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ASPHYXIANTS
Asphyxiant.pptx jkabmans sjw snwksgen sns
CLASSIFICATION
POISON
Corrosives Irritants Systemic Miscellaneous
a. Cerebral
b. Spinal
c. Peripheral
d. Cardiovascular
e. Asphyxiants
Asphyxiant.pptx jkabmans sjw snwksgen sns
 An asphyxiant is a substance that can
cause unconsciousness or death by
suffocation.
 Substances that cause asphyxial death 
asphyxiants
CLASSIFICATION
 Henderson and Haggard
 1. Irritants
 2. Chemical asphyxiants
 3. Simple asphyxiants
 4. Volatile drugs
 5. Systemic poisons
1. Irritants
 Gases injure air passages/lungs/both
 Produce inflammatory change
 Smoke, tear gas, ammonia, formaldehyde, chlorine
2. Chemical asphyxiants
 Combines with Hb --> prevents oxygen from reaching
tissues
 CO, Hydrogen sulphide, cyanide
3. Simple asphyxiants
 Inert gases
 When breathed in high con. Acts mechanically by
excluding O2
 CO2, methane, nitrous oxide, N2
4. Volatile drugs
 No irritant effect on air passages.
 Acts after absorption into blood.
 Toxic to liver, kidney and nervous system
 Aliphatic, aromatic, halogenated hydrocarbons
5. Systemic poisons
 Insecticides
 CARBON MONOXIDE - CO
 CARBON DIOXIDE - CO2
 HYDROGEN SULPHIDE - H2S
1. CARBON MONOXIDE
FEATURES
Colorless, tasteless, non irritative gas produces due to
incomplete combustion of carbon.
 Insoluble in water.
 Burns with blue flame
 Lighter than air
 Mixture of CO with 2 遜 times its volume of air 
highly explosive in presence of flame
source
 Common source - coal gas, smoke from
fires, fumes from
defective heating
appliances.
 Industry - 20%
 Smoking
ACTION
CO in inspired
air
Absorbed into
blood
through
alveoli
Reaches
blood
Asphyxiant.pptx jkabmans sjw snwksgen sns
Asphyxiant.pptx jkabmans sjw snwksgen sns
COHb
Tissues not able
to dissociate
COHb and use
O2 in
oxyhaemoglobi
n
Hypoxia
 Displaces oxygen from its combination with
hemoglobin and forms relatively stable compound
carboxyhemoglobin thus leading to hypoxia.
( affinity 200 to 300 times greater).
 CO affinity to myoglobin (40 times greater) may
cause direct myocardial depression.
 Act as chemical asphyxiants produce death due to
anaemic anoxia.
 Interfers with intercellular respiration.
ELIMINATION
 Eliminated through lungs
 1% is metabolized into CO2
 Not lost through skin, bile, perspiration, urine
or faeces.
 Not absorbed by a body after death
SIGNS AND SYMPTOMS
Asphyxiant.pptx jkabmans sjw snwksgen sns
Asphyxiant.pptx jkabmans sjw snwksgen sns
 Often mistaken for symptoms
of influenza or illness caused
by contaminated food..
 Effects are simply those of
suboxia.
 Bullae are localised over
calves, buttocks, wrists and
knees by external pressure.
 Death usually occurs when
80% of Hb is saturated with
CO.
 CO automatism
Tendency of the dying victim to
wild, erratic, swinging
movements inside the room,
disturbing clothing and
furniture which gives an
impression of violent struggle.
 CO pass from maternal to
fetal blood, produce
intrauterine death ( 10 to

15 %)
 Blood under the skin and in tissues will be
cherry red due to formation of carboxy-
haemoglobin.
CHRONIC POISONING
 Headache, confusion
 Paraesthesia
 Visual disturbances
 HTN, Hyperthermia
 Mental Retardation.
 Parkinsonism
 Psychosis
TREATMENT
 Remove patient to fresh air
 Conscious and breathing, no treatment
 COHb level >25% should be treated
 Provide 100% oxygen
 Endotracheal intubation
 CO2 should not be given
 Gastric lavage in early stage
 Whole blood transfusion
 Complete rest for 48 hrs
POST MORTEM APPEARENCE
 Cherry red appearance of skin, mucous, conjunctiva,
nail bed.
 Anemic cont.. - color pink
 Dark coloured victims - masked
 Color will not be changed by embalming or
preservation by formalin
 During decomposition
 Cherry red -> dark green -> brown
 Blistering of skin of dependent area.
 Congestion of lungs with pink fluid blood
 Pulmonary edema.
 Bilateral symmetrical necrosis and cavitation
of basal ganglia in putamen and globus
pallidus
 Ring shaped hemorrhages in white matter of
brain.
Asphyxiant.pptx jkabmans sjw snwksgen sns
CIRCUMSTANCES OF POISONING
 Suicide is rare
 Accidental is most common
Exposure to exhaust gas of petrol engine
Exposure to gas in mines
Incomplete combustion of wood, charcoal or coal
 Homicide is uncommon
 Unless victim is alcoholic or child
SUICIDE BY CO POISONONG
CARBON DI OXIDE
 Features
 Heavy, colorless gas
 Faintly sweet odour
 Atmospheric air 0.033% CO2
 Product of complete combustion of carbon.
 Seen at manholes, ship holds, old wells
 Action
 Not toxic
 Simple asphyxiant- Preventing tissue from obtaining
oxygen.
Asphyxiant.pptx jkabmans sjw snwksgen sns
5 % - Laboured breathing, Mental confusion

