Interpersonal violence and fire deaths Flashcards
What is IPV?
When a person uses power and control over another through:
Physical,
Sexual, or emotional threats or actions,
Economic control,
Isolation, or other kinds of coercive behaviours
Examples Dating/Relationship Violence, Sexual Violence,
Stalking, Bullying, and their ilk.
Fire safety
In 2019/2020, there were:
Over 14,000 workplace related
fires
17 fatalities
Over 800 non-fatal injuries
Sources of fuel include:
Wood
Paper
Plastic
Rubber
Foam
Loose packaging materials
Waste rubbish
Furniture
Flammable gases
Flammable liquids
Aims of autopsy
Establish positive identity
Was the deceased alive at the time of the Fire?
Determine the cause of death
Any contributory factors (e.g. natural disease, alcohol,
drugs)
Preventing escape time of death
Fire deaths
Accidental – children, elderly, alcohol related, smokers
Suicide – uncommon,
Asian females Crime – arson, concealment of homicide,
insurance fraud
Identification
Visual (including scars, tattoos etc.)
Circumstantial (jewellery, documents, spectacles,
dentures)
Radiographs (cranial sinuses, bony abnormalities, surgical
implants)
Dental and DNA
Cause of death
Neurogenic shock - pain
Thermal Injury (hypovolaemia, shock, acute renal failure)
Inhalation of Smoke and Fire Gases – most common -
asphyxia delayed death, natural disease - ?
Fire caused death, Injuries - ?
Fire caused death, Homicide - ?
Types of burns
Flame burns (including flash burns)
Contact burns (e.g., hot iron)
Radiant burns scalding burns microwave burns
Chemical burns (generally, alkaline more severe than acid)
Inhalation of smoke and fire gasses
Thermal injury to airway (laryngeal oedema, bronchospasm) Carbon monoxide (200 x affinity for Hb)
Cyanide acrolein (wood and petroleum products)
Hydrochloric acid (plastics, furnishings)
Toluene diisocyanate (from polyurethane)
Nitrogen dioxide (automobiles, agricultural waste)
Burn severity
1st Degree: erythema, oedema, pain
2nd Degree: blisters, pain
3rd Degree: full thickness, sensation lost
4th Degree: charring(incineration)
Alternative: Partial thickness Full thickness
Extent and outcome of burn charts
“Rule of Nines” Percentage of total body surface area 100% burns -prognosis poor >70% burns -likely to be fatal
Probability of survival:
Age of Individual
Percentage of total body surface area
Children can survive extensive burns
Elderly may succumb after minor burns AGE + PERCENTAGE < 100
Burns
Antemortem v. postmortem
Differentiation of antemortem burns and postmortem burns is
usually IMPOSSIBLE
Gross- red flare, blistering
Microscopic – vital reaction
HEAT FRACTURES - SKULL FRACTURES (recent research to assist identification of antemortem fractures)
Charred bodies
Post-mortem examination is ALWAYS worthwhile
Internal organs often well-preserved
Splits in skin and muscle (run parallel)
Pugilistic Attitude (occurs as body cools)
Parts of Body may be absent – check scene
X-Rays
Heat epidural (an artifact)
Airways (soot) Carbon monoxide
Delayed death
Shock,
Renal failure
Adult respiratory distress syndrome (ARDS)
Sepsis (burns or pneumonia)
Pulmonary embolism
Escape
Trapped by fire
Unable to see way out
Immobilised by fear
Intoxicated by alcohol or drugs
Illness or natural disease Injuries – pre or during fire
Toxicology
Carbon monoxide levels
Cyanide
Alcohol
Drugs
Fatal fires investigation
About 535 fatal fire investigations from 2002-2006
About 47% of all fires involved substance misuse
Alcohol formed 33%
Prescribed drugs forms 12%
Alcohol and fatal fires
Alcohol associated with fatalities at nights and weekends
Less substance misuse in elderly
Most in 50–59-year group
Characteristics of victims
Mental impairment in 15 %
Depression most common
Physical impairment in 29% of
all fires
Wheelchair users formed 22%
Impaired in some way formed
77%
Alcohol and cigarettes
About 44% are due to combination of both excessive consumption of alcohol and smoking whilst drowsy.
Wakefulness:
* 51% asleep
* 17% unconscious for some reason
* 75% single person household
* 40% men
* 28% women
