Asphyxia

- Absence of pulsation (no pulse or pulse less)

- Defined as lack of O2 in blood and tissues below the normal working
level (1 litre of O2 combined in circulating blood of a normal healthy adult)
due to any interference in respiration
- due to failure of cells to receive or utilize O2 (impaired or absence of
exchange of O2 & CO2 on a normal ventilatory basis; interference with
respiration)
- leading to cell death

3 stages of asphyxia are:

- Stage of dyspnea
- Stage of convulsions
- Stage of apnea or respiratory paralysis

Features Stage of Dyspnea Stage of Stage of Apnea

Convulsions or Respiratory
paralysis
Cyanosis Present Becomes deeper Present with
unconsciousness
Breathing Rapid and deep Difficult and Shallow, infrequent
spasmodic & gasping; then
apnea occurs
Effects Rapid pulse Congestion, edema Weak pulse
High BP & petechial BP reduced
hemorrhages of
lungs, skin, heart &
brain
Convulsions occur

Pathophysiology of Asphyxia

- is a vicious cycle i.e. it occurs in a cyclical form, nonstopping & continuous

event until death of the individual occurs
- Asphyxia --- decreased O2 tension --- capillary dilatation --- capillary stasis ---
capillary engorgement --- stasis of blood in organs --- decreased venous
return in heart --- decreased pulmonary flow --- decreased oxygenation in
lungs --- asphyxia
- nervous tissues are first affected
- consequences:
i) permanent damage to CNS,CVS (within 5-10 mins)
ii) death

Synonyms of Asphyxia
i) hypoxia or suboxia : partial deprivation of O2
ii) anoxia or anoxemia: complete or total deprivation of O2
Note: Asphyxia is accepted in medicolegal sense but synonyms are
accurate & better

Etiology or classification of Asphyxia

i) Mechanical asphyxia : due to mechanical interference due to

external pressure applied to neck, chest or body positioned such that
breathing is difficult (eg, hanging, strangulation, throttling, choking,
drowning, etc)
ii) Pathological asphyxia: due to diseases such as lung pathology
iii) Physical causes: such as high altitude like mountaineering
iv) Drugs/poisons: depressing the respiratory centre directly eg,
narcotics (morphine), anaesthetics, etc
v) Inhaling irrespirable gases: such as CO2, H2S, CO (interfere with O2
carrying capacity of O2) or HCN (interfere with cellular oxidative
enzymes)
vi) Allergic reactions causing laryngeal edema