Asphyxia which means "Pulselessness" and is cause due to absence of oxygen amount in a body. The death cause by asphyxia is known as asphyxial deaths. They are Hanging, Strangulation, Suffocation and Drowning.

1. Submitted To- Dr. Neelkamal Sharma
Submitted By- Nitesh
Roll.No- 1323

2. Stages involved in Asphyxial death
Sign and causes of Asphyxia
Types of Asphyxial deaths with details
CONTENTS
Asphyxial deaths

3. Important Terms
• Hypoxia of the tissue :-Decrease of oxygen supply to the tissues.
• Hypercapnea:- where there is an increase in carbon dioxide retention in the blood and tissues.
• Anoxia:-When there is in absence of oxygen to tissue although adequate blood flow.
• Anoxic Anoxia: Oxygen from atmosphere cannot get entry into blood, e.g., Hanging,
Strangulation, Smothering, Choking, Traumatic asphyxia etc.
• Anaemic Anoxia: It indicates reduced oxygen carrying capacity of blood. Here there is oxygenation
of blood in the lungs but blood has reduced capacity to transfer the oxygen to tissues.
• Stagnant Anoxia:-slowing down of circulation with impaired oxygen delivery to tissues.
• Histotoxic Anoxia: Oxygen although freely available in the bloodstream—cannot be utilized by the
tissues.

4. Asphyxia
• Asphyxia is derived from Greek word and literally means pulselessness.
• “a state in living organism in which there is acute lack of oxygen
available for cell metabolism associated with inability of body to
eliminate excess of carbon dioxide.”
• Asphyxia is considered as a state in which these two elements are
combined and includes:-
• Hypoxia
• Hypercapnea
•

5. Cycle Of Asphyxia

7. Mechanical
asphyxia
Traumatic
asphyxia
Environmental
asphyxia
Toxic
asphyxia
Pathological
asphyxia

8. Stage of
convulsion
Stage of
exhausti
on
Stage of
dyspnea
-Retention of carbon dioxide
– Increase blood lactate
– Respiration becomes labored and
spasmodic
– Complete insensibility,
– Flaccidity of muscle
– Reflexes are lost
– Pupils are widely dilated
– Breathlessness,
– Feeling of oppression
in the chest
– Heaviness in head,

9. Signs Of Asphyxial Deaths
• Pulmonary edema
• Fluidity of blood
• Dilatation of right chamber of heart
• Cyanosis
• Petechial Hemorrhages (Tardieu’s Spots*)

10. Types Of Asphyxial Deaths

13. Hanging
• Hanging is a form of violent death
produced by suspending the body with a
ligature round the neck, the constricting
force being the weight of the body or a
part of body weight.

14. Types Of Hanging

15. Typical & Atypical Hanging

16. Complete & Incomplete Hanging
The constricting force here is
the entire weight of body.
Constricting force is the part
of body weight.
Complete Hanging
Incomplete Hanging

17. Delayed
causes
Cause Of Hanging
1) Asphyxia: Obstruction of air way.
2) Venous congestion: Obstruction of
jugular venous system.
3) Cerebral anemia: Compression of
carotid arteries causing cerebral
ischemia.
4) Vagal inhibition: Vagus nerve or
carotid bodies when compressed
may cause vagal inhibition with
cessation of heart.
5) Combination of asphyxia and
venous congestion.
1) Aspiration
pneumonia.
2) Infection and
septicemia.
3) Pulmonary edema.
4) Hypoxic
encephalopathy.
5) Laryngeal edema.
6) Abscess of
brain/encephalitis.

18. Ligature Material
It may be rope, metallic chains, wire, electric
cord, packing twice,8 cable, belt, bed-sheet,
sari, scarf, oodhani, dupatta, trouser, dhoti etc.
The noose may be:
1) Fixed noose
2) Running noose.
Knots are of following types :
1) Simple slip knot- most commonly used
2) Fixed knot/granny knot

19. External Examination:
In case of fixed knot, the ligature mark is produced as inverted “V” shaped impression with
apex of V corresponding with the site of knot.
In case of slip knot, the noose may tighten around the neck producing mark over neck except
at knot.

