Forensic Pathology for Police - Brainshare Public Online Library

476 18 Temperature-Related Deaths
Scene Investigation
A careful scene investigation is of great importance when evaluating cases that
may represent hyperthermia deaths. Noting the environmental temperature at the
scene is absolutely essential. Unfortunately, persons discovering the body (or first
responders) may have altered the environmental temperature (by opening windows
or turning on fans or air-conditioning) before investigators arrive. For this reason,
it is important to ask these individuals about the temperature when the body
was discovered. If resuscitative efforts are attempted on an individual suspected of
hyperthermia, recording the body temperature in the ambulance or the emergency
department may provide very useful information for eventual death investigation.
Recording the body temperature at the scene of death is advocated by some
within the forensic community. Several potential problems exist with this recommendation.
The first is that simple methods of recording body temperature tend
to measure temperatures of superficial parts of the body, which may actually be
quite cool compared to the underlying body core temperature. The second problem
is that the most commonly employed method to accurately record the body’s core
temperature requires cutting into the body. The method involves making a small,
full-thickness abdominal incision over the liver, with an associated underlying puncture
defect of the liver, and subsequent insertion of a thermometer. Whether or not
such a technique should be employed depends on weighing the benefits of obtaining
the core temperature against the potential artifacts and other issues introduced
by cutting into the body at the scene. Protocols should be established by each death
investigation agency.
Heat-stroke scenarios that are most commonly encountered by the death investigation
community include individuals undergoing extreme physical exertion in
high-temperature settings, the elderly during prolonged heat-waves (Fig. 18.7),
unattended infants and children in automobiles, and drug-induced hyperthermia
(Fig. 18.8).
Fig. 18.7 When an elderly individual is found dead at home during a heat wave, there is no airconditioning
in the home, and the scene temperature is extremely hot, hyperthermia should be
considered a possible cause or contributing cause of death