Suffocation

Introduction

Suffocation  is  a form of asphyxia  caused  by mechanical obstruction to  the  passage  of  air  into  the  respiratory  tract  by means other than  constriction  of neck  or drowning.

It includes  smothering  gagging, choking, burking, traumatic  asphyxia  and  cafe  coronary.

Smothering:

• Asphlxia is  caused  by  mechanical  occlusion  of external  air  passage,  i.e.  entry of  air to  lungs  is  prevented  by  closure of nose  and mouth.
• Lips,  gums,  tongue,  inner  side  of  nose  may  show  bruising  or lacerations.
• Asphyxial  signs (congestion, cyanosis, petechiae)  are  severe  except  when the  head and  face  is  enclosed in  plastic  bag.

Chocking:

• Asphyxia caused  by  mechanical  occlusion of internal  air  passage, i.e.  obstruction  of respiratory  passages (glottis, larynx,  trachea,  bronchi  etc.)

Gagging:

• It is  chocking  by preventing  air entry  through  mouth  and  nostril by  filling  piece of cloth  in  the  mouth.

Traumatic asphyxia:

• It  is  a form of  asphyxia  which is  caused  from  respiratory  atest  due  to mechanical
• fixation  of  chesf resulting from  blunt trauma  to  chest  or external  pressure  on  the  chest,  abdomen  or back which  prevents  normal  respiratory movements  of  the  chest  wall

 It  may be  due to  : 

Stampede  in crowd  (riot  crus  or human pile death). 

1. Crush by  heary  object e.g. 
2. road  traffic  accidentaloe), 
3. railway  accidentar0e), 
4. overturn  of tractor  in far
5. fall  of earth,  stone etc.  in  mine or in  a  building  collapse.

 The characteristic  external  findings  in  case  of  traumatic  asphlxia  are  : 

1. Mosque  ecchymotique:-  Refers  to  the  classical  appearance  of Florid red/blue  congestion  of  face  and  neck  with  variable  involvement  of  the  upper  thorax, back & arms.
2. Deep  cyanosis  of face:- Numerous petechial  hemorrhages  or ecchymotique.
3. Demarcation  line  : Level  of compression  is  indicated  by  a well-defined  demarcating  line  between the  discolored upper  portion  of body  and the  lower  normal  part.
4. Areas of pallor  seen at  the  level  of collar  of shirts,  folds  or creases  in  the  garments.
5. Facial edema.
6. External  blunt  trauma  injuries  can  be seen on the  head,  neck and chest  along with most  or other foreign material.

Burking:

• It  is  combination  of smothering and traumatic  asphyxia.
• It  was the  method used  by Burk  and Hare. Burk  used  to  sit  on  chest  covering  with one  hand  the  mouth  and  nostril and pushing up  the  jaw  with other hand and  Hare  used  to  pull him  around teh  room  by  feet.

Cafe  coronary:

• It  refers  to  accidental  chocking  by bolus  of food  obstructing  larynx.
• Death is  mostly due to  asphyxia,  or due to  reflex  cardiac  arrest caused  by stimulation  of
• laryngeal  nerve  endings.
• It  is  common  when gag reflex  is  suppressed,  e.g. intoxicated  individuals  and following  large  doese  of tranquilizers.

Overlying  (compression  sufiocation)  : It is  a  type  of asphyxia  which  results  due to  compression  of chest,  so as  to  prevent  breathing

Exam Important