Mechanic Asphyxia for General Practice Doctors

1. Theme of the lecture: “Mechanic asphyxia" Prof.Giyasov Z.A.

2. The purpose of the lecture: Familiarize with the various aspects of cases of mechanical asphyxia, necessary for general practice doctors.

3. plan of the lecture:

4. Forensic medical classification mechanical asphyxia -loop - hands - Other items - positional Compression of the neck - strangulation I. asphyxia from compression Compression of the chest , abdomen closing of the respiratory holes II. asphyxia from closing closing of the respiratory tract drowning aspiration III. Asphyxia in the closed space

5. During mechanical asphyxia I. Preasphyxic stage II. Asphyxic stage А) Stage inspiratory dyspnea B) Stage expiratory dyspnea C)Stage short stop breathing D) Stage of terminal respiration E)The final stop breathing F) cardiac arrest

6. Lifetime effects of mechanical asphyxia The main phases: • 1) Phase Preasphyxic •   O2 deficit •   The accumulation of CO2 •   irritation of the central nervous system •    (medulla oblongata) • 2)Dyspnea with convulsions • lengthening of respiratory rhythm •   slow heartbeat •   increase in blood pressure •   loss of consciousness • convulsions • 3) peace • absence of reflexes • Absence of breathing •   drop in blood pressure •   complete prostration 4)terminal breath inspiratory dyspnea 5) Persistent absence of breath with followed by cardiac arrest

7. During postasphyxic state (by R.A.Yakupov (1986) with changes) Stage areflexia, muscle atonia, rapid inhibition of stem   functions I. period asphyxial coma Stage detserebraly rigidity pyramidal hypertension and tonic seizures Stage tonic-clonic seizures and other hyperkinesis II. period stun affective-subcortical psychomotor agitation stage sopor stage deep stun III. The period of disorientation and memory disorders stage easy stun stage of sleepiness IV. Period of consequency

8. General asphyxic signs a) External: • cyanosis of the face • mydriasis • subconjuctive ecchymosis • rapid emergence and abundance of cadaver spots • involuntary urination, ejaculation, and defecation.

9. b) internal: Venous hyperemia of the internal organs and the brain Partial emphysema of lungs Liquid, dark blood Bleeding under the visceral pleura and epicardium. Asphyxic heart Anemic, reduced spleen

10. Different body positions by hanging

11. Typical and atypical hanging

12. semisitting position hanging with the typical fixed location single-loop Body position on Knee when hanging with typical arrangement moving single loop

13. Hanging in the supine position on the back. Double slide moving loop front Hanging in the position Lying to face in the fixed rope loop

14. atypical hanging a child in the cradle

15. Crushing the front and side of the neck to the back of the chair (a, b). Death by asphyxia

16. classification of loops loop subdivision by Device On the material from which made Sliding hard fixed Semi-hard Wire, electrical wire, wooden sticks, back chair, a fork of the tree soft Rope, cord, strap, fabric cloth By the presence of host Without knot Towel, scarf, linen With knot

17. classification of loops loop subdivision According to the number of revolutions in thickness single thin double thick triple multiple

18. types of loops

19. Strangulation furrow at different types of loops

20. Technique of removal of a loop

21. Properties of a strangullation furrow Strangulation furrow Position typical lateral atypical forward the slanting Direction slantupperdirection (slantdowndirection) horizontal single On number of elements double three multiple Number of rollers infringements of skin between elements one two three four Closure closed faltering not closed continuous

22. Uniform on everything extent Breadth narrow the wide unequal Depth deep superficial weakvisible With a print loop structures equal Relief irregular twisting Without a print Consistence soft homogeneous dense non-uniform yellow Colour Yellow-brown brown

23. Typical and atypical arrangement of loops at hanging

24. Various arrangements knots of loops at hanging

25. Prints in the strangulation furrow to drawing fabric relief loops (а,б,в)

26. Prints in a strangullation furrow of drawing material of a loop (rope) a - the front view

27. Reflection in a strangullation furrow of drawing material of a loop (rope) б - the left-side view

28. Strangulation furrow from a belt (a)

29. Double strangulation furrow (б)

30. Elements of a strangulation furrow а –edge; б – wall; в – bottom; г – roller; д – infringementof skin between two furrows with hemorrh

31. Types of a strangulation furrow (scheme) а –single; б – double with elements far located from each other; в – double with multiple elements close located from each other; г – multiple; д – single at two turns of a loop.

32. Hemorrhages in neck muscles, glands and gaps carotid intims

33. Test of N.S.Bocarius

34. Positional asphyxia

35. Drowning types 1. true 2. asphyctical 3. mixed

36. Signs of true and asphyctic drowning

37. continue

38. continue

39. The resistant fine bubbly foam of the white colors around holes of mouth and nose (а, б, в, г) the most frequent sign of drownings in water

40. The scheme of penetration of a plankton in internal at drowning

41. Maceration of skin Hands (а, б, в) "death gloves"

42. В. "Death gloves" A.Being in water. Maceration of brush skin..

43. Terms of a maceration of skin depending on long stay in water, water temperature and age of the victim (by S.P.Didkovskaya)

44. continue

45. Asphyxia in the closed space

46. Asphyxia in the closed space

47. Asphyxia in the closed space

48. Asphyxia in the closed space

49. Asphyxia in the closed space

50. Investigatory experiment