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Forensic Medicine
Dr. Suchita Rawat (MSc, MPhil, PhD)
Unit 3: Injuries and its Characteristics
Injuries: legal and medical definition; Mechanical Injuries: abrasions, bruises,
lacerations, incisions, stab wounds; Firearm injuries; Self-inflicted and defence
injuries, Fabricated injuries. Thermal injuries: Burn and scalds; Electrical injuries;
Aging of injuries; Ante-mortem versus post-mortem injuries.
THERMAL INJURIES
Thermal injuries (dry heat/ moist heat)
Source: Aggrawal, A. (2016).
 Cause: Flame or hot surface vs. hot liquid or
steam
 Site of injury
 Edges (absent vs. present sharply defined
edges)
 Splashing and trickling (absent vs. present)
 Color (black vs. blanched)
 Charing and singeing (present vs. absent)
 Clothes (burnt vs. wet not burnt)
 Scene of crime (ignition accelerants vs. hot
liquids)
1st degree (Erythema
or reddening of skin)
2nd degree
(Blisters/Singeing of
hair/
3rd degree (Epithelium
destroyed/upper
layers of dermis
initiates/Pain fibers
exposed. Most painful
burns
4th degree (Whole
dermis is
destroyed/burns are
painless because pain
fibers are destroyed)
5th degree (Muscles
are destroyed/Burns
are painless due to
destruction of nerve
fibers)
6th degree (Burns
reach up to bone
level/Burns
painless/complete
charring)
Thermal Injuries BURNS
● CLASSIFICATION OF BURNS (Pathological
Classification)
Source: Aggrawal, A. (2016).
Source: Aggrawal, A. (2016).
EFFECTS OF BURNS
● Surface Area
● Degree of heat
● The Duration of Exposure
● Age ie. Children
● sexi.e. women
● site of burn i.e. neck, face,
trunk and anterior abdominal
wall
Rule of Nine:1951 by Dr. A.B. Wallace, a Scottish surgeon
Source: Aggrawal, A. (2016).
● Post Mortem Changes (Clothes/ Facial Features
Crow’s feet/Pugilistic attitude)
forehead, in the angles of
the eyes, and in naso-oral
folds
Neck: pseudoligature
mark
● Post Mortem Changes (Pugilistic attitude)
Source: Aggrawal, A. (2016).
Source: Aggrawal, A. (2016).
Source: Aggrawal, A. (2016).
References
● Aggrawal, A. (2016). Forensic Medicine and Toxicology for MBBS. Avichal
Publication Company, 325.
ELECTRICAL INJURIES
Nature of Current (AC v DC)
Path of current
In low voltage currents organ at lower level is involved [heart]
In high voltage currents organ at higher level is involved
[Respiratory Centre]
PM FINDINGS
Electric entry mark characterizsed by a) Joule burn (endogenous burn)
low voltage: British physicist James Joule (1818 – 1889)
Crater [most
common] (i)
Round or oval
shallow crater (ii)
1-3 cm in
diameter (iii) has
a ridge of skin
about 1 mm
Metallization: (A)
Aluminum – silvery
(B) Copper –
Reddish brown (C)
Iron – Brownish
black.
PM FINDINGS
Crocodile skin: (i) High voltage currents produce extremely high temperatures
(upto 4000°C).
Causes keratin of the skin to melt over multiple small areas. On cooling, molten
keratin over these areas fuses into multiple hard brownish nodules [as resolidified
wax]
PM FINDINGS
Electric exit mark (1) Site - This mark appears where the body was
earthed or ‘grounded’ (2) More damage of tissues than at entry
marks
LIGHTNING
Lightning is an atmospheric discharge of electricity accompanied by thunder, which
typically occurs during thunderstorms, and sometimes during volcanic eruptions or
dust storms. 8 million times/day
Endogenous burns
Small, circular, full-thickness burns involving the sides of the soles of the
feet and the tips of the toes. This is the exit mark of lightning.
Arborescent burns [, feathering, ferning, filigree burns,
Lichtenberg’s flowers lightning marks].
irregular, superficial, thin,
tortuous markings on this
skin resembling fern or tree
20% - 33% cases
* Exogenous burns
Surface burns – 2-3
degree
Deaths Due to Cold
Hypothermia is a condition in which core (rectal)
temperature drops below 35.0 °C (95.0 °F).
FIREARM WOUNDS
● Salient features((1) Types/Confusing
appearances/Wounding from Firearms
i.e. Effects of distance on Firearm
wounds/
Source: Aggrawal, A. (2016).
Source: Aggrawal, A. (2016).
HARD VS. LOOSE CONTACT
ANGLED CONTACT VS.
INCOMPLETE CONTACT
In contact wounds of head –
following features are seen: (i)
Krönlein shot [syn,
Krönleinschuss]- (a) In contact
wounds, occasionally a large exit
wound is produced, and the gases
entering through the wound cause
the expulsion of entire brain out
of the skull
Puppe’s rule Puppe’s rule is used to determine
sequence of shots when more than one shot have
been fired at the cranium. First enunciated by Georg
Puppe (1867-1925) of Germany
Sequence of bullets/ difference between exit and entry wound
 size
 Edges
 burning,
blackening/tattooing/gr
ease, abrasion or
contusion collar
 Bleeding
 wound track colour
 radiological or
microchemical
 examination of wound
skull)
Difference between
Suicidal/Accidental/Homicidal Firearms wound
*site of entrance/distance/direction/number of wounds/hands
of victim/ caderveric spasm/hesitation shots/weapon
Source: Aggrawal, A. (2016).
