Investigating Confined Space Asphyxias: Plastic Bag Involvement and Gas Inhalation - A Case Series and Literature Review.

Q3 Medicine
Acta Medica Lituanica Pub Date : 2024-01-01 Epub Date: 2024-12-04 DOI:10.15388/Amed.2024.31.2.10
Sofija Saulė Kaubrytė, Sigitas Chmieliauskas, Giedrė Kažukauskė, Sigitas Laima, Diana Vasiljevaitė, Jurgita Stasiūnienė
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引用次数: 0

Abstract

Background: Asphyxia within confined spaces, particularly involving plastic bag suffocation and gas inhalation, presents complex forensic challenges. This study explores mechanisms, epidemiology, and forensic considerations of these fatalities, drawing from a comprehensive literature review and analysis of four clinical cases. Plastic bag asphyxia, exacerbated by oxygen depletion and carbon dioxide accumulation, induces rapid loss of consciousness and cardiorespiratory arrest. The method's lethality is increased when combined with inert gases like helium, known for their rapid onset of hypoxia and painless nature. Recent research demonstrates a growing incidence of plastic bag suffocation as a method of suicide. The accessibility of suicide-related information on online platforms contributes to the dissemination of new methods, posing challenges for suicide prevention efforts. Forensic investigations often face obstacles in accurately determining the cause and manner of death, with nonspecific autopsy findings and scene manipulations complicating the diagnostic process.

Materials and methods: A literature research was conducted across PubMed and Google Scholar databases, focusing on articles published in the last 5 years, applying keywords relevant to the topic under consideration and their combinations. 34 pertinent articles were selected, supplemented by data from the Lithuanian State Forensic Medicine Service, involving four clinical cases of confined space asphyxia. Autopsy findings, toxicological analyses, and contextual details were thoroughly examined to determine the mechanism and circumstances of death.

Results: Plastic bag suffocation, often combined with inert gas inhalation, emerges as a common method in suicides. Demographic analyses reveal distinct patterns, with younger age groups demonstrating an increased tendency for gas inhalation suicides. The accessibility and perceived painlessness of helium contribute to its rising usage for suicide purposes. Forensic challenges include nonspecific autopsy findings, manipulations of death scenes, and difficulties in detecting inert gases postmortem. Enhanced surveillance and efforts to restrict access to these tools are crucial in preventing the spread of new suicide methods.

Conclusions: The study highlights the multifaceted nature of asphyxiation deaths within confined spaces and the importance of proactive interventions in suicide prevention. Enhanced surveillance, tailored prevention strategies, and collaborative efforts are essential in addressing evolving suicide methods and reducing their impact.

调查密闭空间窒息:塑料袋介入和气体吸入-一个病例系列和文献综述。
背景:密闭空间内的窒息,特别是涉及塑料袋窒息和气体吸入,提出了复杂的法医挑战。本研究通过对四个临床病例的综合文献回顾和分析,探讨了这些死亡的机制、流行病学和法医方面的考虑。塑料袋窒息,因氧气耗尽和二氧化碳积聚而加剧,导致意识迅速丧失和心肺骤停。当与氦气等惰性气体结合使用时,这种方法的致命性会增加,氦气以其快速缺氧和无痛的性质而闻名。最近的研究表明,越来越多的人用塑料袋窒息来自杀。在线平台上的自杀相关信息的可访问性有助于新方法的传播,对自杀预防工作提出了挑战。法医调查在准确确定死因和死亡方式方面经常面临障碍,非特异性尸检结果和现场操作使诊断过程复杂化。材料与方法:在PubMed和谷歌Scholar数据库中进行文献研究,选取近5年发表的文章,应用与研究主题相关的关键词及其组合。选择了34篇相关文章,并辅以立陶宛国家法医处的数据,其中涉及4例密闭空间窒息的临床病例。尸检结果、毒理学分析和相关细节经过彻底检查,以确定死亡的机制和情况。结果:塑料袋窒息常与惰性气体吸入相结合,成为自杀的常用方法。人口统计分析揭示了不同的模式,年龄较小的群体显示出吸入气体自杀的趋势增加。氦气的易得性和无痛性使其越来越多地被用于自杀目的。法医方面的挑战包括非特异性尸检结果、对死亡现场的操纵以及在死后检测惰性气体方面的困难。加强监测和努力限制获得这些工具对于防止新的自杀方法的传播至关重要。结论:该研究强调了密闭空间内窒息死亡的多面性,以及主动干预自杀预防的重要性。加强监测、有针对性的预防战略和合作努力对于应对不断演变的自杀方法和减少其影响至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Acta Medica Lituanica
Acta Medica Lituanica Medicine-General Medicine
CiteScore
0.70
自引率
0.00%
发文量
33
审稿时长
16 weeks
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