21. Internal Examination

23. STRANGULATION
• Strangulation is a form of violent asphyxial death caused by constricting the neck by
means of ligature or by any other means without suspending the body

24. Types Of Strangulation
Depending on manner of
death
on the basis of means used
to constrict the neck
1. Ligature strangulation(Garroting)
2. Manual strangulation or throttling
3. Mugging
4. Bansdola
5.Palmar strangulation
1. Homicidal strangulation
2. Accidental strangulation

25. On the basis of means used to constrict the neck
Bansdola
Ligature strangulation
Mugging

27. External Examination

28. Internal Examination

29. SUFFOCATION
Suffocation is a type of mechanical
asphyxia caused-
• Either due to lack of oxygen in the
environment or
• By mechanical obstruction to the air
passage by means other than
constriction of neck and drowning.

30. Types
1
2
3
04
Smothering
Choking
Overlying
Traumatic
asphyxia
5
6
7
Gagging
Burking
Inhalation of irrespirable
gases

31. Smothering
Overlay
Gugging

32. Burking
Choking

33. Inhalation of irrespirable
gases

34. DROWNING
• Drowning is a form of asphyxial death
where air entry into lungs is
prevented due to submersion of
mouth and nostrils into water or any
fluid medium.

35. Mechanism of
drowning

36. Cause Of Death
Exhaustion
Hypothermia
Inability to
utilize the
buoyancy of
body
Entrapment in
whirlpool/tidal
waves.

37. Types of Drowning
• Dry drowning
• Wet drowning
-Fresh water
-Salt water
• Shallow water drowning
• Immersion syndrome
• Secondary drowning
This is a classical form of drowning either in fresh
water or salt water. Here water is inhaled and
swallowed and lungs get water lodged.

39. Mechanism of death in dry drowning
No or little water is inhaled in respiratory tract.
Death occurs from asphyxia caused due to
laryngeal spasm. In such cases, death is more or
less instantaneous with lung fields are left dry.

40. Causes of Death
Vagal inhibition
Asphyxia
Ventricular fibrillation
Myocardial anoxia Laryngeal spasm
Exhaustion
Apoplexy.
Concussion/head injury

41. External examination
• Clothes are wet
• cutis anserina i.e. appearance of
gooseflesh or goose skin.
• Washerwoman’s hand
• Cadaveric spasm

43. Internal Examination
Changes in lungs
Respiratory passage shows whitish, fine froth and may
show sand, mud, silt, grit, vegetations etc.
Edema aquosum: This condition develops when person is
passively immersed with no violent effort of respiration
in water or when person is unconscious.
Stomach and proximal intestine may contain
swallowed water or in addition may show sand, mud,
grit, silt etc
Diatom Test

45. Diatoms
Diatoms are unicellular algae found
whenever there is water and
sufficient sunlight for photosynthesis
Diatoms belong to a class of plants
known as Diatomaceae
Diatoms are classified as:
– Oligohalophilic diatoms: living in fresh
water
– Mesohalophilic diatoms: live in sea or
brackish water
– Polyhalophilic diatoms: live in sea or
brackish water.

46. Principle of Diatom Test
• The diatom test is based on principle that when a living person is drowned in water
containing diatoms, many diatoms will penetrate the alveolar wall and be carried to
distant organs such as brain, kidney, liver, bone marrow etc.
Procedure of Diatoms Demonstration
• 2 to 5 gm of tissue or bone marrow is taken in a flask and concentrated nitric acid is
added.
• The preparation is heated for 15 to 20 minutes. This yields a transparent yellow fluid.
• The fluid is centrifuged and the centrifuged deposit is examined by placing a cover slip.

47. Question may be raised whether drowning is antemortem
or postmortem??

50. References
Books Sources:-
• Forensic Medicine and Toxicology by Krishen Vij.
• Review of Forensic Medicine by Sumit Seth.
• Principles of Forensic Medicine by Rajesh Bardale.
Internet sources:-
• CrimeLab.com
• Wekipedia