Emedinews: Insights on Medicolegal issues - Drowning submersion is followed by struggle and subsides with exhaustion

• The survival rate from potentially fatal salt water submersion is about 80% whereas in fresh water it is less than 50%.
• In drowning, breath holding lasts until carbon dioxide accumulation stimulates respiration resulting in inhalation of water.
• Gulping of water, coughing and vomiting is rapidly followed by loss of consciousness. Profound unconsciousness and convulsions are associated with involuntary respiratory movements and the aspiration of water.
• Death within 2 to 3 minutes may be called “Instantaneous deaths" and the death is almost invariable when the period of submersion exceeds 10 minutes.
• There are no pathological findings that are pathognomonic of drowning. Consequently obtaining proof that the victim was alive on entering the water and excluding natural, traumatic and toxicological causes of death are critically important.
• Some pathological changes are characteristic of drowning but the diagnosis is largely one of exclusion. A fine white froth or foam is seen exuding from the mouth and nostrils. The froth is sometimes tinged with blood producing a pinkish color. If the foam is wiped away then pressure on the chest wall will cause more foam to exude from the nostrils and mouth..
• The foam is a mixture of water, air, mucus and possibly surfactant whipped up by respiratory efforts. Thus it is a vital phenomenon and indicates that the victim was alive at the time of submersion

Emedinews:Insights on Medicolegal issues:Embalming

• Embalming is the process of chemically treating a dead body, developed by the ancient Egyptians, to preserve a person's body after death.
• Embalming delays decomposition of the body, restores it to an acceptable physical appearance and reduces presence and growth of bacteria to prevent foul smell and adds fragrance to the corpse.
• Embalming is done by injecting chemicals directly into the bloodstream, chest cavity and abdominal cavity to preserve the corpse's appearance.
• The most commonly used chemicals for embalming are formaldehyde and ethanol. A combination of these two chemicals is sufficient to preserve the body for a short time i.e. up to a week.
• To keep the corpse in good condition for a longer period i.e. up to a month, a solution made up almost entirely of formaldehyde is used.
• There are several steps involved in modern embalming. First, the embalming fluid is injected directly into the deceased’s blood vessels, and pushed through the body with a mechanical pump. Next, the internal organs are hollowed of their contents and filled with embalming fluid. The chemicals are then injected beneath the skin wherever necessary, followed by a final surface embalming on injured areas of the body.
• Embalming certificate is required by law in certain circumstances like air/rail transportation.