10% - Ataxia and unconsciousness

40% - Dyspnea, Muscular weakness

50 % - Dyspnea, Fullness in head, Ringing in

ear, loss of muscular power, unconsciousness,
coma, death.
60-80% - Unconsciousness and rapid death.
TREATMENT
 Artificial respiration
 Free O2
 Cardiac stimulants
POST MORTEM APPEARANCE
 Marked cyanosis
 Congestion
 Suffusion of eyes
 Dilation of the pupils
 Petechial hemorrhages
CIRCUMSTANCES OF POISONONG
 Accidental
HYDROGEN SULPHIDE
FEATURES
 Colorless, heavy, flammable
 Exposure to lower con. smell of rotten eggs is
detected.
 Formed during decomposition of organic matter
containing sulphur.
 Poisoning due to inhalation
 ACTION
 Does not combine with Hb
 Interferes with cellular respiration by inhibiting the
action of cytochrome oxidase.
 SEWER GAS - H2S + CO2 + CH4
Asphyxiant.pptx jkabmans sjw snwksgen sns
 Great dilution Feeling of dullness and
sleepiness, death may occur during sleep
 Weak concentration Cough, giddiness,
nausea, cyanosis of face, muscular weakness
 Moderate concentration metabolic acidosis,
CNS, respiratory and myocardial depression
Death from paralysis of respiratory centre.
 Chronic low level absorption
 Reduced lung function
 Headache
 Depression
 Personality changes
 Chronic eye irritation
TREATMENT
 Patient is removed to fresh air
 Artificial respiration
 100% O2
 Excretion of sulphide.
 Amyl nitrate inhalation and sodium nitrate infusion.
POST MORTEM APPEARENCES
 Rotten egg odour is given off
 General signs of asphyxia
 Color of blood, viscera, bronchial secretions is greenish
purple
THANK YOU
IT ALWAYS SEEMS IMPOSSIBLE UNTIL ITS DONE`!

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Asphyxiant.pptx jkabmans sjw snwksgen sns

