Positional asphyxia: Potpourri of cases

• Jitender Pratap Singh,  
• Manjari Kishore*

Abstract

A legal medicine specialist will likely be able to observe a variety of situations in which  positional asphyxia, a deadly condition resulting from the adoption of specific body positions that cause mechanical interference with pulmonary ventilation, can occur (work, car accidents, torture, kidnapping, etc.). In these circumstances the cause of death is typically difficult to determine because the patient typically presents with a distinct anatomo-pathologic appearance. Because of chest compression, positional asphyxia can occasionally be difficult to differentiate from asphyxia. The primary distinction is in how the incident happened: that is, if the specific posture that resulted in asphyxia was acquired voluntarily or was due to an external mechanical action that led to traumatic asphyxia. Three basic criteria are used to diagnose positional asphyxia: the body posture must impede normal gas exchange (1), moving to a different position must be impossible, and alternative cause of natural or violent death must be ruled out. The authors here present a series of five cases drawn from the professional experience, that were seen by himself and his colleagues in order to highlight the primary patho-physiologic and diagnostic causes of positional asphyxia.

Keywords

restraint asphyxia, positional asphyxia, head-down position, pulmonary ventilation.