Signs & Symptom of Asphyxia, Traumatic Asphaxia, Sexual Asphyxia, Death Due To Sexual Asphyxia

Signs & Symptom of Asphyxia:

§         Stages of Asphyxia/symptoms: Symptoms occur in 3 phages-

1. Dyspnoic phase.
2. Convulsive phase.
3. Apnoeic phase.

1.      Dyspnoic phase: are due to O₂ and liberation of CO₂. Therefore breathing is rapid and deep, pulse rate is increased, BP, victim becoms blue in the face.

2.      Convulsive phase: Convulsion results from CNS due to stimulation by CO₂. cyanosis deepens.

§         Eyes orominent

§         Pupils dilated

·         Tongue may be protruted any may be bitten or indented by teeth.

·         Appearance of haemorrhage (as those demonstrated by Tardu 1879) due to capillary rupture due to capillary pressure. So they are prominent in those areas where capillaries are less supported. eg, conjunctive, eyelid, skin of face, beneath the visceral pleura & epicardium.

·         Pt. become unconscious.

3.  Apnoeic phase: This is absent in death following slow asphyxia. At this stage-

• There is paralysis of nervous system.
• Victim still alive.
• Breathing is shallow. It gradually slows & ultimately stops.
• Death is ensured 20 min after hanging.
• Recovery may occur but permanent destruction of brain due to anoxia.

Traumatic asphaxia.

§         Traumatic asphyxia: It is a form of asphyxia from respiratory arrest due to prevention of the chest expansion or mechanical fixation of the chest by compression of the external violence.

§         Circumstances of traumatic asphyxia:

1. Due to house collapse.
2. By being run over by a vehicle.
3. Due to collapse of a wall inside a mine.
4. When held between the buffers of the two bogies of a train.

§         Post-mortem findings:

Externally:

·         Intense cyanosis of head, neck and upper chest above the level of compression.

·         Below this level, the skin is pale producing a line of demarcation.

·         Stain of dust over the body (house collapse).

·         Tire and grease marks (road accident)

·         There may be fracture to ribs.

Internally:

• Evidence of inhalation of dusts and debris (in case of house collapse)
• Larynx, trachea, lungs, brain congested.
• Tardieus spot- under the mucus membrane of various organs.

 Sexual asphyxia:

§         Sexual asphyxia: Person put himself into asphyxia to get sexual pleasure.

It occurs in psychologically deviated person, adult young male, female rare than male. He prepares a device that can be constricted or relaxed when he wishes. Solitary room, surroundings- picture, sex literature, wearing female clothes.

Death Due To Sexual Asphyxia:

§         Sexual asphyxial death: It is very rare. The degree of asphxia produces by mechanical means is controlled, but in some case doath occurs accidentally. These cases are associated with some form of abnormal sexual behaviour, usually mansochism and transvestism. The victims are always male and usually young. The scene is usually the victims own’s house. Adult males with homosexual preferences tend to carry out the procedure as a means to protection from accidental death.

§         Method:

1. Hanging is the most frequent form seen in sexual asphyxia.
2. Sexual gratification may be obtained by electrical stimulation.
3. Other methods include, covering the head in a plastic or some impervious bag.

§         Violent asphaxial death:

1. Hanging.
2. Strangulation.
3. Suffocation.
4. Drowing.

§         Causes of violent asphyxial death:

1. Asphyxia.
2. Venous congestion.
3. Combined asphyxia & venous congestion.
4. Cerebral anaemia.
5. Reflex vagal inhibition.
6. Fracture of dislocation of the cervical vertebrae.