Forensic Pathology for Police - Brainshare Public Online Library

Causes of Death Other Than Drowning 445
Fig. 16.15 A scene photograph showing a swimming pool in which a combined drowning/electrocution
death occurred. The electric wiring of the pool lights was corroded such that
the water was electrified
SCUBA Deaths
In persons participating in SCUBA (self-contained underwater breathing apparatus)
diving, a variety of mechanisms of death may be at play, including drowning (the
most common cause of death in SCUBA divers), lack of oxygen (due to running out
of air, contaminated tanks, or some type of equipment failure), and various pressurerelated
processes (barotrauma). Specifically regarding pressure-related issues, it is
important to understand that, as a diver descends within the water, non-oxygen gases
normally present within the air we breath (and in the SCUBA tank), such as nitrogen,
dissolve into the body’s tissues.
If a diver ascends (comes to the surface) too rapidly, these dissolved gases can
become gaseous again and cause all sorts of problems. In the lungs, the expanding
gases can burst the lung, resulting in a pneumothorax. In addition, air can escape into
the soft tissues of the central chest and even the skin. When dissolved gas comes out
of tissues, tiny gas bubbles develop and travel within veins. These venous gas emboli
result in “decompression sickness,” characterized by joint pain (the “bends”), difficulty
breathing (the “chokes”), etc. If the diver has a defect in their heart that allows
venous emboli to travel into the arterial system, fatal arterial gas embolism can
occur. Fatal arterial gas embolism can also occur if the lung’s alveoli rupture and
allow air to directly enter blood vessels within the lungs. This catastrophic occurrence
typically happens after a diver has completed the ascent, and is evident when
they simply collapse.
When investigating a SCUBA-related death, it is advisable to consult with unbiased
experts who can perform a detailed examination of the SCUBA gear as well
as the circumstances of the death. Special autopsy procedures for identification of
pneumothorax and gas emboli should be performed. This will typically include chest
X-ray and careful dissection techniques, such as opening the chest cavity and heart
under water, and examining the brain prior to the rest of the body.