyperthermia)
   Dry heat (like fire burns)
   Wet heat “Scalding” (such as steam or hot liquids)
     Causes of death in burns and
1.    Heat cramps (caused by loss of salt from heavy sweating)
2.    Heat exhaustion (caused by dehydration)
3.    Heatstroke ( brain damage).
4.    Brain damage (petechial haemorrhage).
5.    Organs Failure.
6.    Death.
       Burn Degrees
1.   1st -degree (superficial) burns are the
     most shallow. They affect only the top
     layer of skin (epidermis). 45 C

2.   2nd –degree ( partial-thickness) burns
     affect both epidermis and (dermis).
     They cause blistering .50-60 C
 3.     3rd -degree (full-thickness)
        burns involve all three layers
        of skin (epidermis, dermis, and
        fat layer), usually destroying
        the sweat glands, hair follicles,
        and nerve endings as well.
      They cause white or blackened,
        charred skin that may be. . 65 c

4.      4th -degree burns extend into deeper
        than the skin. They involved muscles,
        and bones .
      They cause Charred cadaver. >70 C
 -The burned skin seen
 here over the trunk and
 head of a child,
 occurred from a fire.

-severe scalding injury with
exposure to hot water.
Cold injury(Hypothermia)
-When core body temperature falls below 35 C.
Cardiac shock and arrhythmia follows.

-Death most likely occur at body temperatures be low

-Most common in: alcoholics , infants , old age.
-Light red or pink color
-Erythematous patches on the skin of trunk and
   The color of erythematic reddish-blue (due to
    occlusion of vessels by RBC).
Electrical injury
 Factors affecting the occurrence of electrical injury:
1. Type of current , AC or DC ( AC more dangerous).
2. Strength ( voltage)
3. Path of current , if it pass brain or heart.
4. Duration of contact , longer lead to more damage.
5. Contact surface area , Larger is worse.
 Causes of death from electrical injury:

 Ventricular fibrillation (most common) and Respiratory
-Electrical marker from mains wire
wrapped around the neck
-marked: pallor, blistering

-Extensive electrical burns with
scorching and blistering
Types Wounds
1. Kinetic injuries
 Blunt force injuries: Abrasions, bruises, Laceration.
 Sharp force injuries: incised wound, puncture wounds.

2.Non-kinetic injuries
 Thermal: heat or cold.
 Chemical.
 Electrical: high or low voltage.
 Electromagnetic.
Abrasions, bruises wounds
Abrasions :
 The superficial of wounds
  caused by blunt trauma.

bruises :
 leakage of blood from
  ruptured vessels (arterioles
  and veins) into surrounding
  tissues (skin, muscle, any
  internal organ).
   Laceration, incised wounds
 Laceration: full thickness
  tearing of skin (or other tissues)
 and crushing of tissues by blunt
  force trauma as moving object
  or fall
 Typically over bony prominence
  (scalp, eyebrow cheek ,shin).

 incised wounds(cut , slash)
 clean division of full thickness
  of skin or other tissue under
  pressure of a
 sharp edged instrument .
  Puncture, avulsions wound
 Punctures:
  - are caused by an object
  piercing the skin.
 Avulsions
  -involve the forcible
  separation or tearing of
  tissue from the victim’s
  body. commonly caused
  by animal bites and
  accidents involving motor
  vehicle, heavy machinery,
  guns and explosives.
  Violent Asphyxia Deaths
1- Hanging
It is Asphyxial death caused by
   suspension of the body by a ligature
   around the neck,
the constricting force being the weight
   of the body.
2- Ligature strangulation
A violent Asphyxial death caused by
   constricting the neck by a ligature.
3-Manual strangulation (Throttling)        Suicidal hanging ,with mark
                                          rising to suspension point at
Violent asphyxia caused by constricting
   the neck by the hand.                                 front of neck

      Suicidal hanging
4- Smothering:
A violent asphyxia caused by mechanical
   occlusion of the air passages from
(i.e. the mouth and nostril) by hand or by
   any object.
5- Choking
Violent asphyxia caused by mechanical
   occlusion of the air passage from inside .
   . Fumes, food

6- Traumatic asphyxia (Crush asphyxia)
A violent asphyxia resulting from trauma to
  the chest or pressure on the chest and
  abdomen which prevent respiratory
  movements. The congestion and
  petechial hemorrhages
           Name                  Underlying cause of death
         Suffocation            lack of oxygen in the inspired air
   Suffocation/smothering       blockage of the external orifices
      Gagging/Choking             blockage of internal airways
   Strangulation/hanging        blockage of the internal airways
                                     by external pressure

