THERMAL INJURIES OR DEATH

• Thermal injuries are those caused by appreciable deviation from normal temperature,
capable of producing cellular or thermal changes in the body
• Thermal death is one primarily caused by thermal injuries

I. DEATH OR INJURY FROM COLD

LOCAL EFFECTS
• Frostbite, immersion foot, trench foot
• First: blanching and paleness of the skin due to vascular spasm
• Second: erythema, edema and swelling due to vascular dilatation, paralysis and
increased capillary permeability
• Third: in advanced stage of vascular paralysis, there will be blister formation
• Fourth: Continued exposure to severe cold will later lead to necrosis, vascular
occlusion, thrombosis
SYSTEMIC

• Respiration, heart action, metabolic processes are slowed down on account of cerebral
anoxia.
• There is cold stiffening of the body with blister formation and gangrene of the exposed
parts.
POST-MORTEM FINDINGS

Externally
• Cold Stiffening
• Surface of the body is pale
• Reddish patches especially in exposed portions of the body (frost erythema)
• Onset of rigor mortis delayed
Internally
• Blood is generally fluid in the heart and blood vessels with a bright red color
• Parenchymatous organs are congested with occasional petechial hemorrhage
• Audible cracking sound on flexing the knee and other big joints
• Petechial hemorrhage on the lungs, brain and kidneys
II. DEATH OR INJURY FROM HEAT
A. GENERAL OR SYSTEMIC EFFECTS
Heat Cramps
• a.k.a. Miner's cramps, Fireman's cramp, Stoker's cramp
• Involuntary spasmodic painful contraction of muscles essentially
due to dehydration and excessive loss of chlorides by sweating
• Symptoms
o Onset is usually sudden as muscles cramp with agonizing pain
o Accompanied by headache, dizziness and vomiting
o Face is flushed, pupils dilated with tinnitus & abdominal pain
o Amount of chloride excretion is diminished
Heat Exhaustion
• Due to a heart failure primarily caused by heat and precipitated by muscular exertion
and warm clothing
• Symptoms
o Sudden attack of syncope, general body weakness, giddiness and staggering
movement
o Face is pale, skin is cold and temp is subnormal
o Pupils are dilated, pulse weak and thready, and respiration is sighing
o There may be diarrhea, BOV and dilated pupils
o Exhaustion comes gradually with throbbing in the temples
o Patient usually recovers
Heat Stroke
• a.k.a. Sunstroke, Heat Hyperpyrexia, Thermic Fever
• Symptoms
o Sudden onset that may be followed by premonitory symptoms of headache, malaise,
giddiness and weakness of the legs
o Temp rises suddenly and skin becomes dry
o Face is congested
o Pulse is full and pounding
o Respiration is irregular
o Pupils are usually contracted
o Death occurs ½-1 hour after onset of symptoms