54556213 intoksikasi sianida inggris

Upload: rifni-amalia

Post on 24-Feb-2018

230 views

Category:

Documents


0 download

TRANSCRIPT

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    1/35

    Medical Faculty of

    Trisakti University

    Jakarta

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    2/35

    Many substances that may cause someoneexperiencing a poisoned until it brings adeath.

    Substances that active chemically andphysiology in one body, at the point ofcertain dose toxic! "ill bring anunhealthiness or may cause a death.

    Forensic discuss about toxic substancefrom its varies, symptoms caused, andmethod forensic examination to handleeither for alive or dead victims.

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    3/35

    Toxicology de#nition and factors that a$ecttoxicity

    %pidemiology, signs and symptoms,pharmacokinetic, laboratory examination,and treatment&therapy of cyanide poisoning

    Forensic examination of patient thatexperiencing common poison and cyanidepoison

    medikolegal aspects of deliberate poisoningor unintentionally

    %xample case of cyanide poisoning

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    4/35

    (s a part of medical science that focusedon toxic

    Study about nature and mechanism of

    toxic e$ect, varies substance to"ardsliving things and other biologic system

    ( study about source, characteristic anda savor from toxic, indication andtreatment against poisoning and otherabnormality found in dead victim

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    5/35

    ( substance that may cause bad e$ect

    "hen it gets into a body of a living things,either intentionally or unintentionally

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    6/35

    )rigin*

    +lants opium, cocaine, curare, aatoxin!

    (nimals poison&snake toxin,

    spider&marine animals! Mineral arsenic, plumbum, and things

    that made from synthetic!

    -eroin

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    7/35

    enue* /ature0free poison gas in nature, household! +oison agriculture insecticides, herbesida, pe

    sticides! Toxic industrial laboratories and industry

    acid and strong base, heavy metals! Toxic food1/ in cassava, botulinus toxic,

    preservative, additives substance and toxic inthe form of medicine e.g. sedative hypnotic!

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    8/35

    )rgans that a$ected*2 -epatotosik2 /ephrotoxic

    3ork mechanism*2 Toxic that bind sulfhydryl group +b!2 %$ect on (T+0ase2 Forming methemoglobin nitrate and nitrite!

    The e$ects*2 4ocal2 Systemic2 local0systemic

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    9/35

    %xposureto toxic substances on humans andliving things*

    regular consumption

    exposure from "ork

    environmental exposure andpoisoning, either intentionallyor unintentionally

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    10/35

    -o" to enter*

    (ge

    5ody condition

    -abits

    6diosinkrasi and allergic to vitamin %,penicilin, streptomycin dan procaine

    Time delivery

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    11/35

    ( deadly toxic substance2 %$ects arevery fast and can cause death "ithin afe" minutes2 -ydrogen cyanide formonitrile!2 6n the form of li7uid 08prussit acid and hydrocyanic acid

    2 4i7uids can also be colorless or pale blue atthe temperature of normal room2 volatile and ammable

    2 di$use either by air and explosives2 ery easy to mix "ith "ater2 )therforms* sodium cyanide and potassium cyanidepo"der and "hite!

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    12/35

    a ma9or contributorto morbidity and mortality, observed in approximately:,;;; to in >;;@! and>: of>A= in >;;=! casesof cyanide poisoning is deliberate exposure as reported to the (merican (ssociation

    of +oison 1ontrol 1enters fatal suicide in adult patients may easily be

    associated "ith sudden death frommyocardial infarction, pulmonary embolism, or ventricular dysrhythmias

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    13/35

    4o"0dose in nature and in every product that"e usually eat or use

    1yanide canbe produced by bacteria, fungi and algae

    1yanide is found in cigarettes, motor vehiclefumes, and food and the synthetic product

    1yanide in seed plants,especially grains cassava "ild, "ild tubers, 6ntersection bu$oonery,

    "ild cherry, plum, apricot, "ild amigdalin,9etberry bush, etc.!

