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  • Thermal Injuries

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    Injuries can be caused by mechanical, thermal, chemical or electrical means. Mechanical injuries include blunt force trauma, sharp force injuries, and gunshot wounds. Thermal injuries are caused by heat or cold and include burns, frostbite, hypothermia and heat stroke. Chemical injuries result from corrosive agents or toxic substances. Electrical injuries are caused by exposure to electric current and may cause internal or external burns. The type and extent of injuries are important forensic indicators.

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    Injuries can be caused by mechanical, thermal, chemical or electrical means. Mechanical injuries include blunt force trauma, sharp force injuries, and gunshot wounds. Thermal injuries are caused by heat or cold and include burns, frostbite, hypothermia and heat stroke. Chemical injuries result from corrosive agents or toxic substances. Electrical injuries are caused by exposure to electric current and may cause internal or external burns. The type and extent of injuries are important forensic indicators.

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    28 views22 pages

    Thermal Injuries

    Uploaded by

    Anonymous S0H8cqgnfi
    Injuries can be caused by mechanical, thermal, chemical or electrical means. Mechanical injuries include blunt force trauma, sharp force injuries, and gunshot wounds. Thermal injuries are caused by heat or cold and include burns, frostbite, hypothermia and heat stroke. Chemical injuries result from corrosive agents or toxic substances. Electrical injuries are caused by exposure to electric current and may cause internal or external burns. The type and extent of injuries are important forensic indicators.

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    of 22

    INJURIES

    Injuries (Sec 44 IPC)


    • Any harm whatever illegally caused to any person in body, mind,
    reputation or property
    Hurt (Sec 319 IPC)
    • Means bodily pain, disease or infirmity caused to any person
    MECHANICAL INJURIES THERMAL INJURIES CHEMICAL ELECTRIC

    Firearm & Corrosion Electrocul


    Blunt Sharp Pointed tion
    Weapon Weapon Weapon
    explosion Heat Cold Irritation
    injuries Lightening

    Abrasion General
    Bruise or effects
    contusion Heat Local General Local
    Incised Stab Stroke Effects effects Effects
    Laceration
    wound wounds Heat Burns Hypotherm Trench foot
    Fractures
    and Exhaustion Scalds ia Frost bite
    dislocation Heat
    s Cramps
    THERMAL INJURIES
    Classification
    INJURIES DUE TO COLD

    Frostbite (-2.5oC)
    Trench foot & immersion foot (5-8OC)
    Infarction of tissues due to exposure to
    Result of prolonged exposure to greater degree of cold –2.5oC.
    severe cold (5 to 8oC) & dampness, Commonly affects the tissues distant
    typically seen in soldiers during from heart – Nose, Ear, Fingers & Toes
    winter warfare (MC) - NEFT
    Hypothermia (oral or axillary temperature of less than 350 C)
    • PM finding

    Fat
    Necrosis

    Pink PM staining Bright red blood Wischnewsky spots Fat necrosis of pancreas
    Due to
    unreduced
    Oxygenated Hb
    Paradoxical undressing –
    hide & die syndrome
    (Terminal burrowing)
    INJURIES DUE TO HEAT
    Heat Stroke

    Heat exhaustion /prostration /syncope/ collapse

    • Collapse with normal/subnormal temp


    • Moist, clammy skin; Dilated pupils

    Heat cramps or miner’s cramp

    • Due to rapid dehydration d’ Profuse


    sweating
    Heat stroke (Thermic fever or sunstroke) Rectal temp > 410C
    • Neurological disturbances
    • Occurs – in young persons exposed to high
    temp & doing severe exertion or old
    persons during heat wave
    • Skin dry, hot & flushed with complete
    absence of sweating, Constricted pupils
    SURFACE AREA OF BURN
    Rule of Nine (for adults)
    Lund & Browder (for Children)
    For infants, head is 18% of
    BSA & each leg is 14%. For
    children >1yr, add 0.5% to
    each leg & reduce 1% from
    head for each year till adult
    value is reached.
    Rule of Palm = 1%

    Involvement of 50% of burn proves fatal, even of first degree.


    Minimum 1/3rd area must be involved to label it griveous.
    PM Findings
    Pugilistic attitude (boxing/fencing/defence attitude)
    • Flexed positions of major joints of upper & lower
    limbs
    • Due to coagulation of proteins of muscles
    • Seen in both Antemortam & postmortem burns
    Heat ruptures
    • D’ to excess heat, skin contracts & ruptures
    • Usually seen over fleshy areas (calves, thigh),
    extensor surfaces, joints & head
    • Resemble incised & lacerated wounds
    • No bleeding, no clotted blood & no
    extravasation (as heat coagulates blood in the
    vessels)
    • Intact vessels and nerve seen in floor, no vital
    reactions
    Heat hematoma
    • Head is exposed to intense heat
    sufficient to cause charring of
    skull
    • Resemble extradural
    haemorrhage but no signs of
    injury
    • Diffuse, bilateral, soft friable
    chocolate colored clot,
    honeycomb appearance,
    adjacent brain show hardening
    & discoloration
    • Contains CoHb
    Thermal Fractures
    • Usually - Temporal bones
    • Radiating from a central point or
    curved in long bone shafts
    • Cross suture lines
    • Ragged edges
    SIGNS OF ANTE-MORTEM BURN

    Presence of soot/smoke in respiratory


    tract beyond trachea

     CoHb
    Antemortem vs Postmortem Blisters
    • Red line – vital reaction at site
    • Blister fluid – rich in albumin &
    chloride
    • Loosening of teeth in sockets
    • Crow Feet Sign
    – Seen in flash fires
    – Sign of Antemortem burns
    SCALDS
    • Application of liquid above 60°C
    or from stream (moist heat)
    • Skin sodden & bleached
    • Line of demarcation
    • Clothes are wet but not burnt
    ELECTRIC INJURY
    • Joule burns (Endogenous burn)
    – Diagnostic of contact of
    electricity
    – At the point of contact
    – Round or shallow craters, 1-3
    cm in diameter, floor is lined by
    pale flattened skin
    – Produced by the conversion of
    electricity into heat within the
    tissue (endogenous burn)
    • Spark burn (Exogenous burn)
    – Intermittent contact & arching
    of current from conductor to
    skin
    – No contact (Air gap between
    conductor & skin)
    • High tension electric currents produce
    multiple burns or punched out lesions
    due to arching from conductor to the
    body without contact  Crocodile flash
    burns
    Resistance to Current by body tissues

    Bone > Fat & tendons > Skin (dry > wet) > Blood > Nerves

    Current pearls and wax droppings

    MC cause of death
    • Ventricular fibrillation > paralysis of medullary (respiratory centre) or cardiac arrest.
    LIGHTENING INJURY
    Filigree or Arborescent burns /Lichtenberg’s flower
    • Superficial, thin, irregular and tortuous marking
    over skin mainly over shoulders & flanks
    • Resembles branches of a tree (Fern like pattern)
    of erythema
    • Not associated with burning
    • Slight staining of tissue by hemoglobin from lysed
    RBCs along path of current.
    • Indicates the path taken by current but does not
    corresponds to vascular channels
    • Disappears in 1 or 2 days if survives.

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