Study of Carbon Monoxide Intoxication in Fire Victimis

Abstract

Carbon monoxide poisoning is the leading cause of mortality and morbidity of toxic origin in the world. Its insidious and polymorphic symptomatology makes it difficult to diagnose. It occurs accidentally, because of non-supervised domestic fires, or in fire victims. In fire victims, in particular, the differential diagnosis between carbon monoxide gas poisoning, inhalation of other toxic products of combustion like cyanide, oxygen deprivation, thermal burns and shock due to burns as a cause of death is not an easy task. The authors examined 107 fire victims that were autopsied at the Forensic Medicine from Iasi, Romania, in the last 10 years (2007-2016). Most cases were males (69.16%), young (0-9 years) or older than 60 with a burned surface of 91-100% in 68.22% of cases. Blood samples from the cadavers were collected in all cases in order to analyse carboxyhaemoglobin concentration and haemolysis. Toxicological analysis revealed a carboxyhaemoglobin level of maximum 95% but the majority of cases (70.72%) had a concentration inferior to 50%. An inverse correlation was identified between carboxyhaemoglobin concentration and haemolysis, an indicator of heat dissociation. Our study proves that many fire victims may die because of carbon monoxide intoxication prior to the extent of burns at a lethal potential.

Determination of Direct Oral Anticoagulants in Forensic Toxicology

“…Blood, plasma or serum is the sample of choice in the case of quantitative analysis, but, when the concentration of the drug is very high, this sample can also be used for screening. This can be advantageous, as frequently at the autopsy, it is the only sample that can be collected [25][26][27][28][29][30][31][32][33][34][35][36][37]. Toxicological analysis of hair shafts allows the detection of chronic drug use, but this sample is controversial due to external contamination [38,39].…”

Domestic Poisoning in the Pediatric Age Group

“…In the case of drug poisoning, most cases were secondary to the combination of several pharmacological agents (44%), neuroleptics (25.65%) and non-steroidal anti-inflammatory agents (8%). Non-drug etiology was dominated by acute mushroom poisoning (12.7%), followed by ethanol (11%), carbon monoxide (7.5%), household products (6.52%), and cholinesterase inhibiting insecticides (4.48%) (12)(13)(14).…”

An Unusual Case of Accidental Carbon Monoxide and Ethanol Intoxication in Two Commorientes Deaths

“…Fatal intoxications are still an important problem of public health. In Romania, the most common types of such deaths are generated by ethanol, methanol, ethylene glycol and carbon monoxide [1][2][3]. Nonetheless, any possible substance, legal or illegal, depending on the dose, may prove to be fatal, hence some rare unusual causes of fatal intoxications could also be possible [4][5][6][7].…”

“…From a legal point of view, more frequent are accidental intoxications, followed by suicide. There must be distinguished the CO intoxication with CO 2 (in the case of fermentation in closed rooms) or intoxication with other toxic gases, such as H 2 S, in the septage workers [2,15].…”