Choking ppt

1. Choking – a case report DR.DEBARSHEE CHAKRABORTY POST GRADUATE TRAINEE, DEPARTMENT OF FORENSIC MEDICINE AND TOXICOLOGY, GAUHATI MEDICAL COLLEGE, GUWAHATI. DR.RAKTIM PRATIM TAMULI REGISTER, DEPARTMENT OF FORENSIC MEDICINE AND TOXICOLOGY, TEZPUR MEDICAL COLLEGE, TEZPUR DR. R.CHALIHA PROFESSOR & HOD, DEPARTMENT OF FORENSIC MEDICINE AND TOXICOLOGY, GAUHATI MEDICAL COLLEGE, GUWAHATI

2. Choking is a form of asphyxia caused by an obstruction within the air passages , usually between the pharynx and bifurcation of trachea.

3. Sore –throat Hoarseness Respiratory difficulty Unable to speak or make any sound . Cyanosed (blueness of lip/nail bed) Coughing rapidly Collapse Signs and Symptoms

4. Univesal Sign for Choking

5. Types of choking

6. 1 .Seen in very young, elderly, psychiatric patients or in the infirm . 2.Seen commonly during crying & laughing . 3.Under the influence of a drink, an anaesthetic or in epilepsy or in a state of insensibility . 4. Infants regurgitating the clotted milk and in children rubber balloons, coins, marble etc inhalation during play. 5.Tranquilizing drugs depressing the gag reflex. 6.In head injuries , Vomiting can occur which may be inhaled. . 7.Impaction of large food bolus, blood and clothes in ENT operations, gauze packs etc. 8.A blow to the front of neck. Accidental choking

7. Suicidal choking Its rare . Usually seen in dementia or psychosis patients or in prisoners . Mechanism : a foreign body is thrust into the throat.

8. Homicidal choking Its very rare Practicable only when the victim is suffering from disability or disease Used as a mode of infanticide Mechanism : stuffing a wad of paper or cloth into the pharynx or larynx.

9. History Of The Case The present case which was brought by a local police station for medico legal autopsy to the mortuary of GMCH , was of a young man of 29 years who reportedly mystrically found dead one morning in his own bed by his family members. According to the history given by the family members they all took dinner together the previous night and then he went to his room and slept. The next morning the family members found him dead with vomiting all around the face and cloths after breaking the door when the man did not open the door after repeated knockings.

10. External Examination On external examination , the body was found to be of a male of average built with closed eyes and partially open mouth with vomitus seen all over the face , neck and cloths at places. No injuries were found on external examination .

11. Internal Examination Petechial hemorrhages were found over the surface at places and the chambers of heart are found to contain liquid blood. Heart The coronaries were found to be healthy and not obliterated .

12. Both the lungs were found to be congested and petechial hemorrhages were found over the surface at places. Lungs

13. Larynx and trachea Mucosa was found to be congested and found to contain bolus of partially digested food material.

14. The stomach mucosa was also congested and the cavity was found to contain partially digested food material. The mucosa were also found congested and the cavity was found to contain partially digested food material . stomach Mouth and esophagus The other organs were also found to be congested .

15. Membranes and brain Subarachnoid hemorrhage (SDH) is found to be present over the occipital area bilaterally and the brain too was found to be congested. The scalp and skull all were found healthy without any injury.

16. Conclusion Death was opined to be due to asphyxia as a result of Choking .

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