Forensic Pathology for Police - Brainshare Public Online Library

484 19 Burns and Fire-Related Deaths
Estimating the surface area of a thermal injury is important clinically, when
attempting to treat those who are suffering from burns. The “rule of nines” is frequently
employed by physicians when they attempt to estimate the percentage of
body surface area affected by thermal injuries. The following general percentages
are applied to each of the listed body regions: head – 9%; anterior torso – 18%;
posterior torso – 18%; right arm – 9%; left arm – 9%; right leg – 18%; left leg –
18%; genitalia – 1%. Some forensic pathologists use the rule of nines, others prefer
to diagram, photograph, and describe the extent of burn.
In this chapter, each of a variety of burn injuries will be presented, followed by
a more general description of fire-related deaths, where death may or may not be
related to thermal injury.
Burn Types
Dry Burns
A dry burn is a thermal burn that results from contact with a dry heat source. This
is in contrast to a “wet burn,” or a scalding injury, that results from contact with a
wet heat source. Strictly speaking, fire-related (flame) injuries are at least partially
a type of dry burn, but fire burns will be discussed separately below.
Examples of dry burns include skin burns from contact with hot surfaces, such
as a clothes iron, a hot dish or pan, a stove top, an oven, a heating pad, a furnace,
a hot engine, or a muffler. In the preceding list, although the heating pad does not
generate nearly as much heat as the other examples, it still can result in thermal
injury, so long as the time of exposure is long enough.
A subtype of dry burn is an electrothermal burn, where heat is generated at a very
concentrated location during electricity flow. Such “electrical burns” are discussed
in greater detail in Chapter 17.
Dry burns can result in first, second, third, or fourth degree burns. Depending
on the source of heat, dry burns may cause body hair to singe. This is particularly
true of fire burns, but can occur in other situations as well. Figure 19.5 represents an
example of a dry burn.
Radiant Burns
A radiant burn results from heat or electromagnetic energy that is radiating away
from an energy source. Two general types can be described: radiant heat burns that
are associated with a local heat source in relatively close proximity to the victim
(which commonly occur in fire-related burns), and other electromagnetic energy
burns, such as those occurring in association with ultraviolet and ionizing radiation.
In contrast to dry burns as defined above, where direct contact with the heat
source is required, radiant heat burns do not require direct contact. Strictly speaking,