Meaning of Injury:
Under PPC, the word injury means any harm which is illegally caused to a person's body, mind, reputation or property.
Meaning under Medical Jurisprudence:
The disruption of any tissues of body is known as injury.
Kinds of Injuries:
Following are the kinds of Injuries,
• Mechanical Injuries.
• Thermal Injuries.
• Chemical Injuries.
• Other Injuries.
Mechanical Injuries:
Injuries caused by the use of physical violence to the body are known as mechanical injuries.
Kinds of Mechanical Injuries:
Following are the kinds of mechanical injuries,
• Abrasion.
• Bruises.
• Wound.
Abrasion:
When there is a discontinuity in the skin due to loss of epidermis layer, such injury is known as abrasion.
Characteristics of Abrasion:
Abrasions are not life-threatening injuries although they are painful. They heel without scaring. Abrasions usually involve minimal bleeding.
Medico-Legal Importance:
• Abrasions may be simple in nature but medico-legally they are very important.
• These injuries are usually seen in accidents and assaults.
• It indicates the impact and direction of force. The age of injury can be known; therefore, time of crime. can be calculated.
Bruises:
It is a type of injury when small blood vessels (capillaries) near the skin's surface are broken by the impact of a blow or injury.
Characteristics:
Initially, a bruise will be reddish. After one to two days, the red blood cells begin to break down and the bruise will darken to a blue or purplish color. This color fades to green at about day 6.
Medico-Legal Importance:
• The bruises may be accidental, suicidal or homicidal in nature.
• Self-inflicted bruises are rare as they are painful.
• The shape and size of bruise generally relate to the object, so the weapon or object can be identified.
• The age of injury can be determined.
In case of fall sand, dust, mud, etc. may be found on the body.
Wounds:
Wound is a type of injury in which issues are torn due to heavy, hard and blunt force to the body. They are also called tears or ruptures.
Characteristics:
It involves injury to some deeper layers of skin and parts of body. There may be fracture of bones. Shape and size of injury do not correspond to the weapon.
Medico-Legal Importance:
• Wounds are usually seen in accidents and assaults.
• The type of wound may indicate the cause of injury or the shape of weapon.
• Foreign matter may be found in the wound which may indicate the circumstances of crime.
• These are usually grievous injury.
Types of Wounds:
Following are the types of wounds,
• Incised Injuries.
• Lacerated Injuries.
• Stabbing Injuries.
• Firearm Injuries..
1. Incised Injuries:
It is a wound produced by a sharp weapon such as knife, blade, scalpel, etc. and is a clean court through the tissue which is longer than its depth.
Characteristics:
• The edges are smooth, clean, cut and free from bruises.
• If an incised wound is caused by a heavy weapon, the edges of the wound may show bruises..
• The head of the wound is deeper and it gradually becomes shallower towards the end.
Medico-legal Importance of Incised Wound:
• It indicates the nature of weapon.
• It gives an idea about the impact and direction of the force.
• The age of injury can be determined.
• Position of wound may indicate mode of action, i.e. suicidal, accidental or homicidal.
2. Lacerated Injuries:
It is a type of wound that is produced by the tearing of soft body tissue.
Characteristics:
This type of wound is often irregular and rough. Such wound is often contaminated with bacteria and other fragments.
Medico-Legal Aspects of Laceration Injuries:
• The open skin may look like a cut or tear.
• The wound may hurt, bleed, bruise or swell.
• The wound may have edges that are close together or wide apart.
3. Stabbing Injuries:
A stab wound is an injury is caused by a sharp pointed weapon, when the sharp tip is inserted into the body.
Characteristics:
• In stabbing, wound depth is more as compared to width.
• It is caused by sharp, pointed and cutting instruments such as knife, dagger, nail, needle, etc.
• Stab wounds are called penetrating wounds when they pass through tissues and enter into the body cavity.
• A sharp, pointed, cylindrical or conical instrument may produce a wound with circular margins.
Medico-legal Importance of Stab Wounds:
• Stab wounds are mostly suicidal or homicidal. Accidental wounds are rare.
Position, number and direction of wounds may indicate mode of action, i.e. suicidal, accidental or homicidal.
• The shape of the wound may indicate the class and type of weapon.
• The depth of the wound will indicate the force of penetration.
• Direction and dimension of the wound indicate the relative positions of the assaulter and the victim.
• The age of the injury can be determined.
4. Firearm Injuries:
Forensic Ballistics is the science which deals with the investigation of firearms and the problems arising from their use. Firearm injury is an injury caused by a firearm weapon. A firearm is an instrument which discharges a missile by the burning of gun powder.
Factors Affecting Firearm Injury:
• Type of firearm weapon.
• Type of cartridge.
• Type of projectile.
• Muzzle velocity.
• Range of firing.
• Angle of firing.
• Time since firing.
• Part of body struck.
Medicolegal Aspects of Firearm Injuries:
• Suicide by firearm is seen mostly in males.
• In case of homicidal firearm injury, the weapon will likely not to be found at the scene. There may be evidence of struggle. Variety of wounds can occur depending upon the circumstances.
• Accidental firearm injuries are rare.
Cases:
Entry of Bullet:
When wound of entry is present but wound of exit is absent then,
• The bullet may be stuck in body tissue or bone.
• Bullet may be thrown out through cough or vomiting.
• Bullet may come out through the wound of entry itself.
Multiple Injuries:
When during single fire, there is a single wound of entry of a bullet but multiple wounds of exit are found, it means there is,
Internal bullet fragmentation.
