While the term “asphyxia” literally means “without a pulse,” modern usage limits its application to cases where the body has been exposed to a significant reduction in oxygen levels resulting in impaired tissue oxygenation (delivery of oxygen to the body’s cells). It can result in reduced levels of oxygen (hypoxia), or absence of oxygen (anoxia). Unfortunately, there are no postmortem laboratory tests that can be performed to make a diagnosis of asphyxia as all bodies deoxygenate after death.
If asphyxia is considered pathophysiologically, there are four stages where the transfer of oxygen can be compromised; i.e., oxygen reduction at the cellular level may be caused by (1) decreased amounts of oxygen in the environment, (2) reduced transfer from the air to the blood, (3) reduced transport from the lungs to the tissues, and (4) reduced transfer across cell membranes.
“Classic” signs of asphyxia have been described for many years that consist of tiny pinpoint (petechial) hemorrhages of...
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Andrew TA, Fallon KK. Asphyxial games in children and adolescents. Am J Forensic Med Pathol. 2007;28:303–7.
Azmak D. Asphyxial deaths – a retrospective study and review of the literature. Am J Forensic Med Pathol. 2006;27:134–44.
Amanuel B, Byard RW. Accidental asphyxia in bed in severely disabled children. J Paediatr Child Health. 2000;36:66–8.
Byard RW. The brassiere “sign” – a distinctive marker in crush asphyxia. J Clin Forensic Med. 2005a;12:316–9.
Byard RW. Autoerotic death. In: Payne-James J, Byard RW, Corey T, Henderson C, editors. Encyclopedia of forensic and legal medicine, vol. 1. Amsterdam: Elsevier/Academic; 2005b. p. 157–65.
Byard RW. Issues in the classification and pathological diagnosis of asphyxia. Aust J Forensic Sci. 2011;43:27–38.
Byard RW, Bramwell NH. Autoerotic death. A definition. Am J Forensic Med Pathol. 1991;12:74–6.
Byard RW, Charlwood C. Lethal head entrapment – a specific problem of early childhood. J Forensic Leg Med. 2009;16:340–2.
Byard RW, Gilbert JD. Sleeping accidents in the elderly. J Forensic Sci. doi: 10.1111/j.1556-4029.2011.01838.x.
Byard RW, Hanson KA, James RA. Fatal unintentional traumatic asphyxia in childhood. J Paediatr Child Health. 2003;39:31–2.
Byard RW, Hanson K, James RA, Gilbert JD. Suicide methods in the elderly in South Australia 1981–2000. J Clin Forensic Med. 2004;11:71–4.
Byard RW, Hucker SJ, Hazelwood RR. A comparison of typical death scene features in cases of fatal male and female autoerotic asphyxia with a review of the literature. Forensic Sci Int. 1990;48:113–21.
Byard RW, Jensen L. Fatal asphyxial episodes in the very young – classification and diagnostic issues. Forensic Sci Med Pathol. 2007;3:177–81.
Byard RW, Simpson E, Gilbert JD. Temporal trends over the past two decades in asphyxial deaths in South Australia involving plastic bags or wrapping. J Clin Forensic Med. 2006a;13:9–14.
Byard RW, Tsokos M. Infant and early childhood asphyxial deaths – diagnostic issues. In: Tsokos M, editor. Forensic pathology reviews, vol. 2. Totowa: Humana Press; 2005. p. 101–23.
Byard RW, Wick R, Gilbert JD. Conditions and circumstances predisposing to death from positional asphyxia in adults. J Forensic Leg Med. 2008;15:415–9.
Byard RW, Wick R, Simpson E, Gilbert JD. The pathological features and circumstances of death of lethal crush/traumatic asphyxia in adults – a 25-five year study. Forensic Sci Int. 2006b;159:200–5.
Byard RW, Winskog C. Autoerotic death: incidence and age of victims – a population based study. J Forensic Sci. doi: 10.1111/j.1556-4029.2011.01898.x.
Byard RW, Woodford N. Automobile door entrapment – a different form of vehicle-related crush asphyxia. J Forensic Leg Med. 2008;15:339–42.
Carrick C, Collins KA, Lee CJ, Prahlow JA, Barnard JJ. Sudden death due to asphyxia by esophageal polyp: two case reports and review of asphyxial deaths. Am J Forensic Med Pathol. 2005;26(3):275–81.
Combrinck M, Byard RW. Infant asphyxia, soft mattresses and the “trough” effect. Am J Forensic Med Pathol (in press)
Conroy C, Eastman AB, Stanley C, Vilke GM, Vaughan T, Hoyt DB, Pacyna S. Fatal positional asphyxia associated with rollover crashes. Am J Forensic Med Pathol. 2007;28:330–2.
Dix J, Graham M, Hanzlick R. Asphyxia and drowning – an atlas. Boca Raton: CRC Press; 2000.
Ely SF, Hirsch CS. Asphyxial deaths and petechiae: a review. J Forensic Sci. 2000;45(6):1274–7.
Focardi M, Gualco B, Norelli G. Accidental death in autoerotic maneuvers. Am J Forensic Med Pathol. 2008;29:64–8.
Gilbert J, Jensen L, Byard RW. Further observations on the speed of death in hanging. J Forensic Sci. 2008;53:1204–5.
Green H, James RA, Gilbert JD, Byard RW. Fractures of the hyoid bone and laryngeal cartilages in suicidal hanging. J Clin Forensic Med. 2000;7:123–6.
Hashimoto Y, Moriya F, Furumiya J. Forensic aspects of complications resulting from cardiopulmonary resuscitation. Leg Med. 2007;9:94–9.
James RA, Byard RW. Asphyxiation from shoulder seat belts. An unusual motor vehicle injury. Am J Forensic Med Pathol. 2001;22:193–19.
Kojima T, Nishiyama Y, Yashiki M, Une I. Postmortem formation of carbon monoxide. Forensic Sci Int. 1982;19:243–8.
Prahlow JA, Barnard JJ. Fatal anaphylaxis due to fire ant stings. Am J Forensic Med Pathol. 1998;19:137–42.
Prahlow JA, Doyle BW. A suicide using a homemade carbon monoxide “death machine. Am J Forensic Med Pathol. 2005;26:177–80.
Schon CA, Ketterer T. Asphyxial suicide by inhalation of helium inside a plastic bag. Am J Forensic Med Pathol. 2007;28:364–7.
Shields LBE, Hunsaker DM, Hunsaker JC. Autoerotic asphyxia: part I. Am J Forensic Med Pathol. 2005;26:45–52.
Wick R, Gilbert JD, Byard RW. Café coronary syndrome – fatal choking on food: an autopsy approach. J Clin Forensic Med. 2006;13:135–8.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer Science+Business Media, LLC
About this entry
Cite this entry
Prahlow, J.A., Byard, R.W. (2012). Asphyxial Deaths. In: Prahlow, J.A., Byard, R.W. (eds) Atlas of Forensic Pathology. Humana Press. https://doi.org/10.1007/978-1-61779-058-4_15
Download citation
DOI: https://doi.org/10.1007/978-1-61779-058-4_15
Publisher Name: Humana Press
Print ISBN: 978-1-61779-057-7
Online ISBN: 978-1-61779-058-4
eBook Packages: Biomedical and Life SciencesReference Module Biomedical and Life Sciences