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02-22-2014, 02:27 PM
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A Few Common/Environmental Accidents
DRUGS The kit of an intravenous drug user. A key part of forensic pathology is scene investigation. The appearance of the scene of injury or death can help explain how the injuries occurred or provide evidence for prosecution of criminals The bags of cocaine seen here in the stomach were swallowed by the victim as a form of concealment. This method is commonly used by people smuggling drugs. A latex condom is typically used as a container. Occasionally, the container ruptures or leaks, and a drug overdose ensues, as happened here Trauma can be produced in a variety of ways. Here is the hand of a person with a cocaine intoxication who entered a state of "excited delirium" and began breaking doors and windows, leading to the appearance of the lacerations and blood on the fingers The subcutaneous hemorrhage at the elbow, revealed by multiple incisions made at the time of autopsy, is evidence that this was an injection site for drugs The white circular and irregular scars are from "skin popping" or subcutaneous injection of drugs. Complications include abscess formation, skin necrosis, and possible pneumothorax if an injection site over the thorax is used ENVIRONMENT There are few grossly visible features of drowning. A frothy fluid may exude from mouth and nose. Prolonged immersion may produce skin wrinkling. Seen here are bilateral temporal bone hemorrhages that may occur in association with drowning. Drowning is defined as respiratory impairment from submersion in a liquid medium. This may range from submersion of the entire body to just submersion of the pharynx Drowning may not produce extensive findings. In fact, in 10 to 15% of cases, intense laryngospasm may even prevent water from entering the lungs. In the case shown here, a child drowned in a fresh water canal, and some of the plant material in the water was aspirated into the bronchus Note the bright "cherry red" or bright pink lividity to the hand. Carbon monoxide (CO) poisoning is a form of asphyxia that results when CO is inhaled, diffuses across alveoli, and binds tightly to hemoglobin. Poorly ventilated houses with faulty heaters, housefires, and motor vehicle exhaust are the most common sources When core body temperature falls below 35 C (95 F), this is a condition known as hypothermia. Loss of body heat can occur in a variety of situations, including falling into the cold waters of Loch Ness shown here. Lack of clothing and shelter, even in temperate climates, can predispose to hypothermia. There are no specific gross or microscopic findings with this condition When the ambient temperature of the environment increases considerably, a condition known as hyperthermia can occur. A hot, dry location such as southern Utah, shown here, is an obvious place for hyperthermia, particularly if the person hiking in the illustration does not carry adequate water. However, an enclosed space such as an auto or a building can also present a risk, particularly for infants or aged persons. In a heat-related death, core body temperature is found to be at or above 40.6 C (105 F) BURNS Thermal burn injuries occur with a hot local environment. The burned skin seen here over the torso and head of a child occurred from a fire. The treatment and prognosis depend to a great extent upon the extent of the burn injury - the total body surface area (TBSA) involved. Other factors include age of the patient, underlying diseases, and the presence of an "inhalation injury" from breathing in hot gases, which typically occurs with fires in an enclosed space such as a building Thermal burn injuries can occur from hot objects or liquids. Seen here is an amputated hand that was rendered non-viable by a severe scalding injury with exposure to hot water This man accidentally grabbed a high voltage electrical line, producing the entrance wound injury as seen on the palm of the hand, with subsequent soft tissue damage and swelling extending to the forearm. The appearance is similar to a localized burn. On the back of the hand are the wounds produced as the current exited ALTITUDE This coronal section of the cerebrum shows marked compression of the ventricles and flattening from extensive edema (acclumination of fluid). Marked pulmonary edema (fluid in the lungs) may also occur. This young man was climbing a 5000 meter mountain peak and ignored the warning sign of a persistent, worsening headache along with dyspnea (sudden and severe shortness of breath, or difficulty in breathing). Affected persons must get to a lower altitude |