Drowning MCQs

Attachment of weights to the body to keep it underwater is consistent with both homicidal and suicidal drowning. Differentiating points: Suicidal drowning - Determined suicidal person may attach weights to the body or tie his limbs. It is common among women. Homicidal drowning – The assailant may attach weight to his victim’s body to keep it underwater to conceal the evidence. In addition, there may be signs of struggle on the body, or evidence of struggle at the banks of the river from where the body was recovered. Accidental drowning is the most common form of drowning. It is seen among fishermen, bathers, dock workers, intoxicated, and epileptics. Homicidal drowning is the least common. Reference: Knight's Forensic Pathology, 4th edition, Page No. 400; Textbook of Forensic Medicine & Toxicology, Anil Aggrawal, Page No. 402

Paltauf's haemorrhages are mostly found in the lower lobes . Paltauf’s haemorrhages ( Paltauf’s spots): Appearance → Shining, pale pink or bluish red haemorrhages, immediately beneath the pleurae (Subpleural space). Size → Minute or up to 3-5 cm in diameter Incidence → 50%. Location → Lower lobes of lungs (most common). May also be on interlobar surfaces or anterior surfaces of entire lungs. Mechanism → Tearing (rupture) of the interalveolar partitions due to decreased pressure during forced expirations They are found when the alveolar walls rupture as a result of increased pressure during forced expirations. They are described in 50- 60% of drownings. They are mostly found in the lower lobes on the anterior surface and margins of lung. Reference : Textbook of Forensic Medicine & Toxicology, Anil Aggrawal, Page No. 397

Cadaveric spasm with grass in hand is the definite sign of antemortem drowning. (The medico-legal importance of diatoms is controversial) Definite signs of antemortem drowning: Cadaveric Spasm with weeds/grass in the hand Emphysema aquosum Copious amount of white, fine, leathery froth (D/t Emphysema Acquosum) Paltauf’s haemorrhages Diatoms ( The medico-legal importance of diatoms is controversial. If the same species of diatoms present in the drowning media is present in bone marrow and if the victim had not drunk the same water before submersion is the most important internal sign of antemortem drowning) References: The Essentials of Forensic Medicine & Toxicology, KS Narayan Reddy, 35th edition, Page No. 286, Textbook of Forensic Medicine & Toxicology, Anil Aggrawal, Page No. 395

Accidental drowning is the most common form of drowning. It is seen among fishermen, bathers, dock workers, intoxicated, and epileptics. Homicidal drowning is the least common. Global mortality of drowning is 6.8 per lakh and > 50% is seen within 15 years of age. 1 - 4 age groups is the highest rate of drowning observed worldwide Reference: The Essentials of Forensic Medicine & Toxicology, KS Narayan Reddy, 35th edition, Page No. 290, Textbook of Forensic Medicine & Toxicology, Anil Aggrawal, Page No. 392

Deep inspiration above the water level doesn’t have any effect on floatation of body. The floatation of a dead body is due to the accumulation of putrefactive gases in the body. In India a dead body floats in about 12-18 hours during summer and in about 18-36 hours during winter. Reference: The Essentials of Forensic Medicine & Toxicology, KS Narayan Reddy, 35th edition, Page No. 291