choking ppt
TRANSCRIPT
Choking – a case report
DR.DEBARSHEE CHAKRABORTY POST GRADUATE TRAINEE, DEPARTMENT OF
FORENSIC MEDICINE AND TOXICOLOGY, GAUHATI MEDICAL COLLEGE, GUWAHATI.
DR.RAKTIM PRATIM TAMULIREGISTER, DEPARTMENT OF FORENSIC MEDICINE
AND TOXICOLOGY, TEZPUR MEDICAL COLLEGE, TEZPUR
DR. R.CHALIHA PROFESSOR & HOD,
DEPARTMENT OF FORENSIC MEDICINE AND TOXICOLOGY, GAUHATI MEDICAL COLLEGE,
GUWAHATI
Choking is a form of
asphyxia caused by an obstruction
within the air passages ,
usually between the pharynx and bifurcation of
trachea.
1. Sore –throat2. Hoarseness3. Respiratory
difficulty4. Unable to
speak or make any sound.
5. Cyanosed (blueness of lip/nail bed)
6. Coughing rapidly
7. Collapse
Signs and Symptoms
Univesal Sign for Choking
Accidental
Suicidal
Homicidal
Types of choking
1.Seen in very young, elderly, psychiatric patients or in the infirm.2.Seen commonly during crying & laughing.3.Under the influence of a drink, an anaesthetic or in epilepsy or in a state of insensibility.4.Infants regurgitating the clotted milk and in children rubber balloons, coins, marble etc inhalation during play.5.Tranquilizing drugs depressing the gag reflex.6.In head injuries , Vomiting can occur which may be inhaled. . 7.Impaction of large food bolus, blood and clothes in ENT operations, gauze packs etc.8.A blow to the front of neck.
Accidental choking
Suicidal choking
1.Its rare.2.Usually seen in
dementia or psychosis patients or in prisoners.
3.Mechanism: a foreign body is thrust into the throat.
Homicidal choking
1. Its very rare 2. Practicable only when the
victim is suffering from disability or disease
3. Used as a mode of infanticide4. Mechanism : stuffing a wad of
paper or cloth into the pharynx or larynx.
Cause Of Death in
Choking
Asphyxia Laryngeal spasmDelayed death due to
pneumonia , lung abscess or bronchiectasis
Cardiac Inhibition
History Of The Case
The present case which was brought by a local police station for medico legal autopsy to the
mortuary of GMCH , was of a young man of 29 years who reportedly mystrically found dead
one morning in his own bed by his family members. According to the history given by the family members they all took dinner together
the previous night and then he went to his room and slept. The next morning the family
members found him dead with vomiting all around the face and cloths after breaking the
door when the man did not open the door after repeated knockings.
External Examination
On external examination , the body was found to be of a male of average built with
closed eyes and partially open mouth with vomitus seen all
over the face , neck and cloths at places.
No injuries were found on external examination.
Internal Examination
Petechial hemorrhages were found over the surface at places and the chambers of heart are found to contain liquid blood.
Heart
The coronaries were found to be healthy and not obliterated .
Both the lungs were found to be congested and petechial hemorrhages were found over the surface at places.
Lungs
Larynx and trachea
Mucosa was found
to be congested and found to contain bolus of partially digested
food material.
The stomach mucosa was also congested and the cavity was found to contain partially digested food material.
The mucosa were also found congested and the cavity was found to contain partially digested food material.
stomach
Mouth and esophagus
The other organs were also found to be
congested.
Membranes and brain Subarachnoi
d hemorrhage
(SDH) is found to be
present over the occipital
area bilaterally
and the brain too
was found to be
congested.The scalp and skull all were found healthy without any injury.
Conclusion
Death was opined to be due to asphyxia as a result of Choking.
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