Dr.I.B.

GD Surya Putra P, SpF

Department of Forensic Medicine
Faculty of Medicine, Gadjah Mada
University

Definition of asphyxia
Causes of asphyxia
Phase of asphyxia
Appearence /clasiccal signs of autopsy
Types of asphyxia

Term asphyxia mean lack of oxygen

Etymologically the word means absence
of pulsation
A condition where the cells or organs did
not receive oxygen.
The condition can be partial (hypoxia) or
total (anoxia).

There are three causes of asphyxia :

1. Natural disease
2. Trauma (mechanical)
3. Toxic conditions

Dyspneu
Convulsion
Apneu
Paralyse
ALL PHASE NEED 45 MINUTE

1.
2.
3.
4.

CYANOSIS
PETECHIAE HAEMORRHAGES
VISCERAL CONGESTION
FLUIDITY OF BLOOD

Mean dark blue

The colour of soft tissue or skin change
to blue or purple. And usually we look In
the lip and under the nail.
However becomes observable until at
least 5 g of reduced hemoglobin per 100
ml.

Pinpoint hemorrhages produced by ruptured

of small vessels, predominantly small
venules.
Size from a tent of millimetre to about two
millimetre.
Rupture is caused by sudden over distention
or increases in intravascular pressure.
It is classically seen in the conjunctivae and
sclerae (strangulation).
It often known as tardiev spot

It is due to obstructed venous return and

capillovenous congestion.
There is dilatation of the vessels and
stasis of blood.

It is due to increased activity of

fibrinolysin.

Can be group into three categories:

1. Suffocation
2. Strangulation
3. Chemical asphyxia

There are six general forms :

1. Entrapment/environmental suffocation
2. Smothering (pembekapan)
3. Choking
4. Mechanical asphyxia
5. Mechanical asphyxia combined with
smothering
6. Suffocating gases

It is caused by inadequate or gross

deficiency of oxygen in the environment.
But it is not due to by suffocating gases.
In this case volume of oxygen was 9.6%
It caused by fungus-like organisms ( for
enviromental)
These death are almost accidental in
nature.

It is caused by the
mechanical obstruction
or occlusion of the
external airways, i.e., the
nose and mouth.
These death are usually
either homicide or
suicide, very rarely
accident.

It is caused by obstruction
within the air passages.
The manner of death can be
natural, homicide, or accident.
The diagnosis of choking death
is made at autopsy when the
airways is found occluded
(adanya saluran napas yang
tertutup).
If the material in oro-pharynx is
choking, if laryngo-pharyngx is
called Gagging.

1.
2.
3.

This condition, if there is pressure on the

outside of the body prevents respiration.
Divided into three types :
Traumatic asphyxia
Positional asphyxia
Riot-crush or human pile death

Traumatic asphyxia:
It occurs when a heavy weight
press down on individuals chest
or upper abdomen.
Positional asphyxia :
It occurs when the position of
the bodies
trapped(terperangkap) in
restricted space. (uu ranga
tagepe)
Riot-crush :
It occurs in riots, when the chest
is compressed by stampeding
people piling on top each other.

It is a combination of both these entities.

An accidental form is overlay, where an
infant is placed in bed for the night with
either an adult or a larger child.

This condition is caused by inert gases

such as carbon dioxide and methane.
The gases makes reduction of
atmospheric oxygen.

1.
2.
3.

It is characterized by closure of the blood

vessel and air passages of the neck as a
result of external pressure on the neck.
They are three forms :
Hanging
Ligature strangulation
Manual strangulation

In hanging, there is compression or

constriction of the neck structure by
noose
or
other
constricting
band
tightened by the weight of the body.
There may be either complete or
incomplete suspension of the body.
Commonly, hanging is suicide. Accidental
hanging is uncommon and homicidal
hanging very rare.

HOMICIDE :

Complete
supension : the
distance between
foot an floor is far
Victim : there is
another wounds
Scene : Untidy

SUICIDE :

The distance
between foot and
floor is near
Victim : just one
wound in the neck
Scene: Tidy

The pressure on the neck

is
applied
by
a
constricting band that
tightened by a force other
than the body weight.
All cases are homicides.

It
is
produced
by
pressure of the hand,
forearm, or other limb
against
the
neck,
compressing
the
internal structures of
the neck.
All cases are homicide.

Principally caused by hanging

Transitory anoxia is intentionally induced to
enhance sexual arousement produced by
masturbation.
Loss of control, and accidental death occur.
Such deaths are rare, with the victim always
a male, only a few cases involving female.
Typically found in a private area, sometimes
wearing female clothing, erotic literature,
sexual paraphernalia, and mirror

This condition occur due to chemical

substance.
In chemical asphyxiants, the most
common encountered by medical
examiner is carbon monoxide, and
cyanide.

The example of signs of asphyxia

Ptechie

Cyanosis

Congestion in the
face

Congestion in the brain

THANK

YOU