-
Thermal injuries occur when the body's:
Thermal injuries occur when the body's cooling mechanism fails to compensate for externally applied heat
-
The damage from thermal injuries depends on what three factors?
- Applied temperature
- Ability of the body surface to conduct away excess heat
- time for which heat is applied
-
Flame burns are when skin is:
in direct contact with the flame
-
Contact burns are when skin:
- are in direct contact with a hot object
- -They may have the shape of that object
-
Radiant burns are when skin:
is exposed to heat wavves without any contact with the source
-
First degree burns
- damage is limited to epidermis
- only redness; no blisters
-
2nd degree burns
- Damage to both the epidermis and the upper dermis
- Blisters are common
-
3rd degree burns
- Effects the whole thickness of skin
- painless
-
4th degree burns
Charring of the skin and the underlying soft tissues
-
Deaths due to burns:
- Hypovolemic shock
- infection
- problems of immoblilizaton
- -pneumonia
- -thromboemboli
-
thromboembolism:
Formation in a blood vessel of a clot (thrombus)
that breaks loose and is carried by the blood stream to plug another
vessel. The clot may plug a vessel in the lungs
(pulmonary
embolism), brain (stroke),
gastrointestinal tract, kidneys, or leg.
-
Hypovolemic shock
too much fluid loss through damaged skin
-
Deaths due to fires:
Thermal injry: same as in burns, airway injury from inhalation of superheated atmosphere
- Inhalation injury:
- carbon monoxide
- Lack of oxygen
- toxic fumes
-
Manners of death in fire
- Accidents: most common
- Natural: death due to natural disease followed by fire from a hazard at the scene
- Suicide: self-immolation usally with accelerants
- save any clothing in air-tight cans for analysis
- Homicide: arson, may be concealed as "accidental" fire deaths
-
During fire scence investion _____ and ____ the first started can help the pathologist determin the manner of death
How and where
-
What to look for in an autopsy of a fire related death:
- Burns of skin
- Soot in nose, mouth and airways
- soot in gastric contents
- toxicology
- cherry pink color of skin and internal organs due to formation of carboxyhemoglobin
-
Pugilistic attitude
- boxers stance
- due to heat-induced dehydration and contraction of skeletal muscles
- *flexor muscles are more powerful than extensors*
-
Skin splitting
- possible extrusion of organs
- superheated skin contracts and splits open
- can be mistaken for sharp force trauma
-
Extreme heat induced _______may cause skeletal fractures.
Most common in____ and ___
Muscle contraction
ankles and wrists
-
Heat induced epidural hematomoa
pressure build up of heated brain within the skull forces blood out
-
Heat induced epidural hematoma is more common if:
outside of skull is charred
-
Most fire deaths are due to:
Inhalation injury= carbon monoxide (asphyxia)
-
Hemoglobin's binding affinity to carbon monoxide is ___x that for oxygen
200
-
T/F The absence of carbon monoxide does not mean that the victim did not die of inhaling the toxic atmosphere in a fire
True
-
______ deplete oxygen and produce little carbon monoxide. These are associated with ____
- Rapid flash fires
- associated with volatiles and enclosed space fires
-
Combustion of modern plastic polymers
- cyanide
- nitric oxide
- phosgene
-
The most common type of scalds are:
immersion scalds
-
Children require ____ the time to result in a full thickness burn than adults
1/4th
-
What can you expect to see with immersion scalds?
- clear cut immersion line
- uniform depth and severity of immersion scald burns
- common areas of sparing: Groin, behind knees, palms, (clingches fist) between toes, buttocks if pressed against bottom of tub
-
______ will present the most severe burn with spill scalds.
Site of impact
-
Pattern of spill scalds
- Irregular
- liquid flows with gravity as it cools
- scald depth is non-uniform
- clothing may change the pattern
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