Drowning

D i.e. Hemodilution, overloading of heart and hemolysis resulting in release of potassium

D i.e. Can cause secondary drowning

D i.e. All

Microscopic detection of mucous

• The entry of fluid into the respiratory passage provokes the production of mucus, which when mixed with water and air is churned into the tenacious foam by the violent respiratory movements made by
• The victim during the course of drowning. Foam of almost similar nature may also occur in cases of opium poisoning, organophosphorous poisoning, strangulation, epileptic attacks, acute pulmonary oedema and occasionally after an electric shock.
• Normally, the chloride content of the left and right sides of the heart is the same, i.e. about 600 mg per 100 ml. The difference between two chambers may not be more than 5 mg/100 ml under usual circumstances. 
• A difference of 25 mg% between the chloride concentrations of the two sides of the heart was an indication of death due to drowning. In fresh water drowning, the chloride content of left heart was lower than that of the
  right heart and in case of salt water drowning, reverse situation is observed.

D i.e. None

D i.e. All

Accidental (>suicidal) is the most common type of drowningQ

In suicidal drowning body should be free from marks of any injury indicating an assault or struggle (violence)e. In cases of women the body is usually fully dressed and clothes are tied in such a manner that their private parts are not exposed. Sometimes a determined suicide may tie his legs & hands together or attach weights to his body, take poison, or cut throat before immersion. However, it should be examined whether tie could have been made by person himself.

– If the body is found with heavy weights attached to it or hand & legs tied with rope, it must be either homicide or suicide and with children homicide alone.

Homicidal drowning is very rare except in infants & children. Mark of severe violence applied to head, strangulation, throttling, or bruises are strongly presumptive of homicide.

Post mortel injuries by fishes, crabs, frogs etc. lack signs of vital reaction.

Ans. A: Vagal hyperactivity

Causes of death in drowning:

• Asphyxia
• Ventricular fibrillation/ if an examination of the larynx reveals that a spasm occurred, the victim may have died from sudden exposure to the cold, which caused an immediate heart attack.
• Laryngeal spasm
• Vagal inhibition
• Exhaustion
• Injuries
• In some cases, hypothermia may have been the cause of death rather than drowning.

Bodies discovered in the water are examined to see whether water is actually present in the airway and stomach of the victim and if the lungs have swollen up. If such signs are apparent, then the victim did actually die due to drowning. Further examination of the corpse will reveal if bleeding occurred in the lungs, suggesting that there was a struggle for breath during the drowning.

Ans. Hypovolemia

Ans. Hemoglobin increases

Ans. Hyperkalemia

Ans. Water does not enter lungs because of laryngeal spasm

Ans. Vagal inhibition

• Death in drowning can happen either due to asphyxia, ventricular fibrillation, laryngeal spasm, vagal inhibition, exhaustion, and other injuries. 
• Sudden death in cold water immersion can cause death from inhibition of heart due to vagal stimulation. 
• Such death is usually known as instantaneous physiological death, vasovagal shock, vagal inhibition of neurogenic shock.
• As a result of this, cardiac and respiratory centers are suddenly paralyzed with consequent stoppage of heart and respiration resulting in immediate loss of life. 
• The cause of such vagal inhibition includes sudden fright or emotion and injury to trigger receptor areas, such as carotid sinus, various plexus, testicles, serous membranes, etc. even a trifling injury to these areas may result in sudden death.

Ans. is ‘c’ i.e. Hyperkalemia

Ans. is ‘c’ i.e., Accidental

• Most of the cases of drowning (2/3) in India are accidental. Rest 1/3 being suicidal. Homicidal drowning is less common in India.
• Drowning is a mode of asphyxial death due to aspiration of water or other fluid into the respiratory tract. For death it is not necessary that the whole body is submerged in the liquid, it is sufficient if the face and nostrils are submerged in the liquid. Drowning in India is mostly suicidal attempted by non-swimmer.
• Suicidal drowning is indicated by the absence of signs of struggle or assault (e.g. torn clothes, injury marks). 
• In homicidal drowning, there are signs of struggle and violence (assault) (e.g. head injury, signs of strangulation, or throttling). Head and feet may be tied, heavyweight may be attached to body or body may be tied up inside a gunny bag. Homicidal drowning is very rare except in infants and children.
• Accidental drowning is quite common and usually seen in children, non-swimmers, during floods or due to fall in well etc.