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Drowning and Burn Trauma
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Transcript of Drowning and Burn Trauma
7/24/2019 Drowning and Burn Trauma
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Dr.I.B.GD SURYA PUTRA P, SpF
DEPARTMENT OF FORENSIC MEDICINE, FACULTY OF
MEDICINE, GADJAH MADA UNIVERSITY
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CONTENT OF LECTUREDrowning
D!"ni#ion o$ %rowning &n% i''!r(ion
C&)(! &n% '!*+&ni(' o$ %!&#+
C+&r&*#!ri(#i*( &pp!&r!n*! &# &)#op(-L&or&#or- !/&'in&#ion
B)rn
D!"ni#ion o$ +!&# in0)r-, (*&1%, &n% %r- +!&#An#! 'or#!' 2( po(# 'or#!' )rn
App!&r!n*! &# &)#op(-
L&or&#or- !/&'in&#ion
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DEFINITION OFDRO3NING T+!r! &r!
DRO3NING 4 w&#!r !n#!ring #o #+! r!(pir&#or-
#r&*# or 1)ng(5,IMMERSION 4 #+! *orp(! &r! *o2!r!% $ro' w&#!r5
SUBMERSION 4T+! $&*! *on#&*# wi#+ #+! w&#!r5
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So i$ #+! %!&% o%- $o)n% o)# in #+! w&#!r, i#no# &1w&-( '!&n *&)(!% o$ %!&% - %rowning.
T+!r! &r! #wo prin*ip1!
Con#&*# wi#+ #+! w&#!r
In+&1!% w&#!r in#o #+! r!(pir&#or- #r&*#
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PHYSIOLOGY OFDRO3NING 3+!n p!op1! (in6, #+i( *on%i#ion wi11 '&6!
Br!&#+ +o1%ing
In2o1)n#&r- in(pir&#ion &n% g&(ping $or &ir &##+! r!&6ing poin#
Lo(( o$ *on(*io)(n!((
D!&#+
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THE CAUSE ANDMECHANISM OF DEAD THE CAUSE OF DEATH IS DRO3NING
THE MECHANISM ASPHY7IA 43ET DRO3NING5
LARYNGEAL SPASM 4DRY DRO3NING5
A VAGAL REFLE7 4DRY DRO3NING5
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AUTOPSY FINDING In E/#!rn&1 !/&'in&#ion
A 8washerwoman9 &pp!&r&n*! in #+! +&n%(&n% (o1!( 4Loo6 w+i#! &n% wrin61!%5
8Goose fesh9 4cutis anserina5
8Mushroom like9 &pp!&r&n*! in #+! no(#ri1(,'o)#+, &n% &irw&-( 4w+i#! $o&' or
+!'orr+&gi* :)i%5. So'! #i'!( w! $o)n% (ign( o$ &(p+-/i& &n%
C&%!2!ri* (p&('.
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In#!rn&1 !/&'in&#ion A w+i#! or +!'orr+&gi* $o&' i( $o)n% in #+!
#r&*+!& &n% ron*+i.
3&#!r '&- ! $o)n% in #+! (#o'&*+. T+!r! *o)1% ! %i1&#&#ion o$ #+! rig+#
2!n#ri*1!.
P)1'on&r- !%!'&
Br&in (w!11ingCong!(#ion
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How #o '&6! #+! %i&gno(i( o$
%rowning I# &(!% on
T+! *ir*)'(#&n*!( o$ %!&#+
A 2&ri!#- o$ &)#op(- "n%ing
Chemical test /Laboratory test
; Hi(#op&#+o1og-<To/i*o1og-
; Destruction test /Diatoms test
; T!(# o$ L)ng( J)i*!
; T+! G!##1!r *+1ori%! #!(#
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L&or&#or- #!(# D!(#r)*#ion #!(#<%i&#o'( #!(#
To i%!n#i$- %i&#o'( in #+! #i(()! o$ %rowning 2i*#i'.
Di&#o'( &r! 'i*ro(*opi* )ni*!1)1&r &1g&! 4(i=! >;>?? @'5
U(!% *1o(!% org&n (-#!' 4$!'or&1 on! 'or! or !n*&p()1&#!%
6i%n!- $ro' & non;%!*o'po(!% o%-5. T+! (&'p1! i( %ig!(#!% in *on(!n#r&#!% &*i%, #+!n !/&'in!% #+!
%!po(i# in (#&n%&r% 'i*ro(*op!.
To (!! w+&# #-p! o$ %i&#o'( in #+! w&#!r in w+i*+ #+! 2i*#i'%rown!%, &n% #+!n *o'p&ri(on.
T+! r!()1# n!g&#i2! i( no# '!&n, wi#+o)# %rowning
5
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T+! G!##1!r C+1ori%! T!(# To %!#!r'in! #+! 2i*#i' #+&# %!&% in $r!(+ or
(&1#w&#!r.
T+i( i( &n&1-(i( o$ 1oo% in #+! rig+# &n% 1!$#(i%!( o$ #+! +!&r#.
In $r!(+w&#!r ,#+! *+1ori%! 1!2!1 w&( +ig+ in#+! rig+# #+&n on #+! 1!$#.
In (&1#w&#!r, #+! *+1ori%! 1!2!1 w&( +ig+ in #+!1!$# #+&n on #+! rig+#.
