Thermal injuries

• Fire

  • Thermal artifacts that make it hard to tell a cause of death

    • Bone fractures (skull fractures from heat will be radial)

    • Epidural hemorrhages (not subdural)

    • Skin splitting

    • Abdominal wall defects

    • Heat-induced muscle contraction

  • To tell if they were alive in the fire, look for

    • Hb-CO

    • Soot in the airway

  • Depth of tissue destruction

    • 1^st degree: burned area is red, swollen, and painful

    • 2^nd degree: typically see blistering, scarring may occur

    • 3^rd degree: entire thickness of skin is destroyed, scarring is usual

    • 4^th degree: complete destruction of skin and underlying tissues

  • Rule of nines to determine amount of body burnt

    • Head = 9%

    • Each arm = 9%

    • Each leg = 18%

    • Chest and abdomen together = 18%

    • Back = 18%

• People with exercise-induced heat stroke may have moist skin

• Cold injuries

  • Immersion foot with temps > 0C

  • Frost bite with temps < face="Symbol, serif">C

  • Hypothermia

    • Core body temp < face="Symbol, serif">C

    • Autopsy findings in hypothermic death

      • Pink to cherry-red color of skin (livor mortis)

      • Blue coloration of hands and feet

      • Organ congestion

      • Gastric erosions

      • Pancreatitis

• Immersion burns

  • Sharp demarcations between injured and normal areas

  • May have islands of spared skin in burnt areas

Category: Forensic Medicine Notes , Medical Subject Notes