suffocation
Suffocation (also latin suffocatio or German Suffokation from suffocare "tie up the throat choking, strangulation") is the medical term for all operations due to insufficient oxygen supply ( asphyxia ), but also impaired oxygen uptake or processing to death by lack of oxygen to lead.
to form
Causes of suffocation are:
- an impairment of breathing , see respiratory paralysis , respiratory arrest , burial
- an insufficient concentration of oxygen in the air you breathe (e.g. at high altitudes, sealed rooms)
- as internal suffocation, a blockage of the respiratory chain or the uptake of oxygen by the red blood cells
- vagal reflexes, the bolus death
As with breathing itself, there is also a division into external and internal forms of suffocation:
External suffocation
External suffocation is the one caused by
- a decreased oxygen concentration of the respiratory air of less than 130 mbar O 2 - partial pressure in
- high altitude (hypobaric hypoxia ): with different individual sensitivity, mostly at altitudes above 4000 m. This does not apply to individual, appropriately well-prepared extreme athletes. In 1978, the South Tyrolean Reinhold Messner and the Austrian Peter Habeler were the first mountaineers to climb the 8,848 meter high Mount Everest without an oxygen device . See also : Altitude Medicine
- sealed rooms: through the consumption of oxygen in the air we breathe. Taphephobia as the fear of an apparent death with suffocation in the coffin is one of the so-called isolated phobias .
- Presence of inert gases , mostly nitrogen , which displace the oxygen; in narrow, unventilated spaces such as tanks, containers and shafts and basements; the German name for the chemical element nitrogen is based on its ability to "suffocate" flames and living beings
- Obstruction or narrowing of the airways due to:
- a sinking back of the tongue when unconscious ( glossoptosis )
- Aspiration , for example as aspiration of blood or stomach contents or as foreign body aspiration with drowning as a specific form
- endogenous secretions (mucus) or tissue :
- Mucosal swelling caused by inflammatory changes or allergic reactions, for example glottal edema (glottis)
- Violence (such as strangulation by strangling, strangling, or hanging)
- Respiratory paralysis of various causes
Internal suffocation
In the case of internal suffocation (i.e. with normal oxygen concentration in the air and unhindered breathing), a classification can be made based on the specific points of attack or - as here - based on the trigger:
-
Asphyxiation gases that do not act by simply displacing the oxygen from the air you breathe are
- Carbon monoxide (CO): binds to hemoglobin 250 times better than oxygen ( competitive antagonism ), see carbon monoxide poisoning
- Hydrogen sulfide (H 2 S): an inhibitor of the mitochondrial respiratory chain , see hydrogen sulfide poisoning
- Hydrocyanic acid (hydrogen cyanide, HCN): like hydrogen sulphide, blocks the respiratory chain and was used in the gas chambers of the Nazi extermination camps (known as Zyklon B ). It is still used today to carry out the death penalty in the gas chambers of the US states of Arizona, California and Missouri.
Apnea
Although every end of asphyxiation is associated with respiratory arrest, not every respiratory arrest leads to asphyxiation. In the case of obstructive sleep apnea syndrome (OSAS) in the sleep laboratory, respiratory arrests of a few seconds up to several minutes each night with a corresponding drop in oxygen saturation in the tissue can be registered, usually without acute damage occurring.
Forensic medicine
In forensic medicine , however, external asphyxiation is not considered from the point of view of pathophysiological principles, but that of external causation, and ultimately examined as part of an investigation into questions of guilt and liability . From this point of view, internal asphyxiation as a result of the use of hydrogen cyanide also has an external cause.
ICD-10
| Classification according to ICD-10 | |
|---|---|
| T17 | Foreign bodies in the airways |
| T17.5 | Foreign body in the bronchus |
| T17.8 | Foreign bodies in other and multiple locations of the airways |
| T17.9 | Foreign body in the airways, part unspecified |
| T58 | Toxic effects of carbon monoxide |
| T59 | Toxic effect of other gases, vapors or other smoke |
| T70.2 | Other and unspecified damage from great heights |
| T71 | suffocation |
| ICD-10 online (WHO version 2019) | |
According to ICD-10 , only suffocation due to strangulation and systemic oxygen deficiency due to mechanical hindrance to breathing or low oxygen content in the ambient air are summarized as "T71" under suffocation.
- Oxygen deficiency at high altitude is mentioned under “Other and unspecified damage from external causes” as “Other and unspecified damage from high altitude” (T70.2).
- The aspiration of foreign bodies is one of the “consequences of the penetration of a foreign body through a natural body opening”, more precisely a “foreign body in the airways” (T17.-) with further classification according to anatomical localization ( see also “Foreign body in the trachea ”, T17.5 ; "Foreign bodies in other and multiple locations of the airways", T17.8; "Foreign bodies in the airways, part unspecified", T 17.9) [1]
- Carbon monoxide poisoning of any origin is classified under “Toxic effects of predominantly non-medicinal substances” as “Toxic effects of carbon monoxide” and is given the abbreviation T58
- The effect of hydrogen sulfide is classified under “Asphyxia due to other gases, vapors or other smoke” with T59.
See also
literature
- Wolfgang Schwerd: suffocation (lack of oxygen). In: Wolfgang Schwerd (Hrsg.): Brief textbook of forensic medicine for doctors and lawyers. Deutscher Ärzte-Verlag, Cologne-Lövenich, 3rd, revised and expanded edition 1979, ISBN 3-7691-0050-6 , 71-84.
Web links
Individual evidence
- ↑ Alois Walde , Johann Baptist Hofmann : Latin etymological dictionary. Heidelberg 1938, Volume 1, p. 469 f., And Volume II, p. 625 ( faux ).
