Death from thermal effects and burns

One hundred and fifteen unselected autopsy cases of death from thermal effe cts and/or fire between 1990 and 1999 were analyzed with regard to time of death, signs of vitality at the scene of the fire, the manner and cause of death, and the extent of soft tissue loss. The cases represented approximat ely 6% of all autopsy cases at the Institute of Legal Medicine responsible for a catchment area with approximately 700,000 inhabitants. In 23 victims suffering burn injuries, death occurred during initial medical care or clin ical treatment. The causes of death were primary respiratory arrest due to smoke poisoning or delayed shock caused by thermal injuries to the skin. De ath occurred at the scene of the fatal event in 85 cases: eight cases exhib ited no thermal effects; the cause of death in one of these cases was polyt rauma incurred in a leap from a height; in seven cases there was poisoning due to smoke inhalation. The remaining 77 cases were characterized by signs of intensive thermal and/or fire effects. Clear signs of vitality (carboxy hemoglobin (COHb) in blood, inhalation and/or swallowing of soot) were foun d in 84.7% of the victims dying at the site of the fatal event. Of the 13 v ictims showing no signs of vitality at the scene, a cause of death could be determined in only seven cases; death in the other six cases remains unexp lained. Quantification of the soft tissue loss revealed a possible correlat ion with the temperature and time course of heat exposure. (C) 2001 Elsevie r Science Ireland Ltd. All rights reserved.