drowning and burn trauma

7/24/2019 Drowning and Burn Trauma

http://slidepdf.com/reader/full/drowning-and-burn-trauma 1/28

Dr.I.B.GD SURYA PUTRA P, SpF

DEPARTMENT OF FORENSIC MEDICINE, FACULTY OF

MEDICINE, GADJAH MADA UNIVERSITY



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



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



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&*#



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!&#+



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



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&('.



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



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%! #!(#



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



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+#.



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!&#+



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!&#+



BURNS TRAUMAC&n ! %i2i%!% in#o "2!

.F1&'!<F1&(+

.Con#&*#.R&%i&n# +!&#

.S*&1%ing

>.*+!'i*&1



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*!



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.



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%-.



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



OR



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!(



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



T+! r)1! o$ nin!(



D!&#+ *&)(!% - "r!I# 'ig+# !

. I''!%i&#!

. D!1&-!%



I''!%i&#! %!&#+C&)(!% - %ir!*# #+!r'&1 in0)r- #o #+! o%- or

('o6! in+&1&#ion



D!1&-!% %!&#+M&- ! #wo or #+r!! %&-( &r! *&)(!% -

(+o*6, :)i% 1o((, or &*)#! r!(pir&#or- $&i1)r!&n% (!p(i(



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



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!(

drowning and burn trauma

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