• Bone fragmentation.
• Close range firing in shot gut.
Multiple Wounds of Entry and Exit:
When during single fire, multiple wounds of entry and exit are found, it means there is,
• External bullet fragmentation.
• Long range firing.
Thermal Injures:
Meaning:
Injuries may result from exposure to heat or cold to the external or internal body surfaces.
Kinds of Thermal Injuries:
Thermal Injuries arises either,
• Due to Cold.
• Due to Heat.
Due to Cold:
A tissue injury due to application of cold in any form to the external or internal body surface.
Types of Cold Injury:
Following are the types of cold injuries,
• Hypothermia.
• Frostbite.
• Carbon monoxide poisoning.
• Snow blindness.
1. Hypothermia:
Exposure to cold causes hypothermia where the core body temperature is below 35 degree.
Symptoms:
• Shivering.
• Dizzy.
• Irritability.
• Confusion,
• Altered Vision.
Effects:
• The effects of hypothermia are,
• Uncertainty, clouding of consciousness, loss of reflexes.
• Fall in respiration, heart rate and blood pressure.
• Red patches and whiteness of the skin and stiffness of neck muscles.
• Death is common in case of hypothermia.
2. Frostbite:
It is freezing of body tissue. It results from exposure to extreme cold. Frostbite is a dry cold injury.
Symptoms:
• Initially redness in light skin or grayish in dark skin.
• Tingling and stinging sensation.
• Feels cold, stiff or woody.
Treatment:
• Remove from cold and prevent further heat loss.
• Remove tight clothing and jewelry.
• Rewarm the affected area with body heat until pain returns.
3. Carbon Monoxide Poisoning:
When oxygen in the body is replaced by carbon monoxide, it is known as carbon monoxide poisoning.
Symptoms:
• Headache.
• Dizziness.
• Weakness.
• Bright red lips and eyelids.
• Confusion.
• Possibly death.
Treatment:
• Move to fresh air immediately.
• Seek medical aid.
• Provide mouth to mouth breathing if the victim is not breathing.
4. Snow Blindness:
Inflammation and sensitivity of the eyes caused by ultraviolet rays of the sun reflected by the snow or ice.
Symptoms:
• Redness and tearing.
• Eye movement will cause pain.
• Headache.
Treatment:
• Remove from sunlight.
• Blindfold both eyes.
• Cover the eyes with wet bandages.
• Seek medical attention.
Due to Heat:
A tissue injury due to application of heat in any form to the external or internal body surface.
Kinds:
Injuries due to heat has following kinds,
• Burns.
• Scalds (burning with liquid or water).
1. Burns:
A burn is an injury which is caused by the application of heat to the external or internal surfaces of the body which results in the destruction of the tissues.
Types of Burns:
Following are the three types of burns,
• First Degree Burns.
• Second Degree Burns.
• Third Degree Burns.
First Degree Burns:
First Degree Burns are minor burns. In this case, the top layer of skin turns red and is painful but does not typically swell.
Second Degree Burns:
First Degree Burns affects the top and lower layer of skin. The person may experience pain, redness, swelling and blistering.
Third Degree Burns:
Third Degree Burns affect all three skin layers, i.e. epidermis, dermis and fat. The burn also destroys hair and sweat glands. Third Degree Burns damage nerve endings so the person will not feel pain in the area of the burn itself. Burned skin may be black, white or red with a leathery appearance.
Therapeutic Classification:
Therapeutically, burns are classified as,
• Partial Thickness Burns.
• Full Thickness Burns.
Partial Thickness Burns:
Those burns which heal spontaneously with or without scar formation are known as partial thickness burns.
Full Thickness Burns:
Those burns which requires skin grafting are known as full thickness burns.
Symptoms of Burns:
Burn symptoms depend upon the degree of the burn. Burn symptoms include,
• Blisters.
• Pain.
• Swelling.
• White or Black Skin.
• Peeling skin.
Extent of a Burn:
The extent of a burn is expressed as total percentage of body surface area affected by the injury. Roughly one palm of the individual is equal to 1% burn area. If the burn area is greater than 15% in adults and greater than 10% in a child, then the loss of blood must be replaced.
Medico-legal Aspects of Burn:
Accidents:
A large number of deaths are accidental.
Suicide:
Normally, women commit suicide by pouring kerosene on their cloths before setting fire to themselves.
Homicide:
It is rare. A drunken man may push or throw his wife or child in the fire.
2. Moist Heat (Scalds):
A scald is a type of burn injury caused by hot liquids or vapors or steams. Burning of hair, skin and clothes does not occur. Healing of small scalds is completed in 7 to 10 days with the formation of temporary scars.
Occurrence:
Scalds are usually accidental due to bursting of hot water bottles, bursting of boilers and cooking utensils etc.
Types of Scalds:
Following are the types of scalds burns,
• Immersion Burns.
• Splash Burns.
• Steam Burns.
Immersion Burns:
Immersion burn occurs due to accident or intentional dipping in hot water.
Splash Burns:
Splash burns is the bursting of hot water bottles, boilers or kettles by children.
Steam Burn:
Steam burn is the exposure to superheated steam.
Degrees:
• Erythema or Reddening (coloring) of skin.
• Blisters formation.
• Necrosis of the dermis.
Post Mortem Appearance of Scalds:
Externally, the body will show extensive blisters. There may be ulcer formation due to infection. In death has occurred due to swallowing of hot liquid or inhalation of hot vapor, blister formation shall be present inside the mouth and near the larynx..
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