Definition and classification of mechanical asphyxia

Asphyxia is an acute pathological process arising as a result of lack of oxygen in the

blood and tissues and the accumulation of carbon dioxide in the body. Asphyxial
states can be divided into two major groups:

• asphyxia pathological (non-violent) associated with various diseases, such as

diphtheria or croup some ARVI;
• violent asphyxia (from external influences).

In a violent mechanical asphyxia air access into the body through the respiratory tract
is terminated, so the oxygen is consumed very quickly by tissues, they accumulate
carbon dioxide. The brain is most sensitive to carbon dioxide, where are the vital
centers of the human body (vasomotor, respiratory). Activities of cells of the cerebral
cortex is disordered for the minutes, and death occurs.

Mechanical asphyxia is characterized by the action of an external factors, by the

mechanical interruption of the circulation of air in the respiratory tract, by almost
complete disappearance of oxygen from the blood and tissues, by the accumulation of
carbon dioxide in them.

There are kinds of mechanical asphyxia:

1) from the compression:

a) strangulation (from compression of the neck organs) - hanging, strangling

by ligature, throttling;

b) traumatic - from compression of the chest and abdomen with hard and
friable objects;

2) from closure of respiratory ways;

a) obturation: smothering, choking, drowning.

b) aspiration.

Mechanical asphyxia occurs acutely, all it’s course (from the beginning to death) is 6-
8 minutes (the time of the death of cortex).

Stages of mechanical asphyxia:

1) preasphyctic - reflex respiratory arrest, which lasts about 1 minute;

2) asphyxial, or anoxia, which subdivided into 4 phases (every phase is 1 min):

a) phase inspiratory dyspnea, when there is an amplification and prolongation of

inspiration due to irritation of the respiratory center by carbon dioxide accumulating
in the blood. There increasing of blood pressure, pulse rate, intensifies, activity of the
heart in this phase;

b) phase of expiratory dyspnea. In this phase the exhalation predominates over the
inhalation. This is due to strong excitation of the respiratory and vasomotor centers,
involuntary defecation, urination, ejaculation may occur, there are convulsive
movements of muscles. At the end of the first phase, beginning of the second one the
loss of consciousness occurs;

c) the phase of terminal breathing, manifested in the form of single, irregular

breathing movements. In this phase, there are persistent extinction of all reflections,
collapse, severe convulsions;

d) constant respiratory arrest due to paralysis of the respiratory center.

Irregular heart rate may observe for some time (3-10 min).

Circulatory system organs are damaged in the process of asphyxia, and these changes
are important for the formation of the common symptoms of death from asphyxia.
There is an acute anoxia of the heart muscle, which weakens the heart muscle
contractions. Outflow of blood from the lungs is disturbed, the facial veins are
overfilled with blood, the outflow of blood from all the other organs are disordered
too.

Consequently, the pressure in the thoracic cavity varies and during phases of dyspnea
the petechial hemorrhages under the pulmonary pleura and epicardium occur
(Taurdue spots).

In sudden death (asphyxia) from the lungs into the blood, a large amount of the
enzyme, destroying blood clots, is secreted, so the blood would be liquid & dark
(venous). Liquid blood creates the conditions for the formation of abundant intensive
cadaver spots.