SUFFOCATION
Definition
Suffocation is caused by deprivation of oxygen
either due to lack of oxygen in environment or
from obstruction of air passages. In general it
indicates asphyxia
Common signs of suffocation
Cyanosis
Lips, gums and tongue is swollen
Petechial haemorrge in internal organs
Blood stained froath can be seen in nostrils.
Swollen face.
Oedma in organs.
Right side of the heart becomes congested in various
cases of burking and traumatic asphyxia
Types of suffocation
1.Smothering
2.Gagging
3.Overlaying
4.Burking
5.Chocking
6.Due to irrespirable gases
7.Traumatic suffocation
SMOTHERING
Smothering refers to death resulting from
mechanical occlusion of the mouth and nose that
prevents breathing.
The smothering agent is usually a fabric, an
impervious sheet or a hand, thougH occasionally
a mobile solid such as sand, mud, grain or flour
may be responsible for blocking the air-passages.
GAGGING
Mechanical obstruction of oral cavity is termed as
gagging. It is usually resorted to prevent the victim
from shouting for help & death is usually not intended.
At times, it may be homicidal, particularly when
victims are infants or in individuals incapacitated
by alcohol or drugs, old, infirms. initially the gag
only blocks the mouth and permits air entry
through nostrils. Later the gag becomes
progressively soaked with saliva &/or mucus,
becomes impervious and gets sucked in with
inspiratory gasps. Finally it obstructs the
nasopharynx leading to complete obstruction of
airways & may cause unforeseen death.
The sequence of physiological events is
bradycardia, decrease in respiration, eventual
cessation of respiration, slowing and finally
flattening of ECG occurs.
In case of gagging, gag should be examined for
saliva, mucous and blood.
Sometimes Sudden death due to vagal
inhibition also occurs.
Sruggle marks can also be seen in various cases.
OVERLAYING
It is seen most commonly when an infant is put to
bed with one or more adults. During the night,
one of the adult inadvertently rolls on to or
otherwise crushes and asphyxiates the infant by
compressing the chest thus preventing
respiratory movement and occluding the nose
and mouth with bedding or the body of the adult.
Later on the adult rolls off the child. The next
morning the child is found dead without any
evidence of trauma.
BURKING
Burking is a form of traumatic asphyxia plus smothering
that is homicidal in nature.
It was named after criminals named Burke and Hare
during 1820s.
External sign of suffocation is absent in this case.
CHOKING
It is a form of asphyxia caused by an
obstruction within the air passage. It is almost
always accidental and is usually due to inhalation
of a foreign body, but it can be caused by the
inhalation of the products of disease or by
anatomical changes due to disease. The usual
mechanism of asphyxia in choking is simple
mechanical obstruction.
Cafe Coronary
One of the commonest causes of choking is the
entry of food into the air passages. If food enters
the larynx during swallowing, it usually causes
gross choking symptoms of coughing, distress
and cyanosis, which can be fatal unless the
obstruction is cleared by coughing or some rapid
treatment is offered. However, if the piece of
food is large enough to occlude the larynx
completely, it will prevent not only breathing but
also speech and coughing. The individual may die
silently and quickly, the cause of death
remaining hidden until the autopsy. This is the so-
called café coronary.
TRAUMATIC ASPHYXIA
Asphyxia caused due to mechanical fixation of
the chest so that normal movements of chest wall are
prevented.
This occurs when a large weight falls onto or
presses down on an individual’s chest or upper
abdomen.
The most common form of traumatic asphyxia
encountered is while repairing a car the jack slips
and the vehicles falls on top of the individual.
ASPHYXIA DUE TO IRRESPIRABLE GASES
Deaths from suffocating gases are not due to
the toxic nature of the gases, but rather to
displacement of oxygen from the atmosphere.
Carbon dioxide and methane are two most
commonly encountered suffocating gases. Both
are essentially nontoxic and odorless and are
found in sewers and mines.
The cause of death can be determined from the
circumstantial evidences as there are no specific
autopsy findings. If death is prolonged, the
individuals appear cyanotic with petechial
haemorrhages of the epicardium and visceral pleura.
Medico legal aspects of Suffocation
1.Homicidal
It happens usually when a person is either weak on
unconcious due to drug or in sleep and his/her mouth
and nose is pressed with a cloth or a pillow.
2 .Sucidal
It is impossible to commit a suicide through
suffocation. But it is possible by burying the face again
the bed clothing, mostly seen in mental patients.
Sometimes cut throat wounds can also lead to the
obstruction due to soft part choking the throat. It can
also be done by covering face by plastic bag
3 . Accidental
It is the most common suffocation. At times infants
gets suffocated with the weight of bed cloths or due to
the weight on their mother’s hand while sleeping.
A child may get suffocated while playing with bags.
A person might fall in mud and get suffocated.
