Classification of
Traumatic Deaths
•Mechanical
•Thermal
•Chemical
•Electrical
• A sudden death occurs without any
forewarning; it is unanticipated.
• A traumatic death, in addition to being sudden,
can also be violent, mutilating or destructive; it
can be random and/or preventable or may
involve many deaths.
• A sudden, accidental, unexpected or traumatic
death shatters the world as we know it. It is often
a loss that does not make any sense.
• Survivors are the ones to suffer!
Mechanical Trauma
Divided into two categories:
– SHARP FORCE INJURY
• Knives, axes, swords
• PRODUCE INCISED WOUNDS
• INCISIONS
– BLUNT FORCE INJURY
• Firearm group
– Low velocity vs high velocity groups
• Non-firearm group- baseball bat
• PRODUCE LACERATIONS
Mechanical trauma
• Divided into two categories:
– SHARP FORCE INJURY
• Knives, axes, swords
• PROCUDE INCISED WOUNDS (Doctors make
incisions during surgery)
– BLUNT FORCE INJURY
• PRODUCE LACERATIONS
TRAUMA SURGEONS CLASSIFY
TRAUMA INTO PENETRATING OR
NONPENETRATING
• Penetrating includes gunshot (GSW) and stab
wounds.
• Non-penetrating include auto collisions and
falls (internal bleeding or concussion)
Sharp trauma death
• Common cause of death by sharp trauma is
Exsanguination which means that a major artery
or the heart must be damaged to produce
death
• Exsanguination= bleeding to death
Blunt trauma death
• Most commonly when the brain has been
significantly damaged by force of a hit/fall
• Blunt trauma can lacerate the heart or aorta,
leading to exsanguination or other
complications
Firearm Injury
• Mostly suicidal or homicidal wounds in the
USA
• Gunpowder or smokeless powder
(nitrocellulose) are common propellants.
Rifled weapons vs Smooth bored
weapons
• Rifles and handguns (most common)
• High speed = high powered hunting rifles, military
rifles or a .44 magnum
• Antique weapons and shotguns are smooth bored
weapons
Gunshot classifications
• Size of bullet
• Velocity of bullet
• Penetrating gunshot wound has only an entrance
wound
• Perforating gunshot wound has an entrance and an
exit wound (no bullet would be left in the body)
Caliber
• In firearms, the caliber is the approximate
diameter of the bullet used.
• When the barrel diameter is given in inches, the
abbreviation "cal" is used in place of "inches."
• For example, a (small bore) rifle with a diameter
of 0.22 inch is a .22 cal; however, the decimal
point is generally dropped when spoken, making
it "twenty-two caliber."
The abrasion ring, and a very clear muzzle imprint,
are seen in this contact range gunshot wound.
• Contact range= touches the surface
Powder tattooing is seen in this intermediate (close)
range gunshot wound.
•
The actual entrance site is somewhat irregular, because the bullet can
tumble in flight
Darkness around the entrance wound is
produced from the gases released as a bullet is
fired.
• Those gases are Carbon monoxide, nitrogen
dioxide, carbon dioxide and few others.
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Displayed here is an entrance at the left and an exit at the right.
This particular bullet struck at an angle to produce the ovoid entrance.
Exit wounds vary considerably in size and shape because the bullet can be
deformed in its transit through the body.
There may be no exit wound at all if the bullet's energy is absorbed by
the tissues.
Some bullets (such a "hollowpoint") are designed to deform so that all their
energy will be converted to tissue damage and not exit
General Pathology Images
• Pathology Images
1.
The force may be strong enough to shear off axons, the ends of which retract into globoid
shapes that appear with this silver stain of white matter as "retraction balls".
2.
The forces generated by violent shaking or rotational injury (as in a passenger ejected from a
moving vehicle) can produce stretching of axons in cerebral white matter.