  • 3. CLASSIFICATION POISON Corrosives Irritants Systemic Miscellaneous a. Cerebral b. Spinal c. Peripheral d. Cardiovascular e. Asphyxiants
  • 5. An asphyxiant is a substance that can cause unconsciousness or death by suffocation. Substances that cause asphyxial death asphyxiants
  • 6. CLASSIFICATION Henderson and Haggard 1. Irritants 2. Chemical asphyxiants 3. Simple asphyxiants 4. Volatile drugs 5. Systemic poisons
  • 7. 1. Irritants Gases injure air passages/lungs/both Produce inflammatory change Smoke, tear gas, ammonia, formaldehyde, chlorine 2. Chemical asphyxiants Combines with Hb --> prevents oxygen from reaching tissues CO, Hydrogen sulphide, cyanide 3. Simple asphyxiants Inert gases When breathed in high con. Acts mechanically by excluding O2 CO2, methane, nitrous oxide, N2
  • 8. 4. Volatile drugs No irritant effect on air passages. Acts after absorption into blood. Toxic to liver, kidney and nervous system Aliphatic, aromatic, halogenated hydrocarbons 5. Systemic poisons Insecticides
  • 9. CARBON MONOXIDE - CO CARBON DIOXIDE - CO2 HYDROGEN SULPHIDE - H2S
  • 11. FEATURES Colorless, tasteless, non irritative gas produces due to incomplete combustion of carbon. Insoluble in water. Burns with blue flame Lighter than air Mixture of CO with 2 遜 times its volume of air highly explosive in presence of flame
  • 13. Common source - coal gas, smoke from fires, fumes from defective heating appliances. Industry - 20% Smoking
  • 14. ACTION CO in inspired air Absorbed into blood through alveoli Reaches blood
  • 17. COHb Tissues not able to dissociate COHb and use O2 in oxyhaemoglobi n Hypoxia
  • 18. Displaces oxygen from its combination with hemoglobin and forms relatively stable compound carboxyhemoglobin thus leading to hypoxia. ( affinity 200 to 300 times greater). CO affinity to myoglobin (40 times greater) may cause direct myocardial depression. Act as chemical asphyxiants produce death due to anaemic anoxia. Interfers with intercellular respiration.
  • 19. ELIMINATION Eliminated through lungs 1% is metabolized into CO2 Not lost through skin, bile, perspiration, urine or faeces. Not absorbed by a body after death
  • 23. Often mistaken for symptoms of influenza or illness caused by contaminated food.. Effects are simply those of suboxia. Bullae are localised over calves, buttocks, wrists and knees by external pressure. Death usually occurs when 80% of Hb is saturated with CO. CO automatism Tendency of the dying victim to wild, erratic, swinging movements inside the room, disturbing clothing and furniture which gives an impression of violent struggle. CO pass from maternal to fetal blood, produce intrauterine death ( 10 to 15 %)
  • 24. Blood under the skin and in tissues will be cherry red due to formation of carboxy- haemoglobin.
  • 25. CHRONIC POISONING Headache, confusion Paraesthesia Visual disturbances HTN, Hyperthermia Mental Retardation. Parkinsonism Psychosis
  • 26. TREATMENT Remove patient to fresh air Conscious and breathing, no treatment COHb level >25% should be treated Provide 100% oxygen Endotracheal intubation CO2 should not be given Gastric lavage in early stage Whole blood transfusion Complete rest for 48 hrs
  • 27. POST MORTEM APPEARENCE Cherry red appearance of skin, mucous, conjunctiva, nail bed. Anemic cont.. - color pink Dark coloured victims - masked Color will not be changed by embalming or preservation by formalin During decomposition Cherry red -> dark green -> brown
  • 28. Blistering of skin of dependent area. Congestion of lungs with pink fluid blood Pulmonary edema. Bilateral symmetrical necrosis and cavitation of basal ganglia in putamen and globus pallidus Ring shaped hemorrhages in white matter of brain.
  • 30. CIRCUMSTANCES OF POISONING Suicide is rare Accidental is most common Exposure to exhaust gas of petrol engine Exposure to gas in mines Incomplete combustion of wood, charcoal or coal Homicide is uncommon Unless victim is alcoholic or child
  • 31. SUICIDE BY CO POISONONG
  • 33. Features Heavy, colorless gas Faintly sweet odour Atmospheric air 0.033% CO2 Product of complete combustion of carbon. Seen at manholes, ship holds, old wells Action Not toxic Simple asphyxiant- Preventing tissue from obtaining oxygen.
  • 35. 5 % - Laboured breathing, Mental confusion 10% - Ataxia and unconsciousness 40% - Dyspnea, Muscular weakness 50 % - Dyspnea, Fullness in head, Ringing in ear, loss of muscular power, unconsciousness, coma, death. 60-80% - Unconsciousness and rapid death.
  • 36. TREATMENT Artificial respiration Free O2 Cardiac stimulants
  • 37. POST MORTEM APPEARANCE Marked cyanosis Congestion Suffusion of eyes Dilation of the pupils Petechial hemorrhages
  • 40. FEATURES Colorless, heavy, flammable Exposure to lower con. smell of rotten eggs is detected. Formed during decomposition of organic matter containing sulphur. Poisoning due to inhalation ACTION Does not combine with Hb Interferes with cellular respiration by inhibiting the action of cytochrome oxidase. SEWER GAS - H2S + CO2 + CH4
  • 42. Great dilution Feeling of dullness and sleepiness, death may occur during sleep Weak concentration Cough, giddiness, nausea, cyanosis of face, muscular weakness Moderate concentration metabolic acidosis, CNS, respiratory and myocardial depression Death from paralysis of respiratory centre.
  • 43. Chronic low level absorption Reduced lung function Headache Depression Personality changes Chronic eye irritation
  • 44. TREATMENT Patient is removed to fresh air Artificial respiration 100% O2 Excretion of sulphide. Amyl nitrate inhalation and sodium nitrate infusion. POST MORTEM APPEARENCES Rotten egg odour is given off General signs of asphyxia Color of blood, viscera, bronchial secretions is greenish purple
  • 45. THANK YOU IT ALWAYS SEEMS IMPOSSIBLE UNTIL ITS DONE`!