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DIFERENT MECHANISM OF DRO3NING
IN THE FRESH3ATER AND SALT3ATERIN THE FRES3ATER
M)*+ w&#!r !n#!ring #o #+! &12!o1i &n%
&(orp#ion #o #+! *ir*)1&#ionH-p!r2o1)'! &n% +!'o%i1)(ion
V!n#ri6!1 "ri1&#ion 4H-p!r6&1!'i&5
D!&#+
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IN THE SALT3ATER M)*+ w&#!r !n#!ring #o #+! &12!o1i *on#&in
(&1#.
3&#!r $ro' *ir*)1&#ion !/i#( #o &12!o1i
H-po2o1)'! &n% +!'o*on(!n#r&#ionE%!'& o$ L)ng(
D!&#+
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BURNS TRAUMAC&n ! %i2i%!% in#o "2!
.F1&'!<F1&(+
.Con#&*#.R&%i&n# +!&#
.S*&1%ing
>.*+!'i*&1
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T+! %!"ni#ion F1&'! )rn( *on#&*# o$ o%- &n% :&'!
4:&(+5
Con#&*# )rn( p+-(i*&1 *on#&*# !#w!!n #+!o%- &n% +o# o0!*# 4? oC or +ig+!r5
R&%i&n# +!&# )rn( *&)(!% - +!&# w&2!4!1!*#ro'&gn!#i* w&2!5
S*&1%ing )rn( *&)(!% - +o# 1i)i%( 4w&#!r5C+!'i*&1 )rn( *&)(!% - *+!'i*&1
()(#&n*!
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F1&'! )rn(<:&(+ )rnF1&(+ )rn( &r! 2&ri&n# o$ :&'! )rn.
C&)(!% - ()%%!n igni#ion or !/p1o(ion o$
g&(!(. T-pi*&11- i( & (+or# %)r&#ion, )rn )ni$or'1-.
R!()1# in p&r#i&1;#+i*6n!(( )rn( &n% (ing!%+&ir.
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RADIANT HEAT BURN T+!r! i( no *on#&*# !#w!!n o%- &n% :&'!,
or +o# o0!*#.
Ini#i&11-, #+! (6in &pp!&r( !r-#+!'&#o)( &n%1i(#!r!%, wi#+ &r!&( o$ (6in (1ipp&g!.
3i#+ pro1ong!% !/po()r! #o 1ow +!&#, #+! (6inwi11 !*o'! 1ig+# rown &n% 1!&#+!r- 4&
w!11%on! #)r6!-5.Ini#i&11- #+! +&ir i( in#&*#, i$ *on#in)!( 1ong
!no)g+, #+!r! wi11 ! *+&rring o$ #+! o%-.
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T+! $&*#or %!#!r'in!r&%i&n# +!&# )rn o**)r T!'p!r&#)r! o$ #+! +!&# w&2!
Ti'! o$ !/po()r!
C1o#+ing o$ #+! (6in
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OR
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SEVERITY OF BURNINJURIESD!p!n%( on
. T+! !/#!n% o$ #+! )rn!% &r!&
. T+! (!2!ri#- o$ #+! )rn. T+! 2i*#i'( &g!
. T+! pr!(!n# o$ in+&1&#ion in0)ri!(
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In 1i2ing in%i2i%)&1 T+! !/#!n# o$ #+! )rn i( in%i*&#!% &( #+!
p!r*!n#&g! o$ #o#&1 o%- ()r$&*! &r!&
T+i( i( %!#!r'in!% - #+! 8r)1! o$ nin!(9
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T+! r)1! o$ nin!(
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D!&#+ *&)(!% - "r!I# 'ig+# !
. I''!%i&#!
. D!1&-!%
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I''!%i&#! %!&#+C&)(!% - %ir!*# #+!r'&1 in0)r- #o #+! o%- or
('o6! in+&1&#ion
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D!1&-!% %!&#+M&- ! #wo or #+r!! %&-( &r! *&)(!% -
(+o*6, :)i% 1o((, or &*)#! r!(pir&#or- $&i1)r!&n% (!p(i(
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HO3 TO DISTINGUSHANTEMORTEM BURNS POSTMORTEM BURNS
T+!r! i( !r-#+!'&#o)(()rro)n%ing 1i(#!r( or
)rn( T+!r! i( (oo# in 1&r-n/ &n%
#r&*+!&
T+! 1i2or 'or#i( wi11 +&2! &*+!rr-;r!% *o1or&#ion 4'!&n
*&ron 'ono/i%!in#o/i*&#ion5
Mi*ro(*opi* !/&'in&#ion*&n ! (!!n (ign( o$in:&''&#or- r!&*#ion
T+!r! i( no#!r-#+!'&#o)(
T+!r! i( no# (oo# in1&r-n/ &n% #r&*+!&
3! *&n no# "n% #+! 1i2or'or#i( wi#+ *+!rr- r!%
*o1or&#ionMi*ro(*opi* !/&'in&#ion
*&n no# ! (!!n (ign( o$in:&''&#or- r!&*#ion
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CONCLUSIONC&)(! o$ %!&#+ - Drowning i$ w! "n% *on#&*#
wi#+ #+! w&#!r &n% in+&1!% #+! w&#!r in#o #+!r!(pir&#or- #r&*#
T+!r! &r! (ign( #o %i(#ing)i(+ &n#! 'or#!'$ro' po(# 'or#!' )rn( in0)ri!(