The American journal of forensic medicine and pathology
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Am J Forensic Med Pathol · Jun 1997
Case ReportsUnusual presentation of death due to carbon monoxide poisoning. A report of two cases.
Two cases are reported representing opposite ends of the spectrum of death as a result of carbon monoxide poisoning from car exhaust fumes. In one case, a women was reported to be found dead in bed early in the morning by her husband. The cause of her death, established by autopsy, was carbon monoxide poisoning. ⋯ In the second case, a women was found in a car located in her garage with a hose leading from the exhaust pipe to the interior of the sealed vehicle. Autopsy revealed negligible carboxyhemoglobin saturation of the blood, bilateral infarction of the globus pallidus, and extensive bronchopneumonia. It was concluded that inhalation of carbon monoxide resulted in sublethal hypoxia with subsequent exhalation of carbon monoxide and a delayed death.
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During a 10-year period (1980-1989), at least 43 cases of self-incineration with lethal outcome took place in Denmark. The incidence seems to be increasing: 11 cases took place in the first 5 years and 32 cases in the last 5 years. An even sex ratio as found (male:female = 23:20). ⋯ Most were found dead at the scene, and the cause of death was usually heat exposure. Only a minority had a lethal carboxy-hemoglobin (CO-Hb) concentration. It is concluded that close cooperation between police, fire experts, and the forensic pathologist is necessary to permit a correct classification of the mode of death in these cases.
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Am J Forensic Med Pathol · Mar 1997
Practice Guideline Case Reports GuidelineCriteria for the diagnosis of heat-related deaths: National Association of Medical Examiners. Position paper. National Association of Medical Examiners Ad Hoc Committee on the Definition of Heat-Related Fatalities.
The National Association of Medical Examiners Ad Hoc Committee on the Definition of Heat-Related Fatalities recommends the following definition of "heat-related death": a death in which exposure to high ambient temperature either caused the death or significantly contributed to it. The committee also recommends that the diagnosis of heat-related death be based on a history of exposure to high ambient temperature and the reasonable exclusion of other causes of hyperthermia. ⋯ Deaths may also be certified as heat stroke or hyperthermia with lower body temperatures when cooling has been attempted prior to arrival at the hospital and/or when there is a clinical history of mental status changes and elevated liver and muscle enzymes. In cases where the antemortem body temperature cannot be established but the environmental temperature at the time of collapse was high, an appropriate heat-related diagnosis should be listed as the cause of death or as a significant contributing condition.
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Experimental gunshots were made with Action-1 and -3 ammunition (9 mm Luger) using a part dummy made of textile, pig skin, and gelatine as the target. After ricocheting off a concrete floor tile with impact angles of 15 degrees or 20 degrees, the deformed projectiles penetrated the gelatine block to a depth of between 21 and 37 cm. The ricochet angles varied between 5 degrees and 11 degrees. ⋯ The Action-3 brass bullet was more resistant, had more kinetic energy, and was less deformed than the Action-1 copper bullet. The morphology of the wounds presented a very varied spectrum; round lesions were also observed. The results of the experimental study prove that ricocheted Action bullets present a serious risk of injury.
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Am J Forensic Med Pathol · Sep 1996
The Abbreviated Injury Scale. A valuable tool for forensic documentation of trauma.
Anatomic trauma scoring systems are fundamental to trauma research. The Abbreviated Injury Scale (AIS) and its derivative, the Injury Severity Score (ISS), are the most frequently used scales. We assessed the applicability of the AIS and the ISS systems for postmortem forensic documentation of trauma. ⋯ In conclusion, AIS and ISS scoring systems are applicable to trauma forensic documentation. Using these methods for coding postmortem findings may help in establishing a database for trauma research, and this information could constitute a major part of continuous quality improvement of trauma management. Low ISS values may serve as a warning, sometimes indicating preventable death.