Suicidal asphyxiation by carbon monoxide within a polythene bag

Suicide by Inhalation of Carbon Monoxide of Car Exhausts Fumes

BACKGROUND

Carbon monoxide (CO) is a major and ubiquitous component of fire atmospheres produced when organic matter is burned in an inadequate supply of oxygen. Accidental poisoning by CO is common in cold climates where fireplaces, a gas, electric or kerosene heaters or grills are used inside ill-ventilated buildings. In the Brazilian Amazon, with its hot and humid climate, there is no need for the use of heaters and accidents may occur in cases of residential fires or burning of the forests for land use in agriculture.

OBJECTIVE

We present a case of CO suicide of twenty-six-year-old men.

METHODS

A forensic autopsy was performed to evaluate the circumstances, cause and medio-legal death etiology.

RESULTS

Autopsy evidenced the typical but also not commonly published cherry-red color of the hypostasis, lungs and other organs, and the very fluid cherry-red blood. The cause of death was due to a massive CO inhalation.

CONCLUSION

While these poisonings are well recognized, and a vast number of publications on CO toxicity exist, both in an environmental and industrial context, suicide is infrequently encountered in forensic practice and the typical signs are rarely seen in the literature.

Fatal carbon monoxide poisoning: A lesson from a retrospective study at All India Institute of Medical Sciences, New Delhi

Background:

Carbon monoxide (CO) is a colorless, odorless, tasteless, and nonirritating gas which makes it difficult for those who are exposed, to detect it, leading to unexpected death. This study was undertaken to see the pattern of fatal CO poisoning and to discuss preventive aspect.

Materials and Methods:

It was a retrospective descriptive study of fatal CO cases which were autopsied at All India Institute of Medical Sciences, New Delhi, from the year 2010 to the year 2015. The cases were analyzed as per age groups, circumstances of death, season of death, and sources of CO formation.

Results and Discussion:

The study involved 40 cases of fatal CO poisoning. About 80% of cases were reported in winter months. The maximum cases were reported in the month of January followed by November and December. All the cases except one, died with a source of CO nearby and the person was inside a room or some closed space without ventilation. Source of CO was firepot and electric room heater in most of the cases. Some cases were of CO build inside the car with a running engine. Most of the cases occurred accidentally.

Conclusion:

Clustering of cases is seen in winters. Poisoning can occur in different ways. The study documents the various possibilities of CO poisoning and advocates community education targeting the high-risk groups and masses, especially during the winter season.

Clinical chameleons: an emergency medicine focused review of carbon monoxide poisoning

Carbon monoxide (CO) is a colorless, odorless gas that is found in the environment, in the home, and in the human body as a normal part of mammalian metabolism. Poisoning from CO, a common exposure, is associated with significant morbidity and mortality if not recognized and treated in a timely manner. This review evaluates the signs and symptoms of CO poisoning, conditions that present similar to CO poisoning, and an approach to the recognition and management for CO poisoning. CO poisoning accounts for thousands of emergency department visits annually. If not promptly recognized and treated, it leads to significant morbidity and mortality. CO poisoning poses a challenge to the emergency physician because it classically presents with non-specific symptoms such as headache, dizziness, nausea, and vomiting. Due to nonspecific presentations, it is easily mistaken for other, more benign diagnoses such as viral infection. The use of specific historical clues such as exposure to non-conventional heat sources or suicide attempts in garages, as well as the use of targeted diagnostic testing with CO-oximetry, can confirm the diagnosis of CO poisoning. Once diagnosed, treatment options range from observation to the use of hyperbaric oxygen. CO poisoning is an elusive diagnosis. This review evaluates the signs and symptoms CO poisoning, common chameleons or mimics, and an approach to management of CO poisoning.