this is a short and informative presentation on asphyxia death which my teacher liked a lot. He appreciated me a lot. I hope whoever get this presentation find this very useful for your class. # ppt # asphyxia THANK YOU

1. SAUMYA GUPTA
SEMESTER- 11
GROUP- MD1803

2. It is a condition arising when the body is deprived of oxygen and literally
translates to pulselessness
• NON SPECIFIC SIGNS OF ASPHYXIA:-
• Asphyxia triad- cyanosis,
petechial hemorrhages,
congestion in viscera
• Asphyxia quintet- triad ,
postmortem fluidity of blood,
right ventricle enlargement

3. Sequence of events that may be seen in asphyxia:-
1. Dyspnea- increase in respiratory , heart rate, blood pressure.
2. Convulsive- loss of consciousness, facial congestion, altered HR, BP.
3.Pre-terminal respiratory phase- irregular respiration with altering apnea.
4.Terminal phase- respiratory arrest, hypotension, irregular HR, asystole,
pupil dilate and reflexes are lost.

4. TYPES OF ASPHYXIA
• HANGING: Neck compression due to bodyweight by a ligature that encircles
the neck.
• STANGULATION : Neck compression causing constriction of air passage with
no body suspension
• SUFFOCATION : No neck compression. Mechanical obstruction to passage of
air into respiratory tract, other than constriction of neck.

5. HANGING
• 2 types of classifications
CLASSIFICATION BASED ON POSITION OF KNOT :-
• CLASSIFICATION BASED ON SUSPENTION OF BODY
TYPICAL
HANGING
ATYPICAL
HANGING
COMPLETE PARTIAL

6. STRUCTURES WHICH CAUSES DEATH IN
HANGING:-
STUCTURES OCCLUSION AT RESULTS IN
Jugular vein 2kg Cerebral venous congestion
Carotid arteries 5kg Cerebral anemia
trachea 15kg asphyxia
vertebrae 30kg Cervical vertebrae fracture
MOST COMMON CAUSE OF DEATH IN HANGING IS : ASPHYXIA + CEREBRAL VENOUS CONGESTION

7. AUTOPSY FINDINGS
Findings are discussed under two heads: external and internal findings:-
EXTERNAL:-
• Findings on the face – facial congestion; pale , dribbling of saliva from mouth,
protrusion of tongue, la facie sympathique.
• Findings in the neck – ligature mark is visible and in 85% it is incomplete, oblique
and above thyroid.
• Findings in Other parts of the Body.

8. INTERNAL
1. Thyroid cartilage fracture
2. Hyoid bone fracture(15-20%)
3. Cervical vertebral and carotid artery injuries due to hanging with a
long drop.
HANGMAN’s fracture :
AMUSSAT sign: transverse intimal tears in carotid arteries.
SIMON’s hemorrhages: Stripe like hemorrhages in intervertebral
disc between the lumbar vertebra due to prolonged
stretching/suspension.

9. STRANGULATION
• LIGATURE STRANGULATION:-
Ligature mark usually is transverse, complete and below thyroid.
Face usually congested
Subconjunctival hemorrhage
Bruising or abrasion can be noted around ligatures marks due to relative
movement of ligature due to struggling.

10. Types of strangulation
1. Throttling( Manual strangulation)- It is almost always homicidal.
Strangulation caused due to compression by hands , finger nail
scratches visible on neck , six penny bruise can also be seen around
neck , extensive soft tissue contusion may be present in the neck
muscle and fracture of thyroid cartilage, and hyoid bone fracture is also
seen.
2. Palmar strangulation- One hand kept horizontally covering nostril
and mouth while the other is placed perpendicular to the first with
base of palm covering the neck.

11. .
3. Mugging- Neck compression is caused by bend of elbow/forearm.
CAROTID SLEEPER- If compression is caused using bend of
elbow only carotid artery are occluded, victim becomes unconscious.
CHOKE HOLD- If trachea is compressed by force of forearm ,
asphyxia occurs.
4. Garroting - Thin ligature cord/iron cuffs used from behind to compress
neck.
5. Bansdola- Bamboo stick use to constrict the neck.

12. SUFFOCATION
Types of suffocation
1.Smothering – Closure of mouth and nostril by hands or by any other
means.
ACCIDENTAL
Infant covered by heavy blanket .
Children playing with plastic bag over the
face.
Adult falls into pile of sand/mud.
HOMICIDAL
Intentionally closing mouth and nostril
with pillow /hands.
If hands used it leads to :
perioral injury,
lip contusion ,
tear or rupture of frenulum.

13. 2. Gagging -Thrusting of cloth/pad into mouth obstruction of
pharynx asphyxia.
3. Choking- In normal person sudden entry of foreign body like food
bolus into airway respiratory difficulties asphyxia.
4. Traumatic asphyxia -due to restriction on lung expansion as a result of
mechanical fixation of chest.
e.g:- Any heavy weight on chest-
stampede
burring alive
building collapse
Mechanism: Heavy weight on chest leads to obstruction of venous return
from head to chest.

14. Types of traumatic asphyxia
1. Positional asphyxia- restriction of lung expansion due to abnormal position
of the body like: jack knife position , inverted crucifixion.
2. Overlaying- Happens when a larger person shares a bed with a small baby.
Mechanism: smothering + traumatic asphyxia
3. Burking- accused sits on chest of victim and closes mouth/nostril.
Mechanism: smothering + traumatic asphyxia
4. Wedging: infant falls in the small gap between wall and bed; getting wedged
there.
5. Environmental : due to lack of oxygen in air. e.g: sewage tank