DROWNING
Drowning is a form of asphyxia due to
aspiration of fluid in to air passage.
Whole body submersion is not ncessary
Mouth and nasal cavity submersion sufficient
Mechanism of drowning
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When a person falls in water he sinks partly due
to force of fall and partly to specific gravity of
the body
Rises to the surface due to natural buyoncy
Again sinks due to inhalation of water due to
stimulation of respiratory centre and reflex
from stimulation of skin
Rises to surface and cries for help,coughs so air
is expelled and filled with water then again sinks
In 4-8 min lung is full of water and sinks
Brouardel’s experiment
Stage of surprise lasting 5-10 secs
Stage of respiratory arrest for 1 min, dog is
agitated violent struggle to surface
Stage of deep respiration for 1 min, dog
expelled white foams to surface, agitation
stopped, eyes and mouth were open
Second stage of respiratory arrest, absent
thoracic movement, pupils dilated and fixed
Stage of terminal gasps lasting for about 30
seconds.
Types of drowning:
Wet drowning
 Dry drowning- 10-20%
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LARYNGOSPASM
Commonly seen in children and adults under influence
of alcohol
Secondary drowning or near drowning:
resuscitated victim who survive for 24 hour
Death is due to complications. if survive with
severe brain damage.
 Immersion syndrome: death results from
cardiac arrest due to vagal inhibition
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Types of WET drowning:
Drowning in fresh water
Drowning in salt water
Fresh water drowning
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O.6% Nacl
Water passes from lungs---blood----left
ventricle
Two and half litre of water inhaled and
absorbed in 3 min
Greater strain to heart
Hemolysis and hemodilution
Increase in potassium ion , decrease in
sodium ions—cardiac arrythmia
Calcium ion level falls
Salt water drowning
> 3% Nacl
Water is drawn from blood-----lungs
Haemoconcentration
Marked bradycardia due to raised plasma
Na level
Slow death occurs from asphyxia
Cause of death
Asphyxia
Ventricular fibrillation
Laryngeal spasm
Vagal inhibition
Injuries
Postmortem appearance
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CLOTHES, BODY wet
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Sand , mud attached with the body
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Fine leathery froth in mouth, nostrill
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Cutis anserina: goose like skin (granular)
Retraction of scrotum(reaction phenomena)
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Washerwoman’s hands: skin thickened,soddened
and
wrinkled
o
Cadavaric spasm holding grass,sand and mud.
‘drowning man clutching a straw’
Cont…
Conjuctivae congested
Rigor mortis appears early
PM staining on face ,neck , chest, limbs is
pinkish in colour .
INTERNAL FINDINGS
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Froth in Larynx, trachea, bronchus and bronchioles
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Lungs voluminous, oedematous and blood stained fluid,
balloon like appearance, indentations and there is pitting on
pressure.
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Cut surface lung frothy fluid,fluid actually penetrates the
alveoli and reaches tissue and blood called
Emphysema aquosum, in unconscious person water
reaches the lung without froth formation called oedema
aquosum
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Paltauff’s hemorrhage-due to forceful expiration subpleural
hemorrhages are present.
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Stomach and intestine contains water- ml significance
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Bleeding in middle ear, temporal bone and mastoid process
Differences in lungs between fresh
water and sea water drowning
Fresh water
drowning
Balloned but light
Pale pink in color
Emphysematous
Do not collapse after
removal from the
body
On cut section
crepitus is heard
Sea water drowning
Balooned but heavy
Purplish or blue in
color
Soft and jelly like
Tend to flatten out
No crepitus is heard
Tests for drowning
 Gettler test
when drowning occurs in fresh water left
side of heart compared to right side will show
50% lower chloride content & in sea water
drowning 30-40% rise compared to right heart.
 Plasma specific gravity
in drowning specific gravity of plasma in left side
of heart is less than that in right side.In non
drowning cases its reverse.
 Magnesium
In salt water drowning magnesium content of left
side of heart is more than 1.25 mg/1000ml than
that of right side
Diatom tests
-microscopic,unicellular ,algae
-impregnated with silica, chlorophyll, diatomin
-only a live body with a circulation can
transport diatoms from lung
Bone marrow is highly suitable and reliable
Time since death
Rigormortis sets in early
Floating of body 18-24 hours summer,24-36
hours winter
Skin becomes glove like in 2,4 days
Adepocere in 5-15 days
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