Types of thermal injuries

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

Degree Any degree 1st, 2nd

& 3rd 1st, 3rd, 4th
Air passage Contains soot No soot No soot

Hair Singed Wet Eaten

Thick, viscid &
Blood
contains COHb
Dry & charred Sodden & bleached Stained & corroded
Skin Flame or Steam or hot Corrosive acid or
Cause
heated body
Thick with liquid
Less Much
alkali
Scar disfigurement disfigurement disfigurement
Clothes Burnt Wet
From above
Eaten
From below At & below site of
Site & spread upward downward contact
Present
At circumference of Absent With mineral
Charring
Vesicles
Over burnt area Rarely found
burnt area acid
 Factors affecting degree of burn
A) Extent of burnt area:
D) Age
is determined by rule of nine of Wallace.

B) Depth
E) Sex of burn:
The 3rd degree burn is the most serious one.

F)Site
C) General
of burn.health.
Neck, abdominal wall or genitalia are more
dangerous than those of the extremities.
 Causes of death from burn
III)
II)
IV) Deathdeath
I) Rapid within
Immediate 2-7
causes
after one days:
"within 6-48
"within
week: hours”:
6 hours“

- Supra-renal
 Secondary haemorrhage.
oligaemic
 Neurogenic shock. shock.
- Rupture of an acute duodenal ulcer (at 12th
day)

(curling'saccidental
Associated
ulcer) (stress
serious
ulcer):
injuries
may
to
be due
vital
- to
Bronchopneumonia.
hypovolaemia causing devitalization of
organs.
 Secondary toxaemic shock.
mucous membrane in addition to the absorbed
- burn toxins which
Inflammation
 Asphyxia ofare excreted
serous
(suffocation). by the liver into
membranes.
the duodenum.
 Acute oedema of glottis (in the neck).
- Septicemia.
 Traumatic asphyxia.
- Liver, kidney or heart damage: cell
- degeneration
Tetanus, and necrosis
gangrene and of these organs due
erysipelas.:
 Pulmonary fat embolism (burn in a fatty area(.
to the effect of burn toxins metabolism.
 Burn
Age vitality
of Burn
Appears
Antemortem
immediately
burn Postmortem burn
Erythema 36 hs 48 hs
Line of hyperemia
Appears Present Absent
2-3hs
Vesicles 1w 2 ws
Vesicles
Presence of COHb Albuminous fluid
Present
absent poor in
Absent
2–3
Sepsis rich in chloride
36 hs albumin and chloride
days
Infl., pus
Vital reaction
Superficial slough 1 w Nil
Nothing
healing
Cause of death But burn
Other causes

Deep slough 3 ws
Soot in URT Present Absent
Red Coppery
Scar 2m 6m
 Postmortem Picture
Complications of Burn
of Burn

--Particles
The bodyofshows
soot are present
evidence ofin the air
antemortem
passage.
burns of various degrees.

-- Subcutaneous
The body presents a peculiar
or subserous attitude;hge
peticheal
attitude
may of defence,
be present . boxing or "Pugilistic
attitude".
- Haemoconcentration
Sepsis of blood
Deformities due
Keloid to loss
formation
- Crimson
of plasma and red cherry
colour red
of hypostasis.
colour of the skin.

--Skull
Generalized
may showvisceral congestion
thermal fracture and Hge
"fissure
in the internal
fracture“. - organs.
 Points of differentiation () thermal & traumatic fracture

Thermal Fracture Traumatic Fracture

Postmortem
The fracturesigns
is notofdisplaced
burn Other postmortem
The fracture
signsisofdisplaced
death
The brain is shrunken The brain is edematous
& associated with contused wound in scalp
Extradural haematoma Extradural haematoma
doesn’t fill the space fill the space
Factors influencing the effect of electric current
Electric
Physical
burn Physiological
Resistance of body
tissue
Voltage
Humidity
Nature of current Pathway of current

Anticipation of shock
Duration of contact General health
 Causes of Death
Ventricular fibrillation
Central
Respiratory failure

Peripheral
Cardiac arrest
Cerebral anoxia
Electric burn
Hyperthermic effect
 P.M. PictureCurrent Marks
of Electric Burn
NMicroscopic
/ E appearance
appearance
- It
- is of the
Compression same
of size
the and shape
stratum
Rapid onset of rigor mortis as
corni the
which
conductor.
stains deeply with superficial carbonization.
 Marked hypostasis
- Grayish-white painless areas of aseptic
- Separation of the cells in the form of slits
necrosis.
(electric channels).
 Presence of current mark
- They vary from superficial circumscribed
- Elongation of both cells and nuclei.
lesions
Internaltosigns
severe burns with full thickness
of asphyxia
tissue necrosis.
-The electric current is DC not AC.
Lightning syndrome
Definition
Characterized
-About by:
20.000 amperes.
It is the discharge of the atmosphere
Loss of consciousness.
potential () clouds, or () clouds and
-About
Earth. 100 - 1000
Skin burn million
(similar to 1volts.
st degree burn.

Conductive deafness.
- A single flash lasts 1/1000th of a second.