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Asphyxia and AnoxiaAsphyxia and Anoxia

Dr. Abdulmonem Al-HayaniDr. Abdulmonem Al-HayaniMBChB, DipFMS(Lon), PhD(Aber)MBChB, DipFMS(Lon), PhD(Aber)

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Dead at FireDead at FireThe body of a 32 years old female Nurse The body of a 32 years old female Nurse

(Fiona) was recovered from her house, (Fiona) was recovered from her house, after a huge fire that destroyed the whole after a huge fire that destroyed the whole hose. Police investigations revealed that hose. Police investigations revealed that the fire was not an accident. the fire was not an accident.

What Questions you would like to ask What Questions you would like to ask more?more?

How did Fiona Passed Away?How did Fiona Passed Away?

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Outcome=Aims=GoalsOutcome=Aims=GoalsWhy this lecture?Why this lecture?Definitions of Asphyxia and Anoxia?Definitions of Asphyxia and Anoxia?Signs of Asphyxia?Signs of Asphyxia?Types of Asphyxia (Causes)Types of Asphyxia (Causes)Common examples of Anoxia and Common examples of Anoxia and

Asphyxia Asphyxia

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Why this lecture?Why this lecture?

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Definition of Asphyxia Definition of Asphyxia Situations in which there is an obstruction Situations in which there is an obstruction

to breathingto breathingBody will be deprived to O2Body will be deprived to O2Either no air or insufficient air getting into Either no air or insufficient air getting into

the bodythe body

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Definition of Anoxia Definition of Anoxia Anoxia = HypoxiaAnoxia = Hypoxia

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Definition of AnoxiaDefinition of Anoxia Failure of O2 which is already in the Failure of O2 which is already in the

body to get into the tissuesbody to get into the tissues Causes of anoxia:Causes of anoxia:1.1. ShockShock2.2. AnemiaAnemia3.3. CO poisoningCO poisoning4.4. Heroin intoxicationHeroin intoxication

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Signs of AsphyxiaSigns of Asphyxia

Congestion CyanosisPetechail

Hemorrhage

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Types (causes) of AsphyxiaTypes (causes) of Asphyxia

1.1. EnvironmentalEnvironmental2.2. Crush AsphyxiaCrush Asphyxia3.3. Suffocation/SmotheringSuffocation/Smothering4.4. Positional AsphyxiaPositional Asphyxia5.5. ChockingChocking6.6. Compression of the NeckCompression of the Neck7.7. Hanging/StrangulationHanging/Strangulation

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Example of AsphyxiaExample of Asphyxia

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DrowningDrowning Where?Where? SeaSea RiverRiver CanalCanal BathBath othersothers

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DrowningDrowning Body recovered dead?Body recovered dead?1.1. Death before entering water Death before entering water

(concealment of homicide)(concealment of homicide)2.2. ImmersionImmersion3.3. True drowningTrue drowning4.4. Death in water from other causes (heart Death in water from other causes (heart

diseases, trauma)diseases, trauma)5.5. HypothermiaHypothermia

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True drowning (Asphyxia)True drowning (Asphyxia) Phases of drowning:Phases of drowning:1.1. Breath holdsBreath holds2.2. Inhalation of water, coughing, vomiting Inhalation of water, coughing, vomiting

and loss of consciousnessand loss of consciousness3.3. Convulsions, respiratory arrest then Convulsions, respiratory arrest then

cardiac arrestcardiac arrest

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DrowningDrowning Types?Types?1.1. Fresh waterFresh water2.2. Sea waterSea water

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Autopsy signs of DrowningAutopsy signs of Drowning Classical signs only in 35% of casesClassical signs only in 35% of cases1.1. Froth in nose and mouthFroth in nose and mouth2.2. Pulmonary edemaPulmonary edema3.3. Overdistention of lungsOverdistention of lungs4.4. Dry drowningDry drowning

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Autopsy signs of DrowningAutopsy signs of Drowning

5. Middle ear hemorrhage5. Middle ear hemorrhage6. Chemical tests (unreliable)6. Chemical tests (unreliable)7. Non-specific changes of immersion7. Non-specific changes of immersion

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Autopsy signs of DrowningAutopsy signs of DrowningThe best sign is:The best sign is:

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Example of AnoxiaExample of Anoxia

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Fire FumesFire Fumes Commonest cause of death in firesCommonest cause of death in fires Autopsy signs of fire fumes inhalation:Autopsy signs of fire fumes inhalation:1.1. Burns to air passagesBurns to air passages2.2. SOOTSOOT3.3. Pulmonary edemaPulmonary edema4.4. Toxins in blood e.g. cyanide, plastics Toxins in blood e.g. cyanide, plastics

chemicals etc…chemicals etc…

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The most useful sign isThe most useful sign is

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Key LessonKey Lesson

As a GP you will see many cases of As a GP you will see many cases of Asphyxia and Anoxia, so please think Asphyxia and Anoxia, so please think

about a possibility of crime when you see about a possibility of crime when you see such casessuch cases

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Questions & CommentsQuestions & Comments