    Traumatic asphyxia          Restriction of chest movement

  For example co poisoning      Failure of oxygen transportation

For example cyanide poisoning     Failure of oxygen utilization
 Signs of asphyxia
A) Congestion of the face:
- Due to venous congestion (venous return to the heart is prevented)
B)Facial edema:
- Increased venous pressure causes tissue fluid transudation.
C) Cyanosis:
- Excess de-oxygenated hemoglobin in the venous blood
D) Petechial hemorrhages in the skin and eyes:
- Due to raised venous pressure
Sequence of physical Signs of
1-incresed efforts to breathe, facial congestion and the onset of cyanosis.
2-deep,or attempts to respiration with heaving chest , deep congestion and
   cyanosis, the appearance of petechiae if venous return is impaired.
3-loss of consciousness and possible convulsions, evacuation of bladder and
4-reduction in the depth and frequency of respiration, irreversible brain
   damage begins , the pupils dilated and death ensues.
-It is a form of violent asphyxia in which death
    results from submersion of mouth and
    nostrils of a living person under water.

 Wet : due to obstruction of air passages and
  lung by inhaled water .
 Dry : sever laryngeal spasm, no water in
   lung , in 10 to 15% of cases.
-Physiopathological changes:                       profuse- blood-tinged froth
-In fresh water hypervolemia hypoxia and           around mouth and nose
   potassium excess.
-In salt water pulmonary edema hypovolemia
   and circulatory shock.
Washerwomen(wrinkled) . Changes in foot
of body that had been in water for several

   Hand from body recovered from
   shallow river . showing trauma
     ‫دساسه قبم بهب الذكخىس صبلح الشهيح، أسخبر علن االجخوبع بجبهعت الولك سعىد‬
                             ‫على األفشاد الزيي حبولىا االًخحبس‬
                                                             ‫662 حبلت اًخحبس في السعىديت‬    ‫‪‬‬
                                                  ‫الزكىس أكزش جشأة على االًخحبس هي اإلًبد‬   ‫‪‬‬
‫اسحفبع هحبوالث االًخحبس الخي ال حٌخهي بىفبة هي أكزش عٌذ السعىديبث حيذ حصل إلى أكزش هي 4‬     ‫‪‬‬
                                                                        ‫أضعبف عي الزكىس‬
                                                  ‫97 في الوبئت هٌهن هي العبطليي عي العول‬    ‫‪‬‬
                           ‫23 في الوبئت هٌهن يٌخوىى للفئت العوشيت هي 02 إلى أقل هي 42 سٌت‬   ‫‪‬‬
                                   ‫22 في الوبئت هٌهن حبلغ أعوبسهن هب بيي 42 سٌت و92 سٌت‬     ‫‪‬‬
         ‫العزاة 55 في الوبئت، وًسبت الوخزوجيي 33 في الوبئت، و ًسبت الوٌفصليي 7 في الوبئت‬    ‫‪‬‬
                                 ‫(75 في الوبئت) هي الحبصليي على هؤهالث هخىسطت وربًىيت‬       ‫‪‬‬
           ‫94 في الوبئت هي الوبحىريي كبًىا يخعشضىى لسىء الوعبهلت هي الىالذيي وبصفت دائوت‬    ‫‪‬‬
             ‫5 -51% هي هشضى االضطشاببث الٌفسيت خبصت االكخئبة يقذهىى على االًخحبس .‬          ‫‪‬‬
                                                                ‫7 -51%هي هذهٌي الخوىس.‬      ‫‪‬‬
  ‫‪ ‬سجلج هٌطقت الشيبض أعلى ًسبت في حىادد االًخحبس بيٌوب كبًج هٌطقت‬
                                                       ‫القشيبث هي أقل‬
  ‫‪ ‬بلغ عذد حبالث الىفيبث الٌبجوت عي االًخحبس بيي السعىدييي 001 حبلت،‬
   ‫بوب يعبدل6.73 في الوبئت، كبى هٌهب 28 ركشا و81 أًزى، بيٌوب بلغ عذد‬
  ‫حبالث الىفيبث الٌبجوت هي االًخحبس لغيش السعىدييي 061 حبلت، وهى هب‬
‫يعبدل 2.06 في الوبئت، كبى هٌهب 421 ركشا و63 أًزى، في حيي بلغ عذد‬
                         ‫الوٌخحشيي هجهىلي الهىيت 6 حبالث هي الزكىس.‬
‫الجسر المعلق في الرياض‬
 Definition of un-natural causes of death
 Firearm and explosive injuries
 Drug abuse and poising
 Unnatural sexual offences
 Injury due to heat , cold
    and electricity
   Wound injures
   Asphyxia
   Drowning
   Statistical data
 Simpson's forensic medicine (Book)
 Web sites
 Forensic medicine by prof. Aiman Zaher (Lecture)
Thank you