Burns and Fire Deaths

Abstract

Burns occur with exposure of the body to dry heat, i.e. through contact with hot objects (contact burns) or flames. The classification most commonly used in forensic medicine divides them into four degrees. Fire-related deaths are often challenging for the pathologist. Fire-related death may occur at a scene or in a hospital, during treatment. Regarding hospital treatment of burns, the most important prognostic factors include their degree, total body surface area burnt and age, as well as the presence of inhalation injuries. The most common causes of death, especially early on, include shock, sepsis and respiratory insufficiency. In cases of death at a scene, in bodies without significant carbonization, the causes of death due to fire and exposure to high temperature generally involve smoke inhalation and CO toxicity, with airway injury and local burns to the skin. In cases with significant charring, determining the cause of death may be challenging, and knowing and differentiating signs of vitality, as well as post-mortem heat artifacts is crucial for adequate interpretation of the autopsy findings. The manner of death in bodies recovered from fire is most commonly accidental but may also be suicidal (self-immolation) and homicidal. The approach to fire-related death should involve careful evaluation of case circumstances, as well as precise autopsies with careful interpretation of macroscopic and microscopic findings. © 2024 Taylor & Francis Group, LLC