WEEK EIGHT: Neglect, Abuse, and Updates

Yajaira G -

Hi Peeps!
This week was filled with more learning! This week, instead of going to the medical examiner’s office first, I went to the courthouse in Florence, Arizona, where the office held a lecture on assault, abuse, and neglect. Here are a few things I learned:

Neglect can include nursing home deaths and cases involving children. In nursing homes, there typically are natural deaths. There may be accidental deaths, which may include those involving medications or falls, but then there is also gross neglect. Gross neglect can later be classified as a homicide death. This could include malnutrition, dehydration, starvation, etc. For children, neglect typically is seen in bathtub and swimming pool drownings, as well as malnutrition, starvation, and dehydration. An example of neglect may be presented as pressure sores, also referred to as decubitus ulcers. This is typically caused when a person is unable to move or refuses to be moved for a long time. For pressure sores, four different stages may be presented: Stage one is non-blanching of the skin, which means when pressure is added, the redness will not go away. Stage two is skin thickness, which is skin loss of the epidermis and/or the dermis. Stage three is full skin loss in the area, and in stage four, there will be exposed bone, muscle, and any other underlying tissue.

Another topic that was discussed was excited delirium, a term that has recently fallen out of favor. This is a violent struggle that turns into an attempt to restrain a confused, hyperactive, and/or violent individual. During or after struggling with an individual, the individual then becomes unresponsive and non-responsive to CPR. Catecholamines are hormones produced by the adrenal glands that are released in response to physical or emotional stress. The body’s stress response increases the heart rate, which can also increase blood pressure and increase the oxygen demand from the heart muscle. Approximately 3 minutes after a struggle ends (i.e., stopping physical activity), catecholamine levels will be at their highest, which increases the risk of post-exercise peril. Post-exercise peril is a term used when right after stopping a strenuous activity, there is a higher increased risk of cardiac arrhythmias.

These are just a few things I learned from the lecture. After the lecture, we headed over to the Medical Examiner’s office to observe a postmortem examination. One of the cases that stood out to me was a case in which the decedent’s skin and sclera (the whites of the eyes) were yellow. This is a sign of jaundice. There are many different reasons as to why a person can have jaundice. What I found fascinating during this case was that I was able to observe the vitreous humor, a transparent, colorless liquid that is in the posterior chamber of the eye, but in this case, it was a clear yellow color. Another thing that I noticed was that the skull and spine were also tinted yellow. I found this to be very interesting.

I enjoy learning new things everyday!

Thanks for reading!!!

 

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    lena_t
    This a great breakdown! Very easy to follow along! I was wondering why excited delirium have recently fallen out of favor. Is there a long build up before excited delirium?

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