Violent Shaking
Rotational injury
Natasha Richardson
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Starred in “The Parent Trap”
Wife of Liam Neeson (TAKEN)
Traumatic Brain Injury
Not sudden
Mechanical Traumatic Death
Nonpenetrating trauma
The cause of death was "epidural
hematoma due to blunt impact to the
head."
John Travolta's Son Jett
• Head trauma associated with seizure
• Hit his head in the bathtub and died.
• Had Kawasaki Syndrome- collection of
symptoms that stem from swollen arteries.
• Mechanical Traumatic Death
Heath Ledger
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The Dark Knight (The Joker)
Brokeback Mountain
ChemicalTraumatic Death
Ruled accidental not suicidal (insurance??)
$10 million policy to Matilda Rose
(daughter)
• TMZ on the Insurance Policy
Other Blunt Force Injury
• Most common blunt force injury in our
society are from transportation
collisions. (planes, train, buses,
automobiles)
• Gunshot trauma most common for adults
and lethal head injury.
• Children- lethal battery is most
commonly due to head injury…then chest
and abdominal trauma
Two terms to know:
• CONTUSION: an accumulation of blood in the
tissues outside the blood vessels
• HEMATOMA: A more severe contusion
– A contusion with MORE blood
– a blood tumor
– Hema- Latin for blood
– Toma- Latin for tumor
Characteristically, blunt impact of the head will
produce a hematoma, referred to as a “goose egg”
Ms. Keen had a extracranial hematoma. A blood
tumor outside the skull. Between the dura mater
and the inner table of the skull.
Extracranial Hematoma
Lobes of the Brain
Injury to Parietal Lobe
An injury to this part of the brain can
lead to reading and object-recognition
problems, inability to focus visual
attention or to attend to more than one
object at a time, dizziness, trouble with
math, forgetfulness, loss of awareness
of one’s own body parts, concentration
difficulty, word recognition and even an
inability to tell left from right.
Hematoma
CONTUSION:
Chemical Trauma
• Drug overdose
• Poison deaths
• 50% of all chemical deaths come from ethanol
(depressant) DRINKING ALCOHOL
• Ethanol is the drug with the longest history
of abuse
• Depressants cause more deaths than
stimulants (cocaine)
• Marijuana has never caused an overdose
death. (it has caused many driver accidents,
domestic disputes and work related issues)
Chemical Trauma
• CARBON MONOXIDE POISONING
It is colorless, odorless, tasteless and an explosive
gas caused by the incomplete burning of fuels.
• Accidental, homicidal, suicidal
• CYANIDE POSIONING similar to CO poisoning in
that interferences with the oxygenation of the brain
• Cyanide has a distinct odor. It smells like almonds
(half of population cannot smell it) It is very
detectable.
• A forensic pathologist can be killed by opening the
stomach of a person who has ingested KCN from the
release of the gases.
• California used KCN tablets to drop into HCl solution
in the gas chamber.
• Produces a red stomach. (Sherlock Holmes)
Thermal Trauma
• Exposure to excessive heat or cold may
produce death.
• HYPOTHERMIA is excessive cold.
– Common in intoxicated individuals
– Alcohol intoxication reduces the appreciation of
the cold while increasing the loss of body heat
because of dilatation of the blood vessels on the
surface of the body.
• HYPERTHERMIA is excessive heat.
– Deaths common in elderly people in northern cities
and in infants left in parked cars
Thermal Trauma
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Thermal burns
Hot liquids
Flaming hydrocarbons
Doused with gasoline (Michael Brunner)
Electrical Trauma
• Ventricular fibrillation- nonpropulsive
quivering that leads to no resucitability
within minutes
• Electrocution
• Electrical burns
• Struck by lightening
• DNR=Do Not Resuscitate (must be written in
a will to allow)
Asphyxia
• Drowning
• Dry Drowning- inhalation of water
• Manual strangulation- fracture of the
hyoid bone
• Hangings (instant rigor mortis)
Anaphylaxis
Anaphylaxis is a
serious allergic
reaction that is rapid
in onset and may
cause death.
BEES
ANTS
SHELLFISH
PEANUTS