Examination of alcoholic intoxication

In cases of examination in connection with suspected death from alcohol intoxication arises the need to prove not only the fact of reception shortly before the death of alcoholic beverages and death from poisoning ethyl alcohol, but also to determine the degree of alcoholic intoxication at the deceased.
The results of calculations of the amount of alcohol taken in the composition of the alcoholic drinks can have a certain importance to the examination of the corpses only in cases when at the moment of accident the subject was observed stage of elimination of alcohol. The main difficulty is defining the period of time from taking alcoholic beverages prior to death. If this fact is not installed, the EA can only judge about the degree of intoxication entity in the period of death on the basis of data about quantitative content of alcohol in the blood of the corpse. To install the same amount of alcohol taken shortly before his death, the expert may not. The quantitative content of alcohol in the body of the subject at the time of death can be calculated by the formula; A = R x r x S, where r is the factor distribution of alcohol in the body (factor reduction). For more accurate determination of a dose taken alcohol to the obtained result it is necessary to add the amount of alcohol that has not had time to be absorbed into the bloodstream and is still in the stomach.
The value of the factor reduction for men on average equal to 0.68, for women - 0,55. For obese people should be taken less the value of the factor of reduction (0,55 - 0,65)than for subjects of moderate or low power (0.70 to 0.75).
Any specific death from poisoning ethyl alcohol of morphological changes in tissues and organs of the body is not.
The conclusion of the death from alcohol poisoning is given only after careful histological examination of the internal organs of the body. In this study can be identified severe diseases of the cardiovascular system, contributing to death at a relatively low concentrations of ethanol in the blood. In some cases, on the contrary, leading to death is a disease, and alcohol intoxication is the only contributing factor.
Such cases are very difficult to estimate. In cases, when the blood of the deceased is determined by the concentration of alcohol 5 q and above, a forensic expert has the right to conclude fatal alcohol poisoning, regardless of the nature, established at the opening of the disease. At lower concentrations of alcohol in the blood to the conclusion that the death was caused by alcohol poisoning, you should carefully analyze existing diseases and their possible impact on mortality.
It is necessary to take into account individual peculiarities of the personality of the deceased, in particular related to the specifics of genetically enzyme metabolism of alcohol-dependent activity of alcohol dehydrogenase (ADH) and aldehyde-dehydrogenase (ALDH). They split ethanol to acetaldehyde, which is the most toxic of its metabolite, and acetaldehyde to acetic acid and water. Maximum activity of these enzymes is observed in the liver and kidneys. Found that in the human liver has two forms ADH - typical and atypical ADH. Atypical form of ADH is different from the normal exceptionally high enzymatic activity exceeding the normal activity of ADH 8 - 10 times. The observed sometimes the so-called adverse metabolic background splitting of ethyl alcohol in the human body depends largely on the availability of atypical forms of hepatic ADH, exceptionally high activity which leads to rapid oxidation of ethanol to acetaldehyde, and hence the rapid accumulation in the body.
This acetaldehyde, being many times more toxic in comparison with ethyl alcohol, largely determines the severity of alcohol intoxication. These individuals often have also been observed insufficient functioning of the enzyme system ALDG translating acetaldehyde in the water and acetic acid. It also contributes to the rapid accumulation of acetaldehyde in the blood. Persons with such atypical forms of ADH and ALDG can die from poisoning ethyl alcohol at a very low content in blood.
In the diagnosis of alcohol intoxication on the corpse of the victim significant difficulties arise when evaluating the results of the forensic chemical study of organs and tissues at different stages of post-mortem period when an autopsy is performed over a considerable time after the death.
Cases of formation of ethyl alcohol in the body in large concentrations is very rare, because this requires a certain set of conditions: specific flora, cadaveric material without Express putrefactive changes, the relatively high temperature of the environment. Consequently, the high concentrations of ethanol in the internal organs of the corpses, which were kept at a relatively low temperature, indicates lifetime intake of alcohol in the body. The same takes place in cases of detection of high concentrations of ethanol in the study of the decayed corpse. To check the possibility of his education in the corpse should be bacteriological examination of internal organs of the body.
If you suspect that the death was caused by alcohol intoxication, on judicial-chemical study are: blood from the leg veins syringe in a test tube or in a bottle from under penicillin up plug (no-take blood from the heart cavities of the body); urine; cerebrospinal fluid in the lumbar puncture; the contents of the stomach; convolution blood of the areas of damage (presence and a certain concentration in them ethyl alcohol indicates the degree of intoxication). You can also take the intraocular fluid in which the alcohol concentration is the same as in the blood. Liquid take a needle puncture needle doing in the corner of the eye (you can get 5 ml fluid). Under rotting corpse for research take 500 grams of muscle, the contents of the bladder, stomach content. You must also determine the mass of a corpse. Syringes, pipettes, dishes for the taking of interest must be chemically pure.