Types of thermal injuries Definition Old classification Recent

Types of thermal injuries Definition Old classification Recent classification q Dry or simple burn. degree burn AFirst thermal injury is a tissue injurydegree resulting Epidermal 1 st & 2 nd degree q Scald or moist burn. Secondthe degree burn from application of Byheat in any form to Third degree burn q Chemical orinternal corrosive burn. the external or surface of the burn body. Dermo - epidermal Fourth degree burn 3 rd & 4 th degree q Electric burn. Lecturer of Forensic Medicine & Clinical Toxicology Fifth degree burn Deep burn q Radiation burn. 5 th & 6 th degree Sixth degree burn

Dry burn Any degree Degree Air passage Contains soot Hair Blood Skin Cause Singed Thick, viscid & Corrosive 1 st, 2 nd & 3 rd 1 st, 3 rd, 4 th No soot Wet Eaten contains COHb Sodden & bleached Stained & corroded Dry & charred Flame or heated body Thick with Scar disfigurement Burnt Clothes From below Site & spread upward Charring Vesicles Scald Present At circumference of burnt area Steam or hot Corrosive acid Less liquid or. Much alkali disfigurement From. We above downward t Absent Over burnt area disfigurement Eaten At & below site of contact With mineral Rarely found acid

Factors affecting degree of burn A) Extent of burnt area: D) Age is determined by rule of nine of Wallace. B) Depth of burn: E) Sex The 3 rd degree burn is the most serious one. F)Site General C) of burn. health. Neck, abdominal wall or genitalia are more dangerous than those of the extremities.

Causes of death from burn III Death after within days : hours”: I) IV) Immediate causes within 66 -48 hours “ II )) Death Rapid death "2 -7 within one week: - Supra-renal haemorrhage. Ø Neurogenic shock. v Secondary oligaemic shock. - Rupture of an acute duodenal ulcer )at 12 th day )Associated ) curling'saccidental ulcer) (stress ulcer ) : may be due Ø serious injuries to vital - to Bronchopneumonia. hypovolaemia causing devitalization of organs. vmucous Secondary toxaemic membrane inshock. addition to the absorbed toxins which excreted by the liver into - burn Inflammation ofare serous membranes. Ø Asphyxia (suffocation). the duodenum. v Acute oedema of glottis (in the neck). Ø Traumatic asphyxia. - Septicemia. Liver, kidney or heart damage: cell degeneration and necrosis of these organs due Tetanus, gangrene and erysipelas. : erysipelas. vto. Pulmonary fat embolism (burn in a fatty the effect of burn toxins metabolism. area). -

Burn vitality Age of Burn Erythema Appears Antemortem immediately 36 hs Appears Line of hyperemia Vesicles 2 -3 hs Vesicles Presence of COHb Sepsis Vital reaction Superficial slough Cause of death Deep slough Soot in URT Scar Red burn Postmortem burn 48 hs Absent Present 1 w 2 ws Albuminous fluid Present rich in chloride absent poor in Absent – 3 albumin and 2 chloride 36 hs days Infl. , pus healing 1 w Nothing But burn Nil Other causes 3 ws Present 2 m Coppery Absent 6 m

Postmortem Picture of Burn Complications of Burn --Particles soot are present the air The bodyofshows evidence ofin antemortem passage. burns of various degrees. The body presents a peculiar attitude; hge -- Subcutaneous or subserous peticheal attitude of defence , boxing or "Pugilistic may be present. attitude". Sepsis Deformities - Haemoconcentration of blood due to loss Keloid formation - Crimson red cherry colour red of hypostasis. of plasma and colour of the skin. Generalized visceral congestion Hge --Skull may show thermal fracture and "fissure in the internal organs. fracture“. -

Points of differentiation () thermal & traumatic fracture Thermal Fracture The fracturesigns is not of displaced Postmortem burn The brain is shrunken Extradural haematoma doesn’t fill the space Traumatic Fracture The fracture is of displaced Other postmortem signs death The brain is edematous & associated with contused wound in scalp Extradural haematoma fill the space

Factors influencing the effect of electric current Electric burn Physical Voltage Physiological Resistance of body tissue Humidity Nature of current Pathway of current Anticipation of shock Duration of contact General health

Causes of Death Ventricular fibrillation Central Respiratory failure Cardiac arrest Cerebral anoxia Electric burn Hyperthermic effect Peripheral

Marks P. M. Picture. Current of Electric Burn NMicroscopic / E appearance It is ofonset the same size and shape as which the Compression the stratum corni Ø-- Rapid of of rigor mortis conductor. stains deeply with superficial carbonization. Ø Marked hypostasis Grayish-white painless areas of aseptic - Separation of the cells in the form of slits necrosis. (electric channels). Ø Presence of current mark - They vary from superficial circumscribed - Elongation of both cells and nuclei. severe burns with full thickness Ø lesions Internaltosigns of asphyxia tissue necrosis.

-Lightning The electric current is DC not AC. syndrome Definition -Characterized About 20. 000 by: amperes. It is the discharge of the atmosphere Loss of consciousness. potential () clouds, or () clouds and -Earth. About 100(similar - 1000 million volts. burn. Skin burn to 1 st degree Conductive deafness. - A single flash lasts 1/1000 th of a second.