Shahab 02

It is an injury caused by heat or any physical or

chemical agent having an effect similar to heat.

1.

Contact burns. Physical contact Produces blisters Cause erythema

2. Flame burns: Contact of flame with body Vesication Singeing of hair Blackening of skin Flash burns Effect of kerosene oil and petrol produce sooty blackening

3.

Scalds Occur on contact with hot liquid Exposed surface

4. Chemical burns Ulcerated patches No blisters No singeing of hair No red line of demarcation

Radiant heat burns 6. Ionizing radiation heat burns 7. Electrical burns 8. Microwave burns
5.

First degree(epidermal) 2. Second degree(Dermo-epidermal) 3. Third degree(Dermal)

1.

 Erythema
Blister Surrounded by a thin red area of inflammation

Self healing
Singeing of hair No scar formation

Sensations are present

 Coagulation necrosis of epidermis and dermis Dry, white and leathery appearance

Necrosed tissue separates

Scar formation Pain and shock

Skin grafting

 Destruction of whole skin, muscle and bone occurs.

Painless No blisters

No spontaneous regeneration occurs

 Temperature

Duration of exposure
Extent and position Burn index

point is given to second degree burn. 1 point is given to a third degree burn.

Immediate

Redness
2-3 hrs

Vesication
36-72

Inflammation
After a week

Throwing off of superficial sloughs of third degree burn

Final result

Formation of scar

1.

Immediate causes Neurogenic shock Asphyxia Delayed causes Severe pain, injury to vital organs Secondary shock Accidental injuries Acute tubular necrosis Inflammation Sepsis Exhaustion Complications: tetanus, gangrene, ascites etc

 1. 2. 3. 4. 5.

6.

External features: Clothing: Should be checked for petrol, kerosene and any other inflammatory substance Site Distribution Extent Blisters Due to increased permeability of blood vessels Contain serous fluid Face Swollen Burnt tip of tongue Froth will be pink

7.
8. 9. 10. 11. 12. 13.

Eyes Crows feet Skin Marbled appearance Hair singed, completely or partially burned Postmortem staining Cherry red in color Heat ruptures due to contraction of burned tissue Degloving Boxing attitude/Pugilistic attitude/fencing posture

1.

Skull Heat hematoma

Feature
Cause position Distribution

EDH due to burns

Charring of skull due to heat Usually bilateral Diffused

EDH due to tauma

Blunt force to head Usually unilateral Localized

Appearance

Honeycomb appearance, soft clot chocolate or pink color

Eggshell fracture without radiating fracture lines Absent

Smooth, rubbery and reddish purple in color

Radiating lines are present May be present

Skull fracture Injury to CNS

Brain Congested and swollen Flattening of gyri and sulci 3. Neck 4. Larynx, trachea and bronchiole Presence of carbon particles and soot 5. Blood Thick due to hemeconcentration Cherry red in colour Contain more than 10% CO Kunkels test Nicotine in urine
2.

Pleura Congested and filled with serous fluid 7. Lungs Congested and shrunken 8. Heart Filled with blood 9. Stomach and intestines Curlings ulcer
6.
Puppet organs

Indentification:
Gender of the deceased
Race Age Dental identification Clothing Xray examination Fingerprinting

Feature Line of redness Vesicles

Antemortem burns Present Contains serous fluid rich in albumin

Postmortem burns Absent Contain air, if fluid present contains little albumin Absent

Inflammation

Present along with pus

Soot
Base of vesicles Carboxy-Hb Enzyme reaction

May be present
Red and inflammed Present Increase in periphery

Absent
Dull, dry and yellow Absent No

Burning
Blisters

Soot
Cherry red colour of blood

Suicidal and homicidal Depends upon site of injury

Accidental burning

 Known as bride burning cases