Asphyxia due to abnormal posture

Introduction Postural asphyxia refers to suffocation death caused by the body's long-term restriction in an abnormal position, which causes respiratory movement and venous return to be blocked. Asphyxia: As the body's respiratory process is blocked or abnormal for some reason, the resulting pathological state of tissue and cell metabolism, dysfunction and morphological damage caused by carbon dioxide retention is called asphyxia. The condition is focused on prevention, and the body should not be fixed in a certain position or posture for a long time.

Cause

The body is limited to an abnormal position for a long time, causing suffocation caused by respiratory movement and venous return to die. Human breathing requires three factors to work together: (1) the ventilation function of the lungs; (2) the patency of the respiratory tract; and (3) the function of the muscle pump. The cause of death in the case of postural asphyxia is still controversial. Especially in the case of death caused by some non-fatal injuries during his lifetime, how to evaluate the role of suspension and injury in the cause of death is related to the judgment of the nature of the case and the criminal accountability of the specific responsible person. Some people used simulation experiments with animals. The results showed that the anatomical findings of the experimental animals and the results of blood gas analysis were completely consistent with the changes in suffocation seen in forensic identification. However, this orthostatic suffocation is not the same as sudden death, strangulation, sudden death, and suffocation caused by compression of the chest and abdomen. There is no mechanical violence directly affecting the trachea, blood vessels in the neck, and no mechanical violence directly affects the chest and abdomen. The cause of suffocation death may be respiratory failure due to restrictive ventilatory disorders. After the experimental animals were fixed in the upper limbs, the upper limbs were restricted in activity, and because the body weight fell, the thorax was pulled down passively, and the thorax was lost to the function of free expansion. The intercostal muscles were in the inhaled state, which hindered the call. The gas movement went smoothly. At the beginning, the breathing process is completed by the diaphragm compensation. As time goes on, the diaphragm is fatigued and the breathing function is getting worse. Due to the continuous accumulation of CO2 in the body, it affects the respiratory function of the central nervous system, and the function of inhalation is getting worse. Eventually peripheral and central dyspnea, acidosis, respiratory failure, and suffocation death.

Death caused by orthostatic asphyxia is a special, rare suffocation. This deserves the attention of the forensic community and will be used for reference in the identification of relevant cases in the future. Due to the occlusion of the upper airway caused by the continuous sag of the head, the mechanism of asphyxia is the hypoxia of the body caused by external respiratory disorders.

an examination

Related inspection

Whole body condition check

Whole body condition check: It is a general observation of the general health of the examinee and is the first step in the physical examination process. Including gender, age, body temperature, breathing, pulse, blood pressure, development, nutrition, state of consciousness, facial expression, posture, posture, gait, etc. At the same time, attention should be paid to the patient's appearance, personal hygiene, breathing or body odor, as well as the mental state of the inspected person and the response to people and things in the surrounding environment and the comprehensive assessment of systemic and organ function.

Differential diagnosis

Differential diagnosis of confusing and confusing symptoms caused by abnormal position:

1. Respiratory failure: Respiratory failure is a serious disorder of lung ventilation or ventilation due to various reasons, so that effective gas exchange cannot be performed, resulting in hypoxia with or without carbon dioxide retention, resulting in a series of physiological functions and Clinical syndrome of metabolic disorders. Respiratory failure is an important part of respiratory physiology research, an important cause of death from respiratory diseases, and the application of various types of mechanical breathing devices and respiratory physiology devices in the respiratory failure care unit (RUCU) to achieve significant therapeutic effects. Respiratory failure relies solely on clinical diagnosis of arterial blood gas analysis.

2, apnea-like phenomenon: apnea refers to breathing pause for more than 20 seconds or less than 20 seconds but accompanied by bradycardia and abnormal breathing of the purple group. According to the cause of primary and secondary, primary apnea is divided into three types: central, obstructive and mixed. About 25% of premature babies develop varying degrees of apnea.

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