This Photo by Unknown Author is licensed under CC BY-SA

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MSC IV_Forensic medicine - Thermal and firearm injuries.pdf

  • 1. Forensic Medicine Dr. Suchita Rawat (MSc, MPhil, PhD)
  • 2. Unit 3: Injuries and its Characteristics Injuries: legal and medical definition; Mechanical Injuries: abrasions, bruises, lacerations, incisions, stab wounds; Firearm injuries; Self-inflicted and defence injuries, Fabricated injuries. Thermal injuries: Burn and scalds; Electrical injuries; Aging of injuries; Ante-mortem versus post-mortem injuries.
  • 4.
  • 5. Thermal injuries (dry heat/ moist heat) Source: Aggrawal, A. (2016).  Cause: Flame or hot surface vs. hot liquid or steam  Site of injury  Edges (absent vs. present sharply defined edges)  Splashing and trickling (absent vs. present)  Color (black vs. blanched)  Charing and singeing (present vs. absent)  Clothes (burnt vs. wet not burnt)  Scene of crime (ignition accelerants vs. hot liquids)
  • 6. 1st degree (Erythema or reddening of skin) 2nd degree (Blisters/Singeing of hair/ 3rd degree (Epithelium destroyed/upper layers of dermis initiates/Pain fibers exposed. Most painful burns 4th degree (Whole dermis is destroyed/burns are painless because pain fibers are destroyed) 5th degree (Muscles are destroyed/Burns are painless due to destruction of nerve fibers) 6th degree (Burns reach up to bone level/Burns painless/complete charring)
  • 7. Thermal Injuries BURNS ● CLASSIFICATION OF BURNS (Pathological Classification) Source: Aggrawal, A. (2016). Source: Aggrawal, A. (2016).
  • 8. EFFECTS OF BURNS ● Surface Area ● Degree of heat ● The Duration of Exposure ● Age ie. Children ● sexi.e. women ● site of burn i.e. neck, face, trunk and anterior abdominal wall
  • 9. Rule of Nine:1951 by Dr. A.B. Wallace, a Scottish surgeon Source: Aggrawal, A. (2016).
  • 10. ● Post Mortem Changes (Clothes/ Facial Features Crow’s feet/Pugilistic attitude) forehead, in the angles of the eyes, and in naso-oral folds Neck: pseudoligature mark
  • 11. ● Post Mortem Changes (Pugilistic attitude) Source: Aggrawal, A. (2016).
  • 13.
  • 15. References ● Aggrawal, A. (2016). Forensic Medicine and Toxicology for MBBS. Avichal Publication Company, 325.
  • 16. ELECTRICAL INJURIES Nature of Current (AC v DC)
  • 17. Path of current In low voltage currents organ at lower level is involved [heart] In high voltage currents organ at higher level is involved [Respiratory Centre]
  • 18. PM FINDINGS Electric entry mark characterizsed by a) Joule burn (endogenous burn) low voltage: British physicist James Joule (1818 – 1889) Crater [most common] (i) Round or oval shallow crater (ii) 1-3 cm in diameter (iii) has a ridge of skin about 1 mm Metallization: (A) Aluminum – silvery (B) Copper – Reddish brown (C) Iron – Brownish black.
  • 19. PM FINDINGS Crocodile skin: (i) High voltage currents produce extremely high temperatures (upto 4000°C). Causes keratin of the skin to melt over multiple small areas. On cooling, molten keratin over these areas fuses into multiple hard brownish nodules [as resolidified wax]
  • 20. PM FINDINGS Electric exit mark (1) Site - This mark appears where the body was earthed or ‘grounded’ (2) More damage of tissues than at entry marks
  • 21. LIGHTNING Lightning is an atmospheric discharge of electricity accompanied by thunder, which typically occurs during thunderstorms, and sometimes during volcanic eruptions or dust storms. 8 million times/day Endogenous burns
  • 22. Small, circular, full-thickness burns involving the sides of the soles of the feet and the tips of the toes. This is the exit mark of lightning.
  • 23. Arborescent burns [, feathering, ferning, filigree burns, Lichtenberg’s flowers lightning marks]. irregular, superficial, thin, tortuous markings on this skin resembling fern or tree 20% - 33% cases * Exogenous burns Surface burns – 2-3 degree
  • 24. Deaths Due to Cold Hypothermia is a condition in which core (rectal) temperature drops below 35.0 °C (95.0 °F).
  • 25.
  • 26.
  • 27. FIREARM WOUNDS ● Salient features((1) Types/Confusing appearances/Wounding from Firearms i.e. Effects of distance on Firearm wounds/ Source: Aggrawal, A. (2016). Source: Aggrawal, A. (2016).
  • 28.
  • 29.
  • 30.
  • 31. HARD VS. LOOSE CONTACT
  • 33.
  • 34.
  • 35. In contact wounds of head – following features are seen: (i) Krönlein shot [syn, Krönleinschuss]- (a) In contact wounds, occasionally a large exit wound is produced, and the gases entering through the wound cause the expulsion of entire brain out of the skull
  • 36.
  • 37. Puppe’s rule Puppe’s rule is used to determine sequence of shots when more than one shot have been fired at the cranium. First enunciated by Georg Puppe (1867-1925) of Germany
  • 38. Sequence of bullets/ difference between exit and entry wound  size  Edges  burning, blackening/tattooing/gr ease, abrasion or contusion collar  Bleeding  wound track colour  radiological or microchemical  examination of wound skull)
  • 39.
  • 40. Difference between Suicidal/Accidental/Homicidal Firearms wound *site of entrance/distance/direction/number of wounds/hands of victim/ caderveric spasm/hesitation shots/weapon Source: Aggrawal, A. (2016).
  • 41.
  • 42.
  • 43. This Photo by Unknown Author is licensed under CC BY-SA