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    14/35

    Fog Inhalation

    Intentional poisoning (suicide)

    Industry exposure

    Iatrogenic exposure

    Consumptionof Supplements Containing Cyanide

    (Uncommon)

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    15/35

    1yanide in thebody "ill inactive some oxidative enBymes radically the"hole system, especially cytochrome oxidase by bindingto the ferric heme group from the oxygen carried by blood

    The process of oxidation and reduction occurs as follo"s*

    1ytochrome oxidase Fe C C Fe C C C cytochrome oxidaseC 1/ &0000 Fe C C C cytochrome oxidase0cyanide0

    )xidiBe cyanide d in the body get into

    cyanates and sulfosianat and expelled from the bodythrough urine.Toxic dose orally for -1/ is D;0E; mg,"hile doses toxic to 1/ or /a1/ is >;; mg.

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    16/35

    Main e$ects* hypoxia system arise progressivelySymptoms and physical signs that found are depend on the2 The dose of cyanide2 /umber of exposures2 Type of exposure2 Types of cyanide component

    symptoms in the body*2 blood pressure, vision, lung, central nerve, heart,endocrine system, autonomic system and metabolic system2 sore eyes because of irritation and diGculty breathing dueto irritate the respiratory tract mucosa

    2 highconcentrations only "ithin

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    17/35

    2 %xposure of hydrogen cyanidemay cause irritation against eyesand skin immediately after exposure or at

    least A; to D; minutes 6n lo" concentrations, the

    e$ects of cyanide emerging about

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    18/35

    2 cyanosis of the face, the foam out from

    the mouth,rapid and "eak pulse, rapid breathing

    and sometimes irregular, dilated pupils a

    nd slo"er reex, air breathing smellstonsil, the vomit also smells2 5y the death, cyanosis more realand arise t"itch muscles

    and convulsions "ith urinaryincontinence and alvi

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    19/35

    26nhalation* palpitations, diGculty tobreath, nausea, vomiting,

    headache, salvasi,lakrimasi, mouth and throat irritation, diBBiness and "eaknessof extremities arise 7uickly and thencollapse, convulsions, coma and death2 1hronic poisoning victim looks pale, cold

    s"eats, diBBiness, discomfort in thestomach, nausea and colic, feel pressed onthe chest and shortness of breath.2 Signs the end*coma and dilated pupils, tremors, arrhythmi

    as, convulsions, coma emphasis on therespiratory center, respiratory failure untilthe heart stop beating2 color skin looks Hcherry0redH

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    20/35

    +aper #lter test

    Ieaksi Schonbein +agenstecher IeaksiKua9acol!

    +russian 5lue reaction

    Micro Method Kittler L Kolabaum

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    21/35

    +oisoned by 1/ inhalation*08move victim to the place "here clean air isavailable, give0amyl nitrite"ith inhalation, < ampoule ;.> ml! every: minu

    tes, stop giving "henthe systolic blood pressure is less than=; mm-g08 give arti#cial respiration "ith

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    22/35

    1/ poisoning ingested2 do an

    emergency action "ith inhalation of amylnitrite, one ampoule ;.> ml,"ithin Aminutes! every : minutes2 Kive arti#cialrespiration "ith

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    23/35

    cases of deaths due to poisoning*2 %xamination at the place of incident2 )utdoor examination

    0 smell0 1lothes0 5ruises corpse0 1hanges in skin color

    0 /ails0 -air0 sclera

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    24/35

    )penchest and abdominal cavity, specify "hether there is an unusual smell smell

    of poison!2 1onsider the color of blood and thecolor of organs is bro"nreddish

    2 6n lung, there is an acute damming

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    25/35

    Taking blood fromthe heart separately from theright and left respectively for about :; ml

    2 5lood side for about A;0:; ml, takenfrom of iliac vein2 Urine and gastric "ashings all of takenfrom the bladder

    2 )rgan liver should be takenafter reserved for pathologyanatomy examination

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    26/35

    2 idneys should be taken both

    2 5rain, lipoid system inside2 another "ay to take samples*Ket the place "here toxic getsin stomach, the in9ection site!

    5lood)ut point urine, bile!

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    27/35

    pemeriksaan bagian luar 9enaBah

    tercium bau amandel

    Sianosis pada "a9ah dan bibir, busa keluar

    dari mulut, dan lebam mayat ber"arnaterang

    pemeriksaan bedah 9enaBah tercium bau

    amandel yang khas pada "aktu membuka

    rongga dada, perut dan otak sertalambung, darah, otot dan penampangtubuh dapat ber"arna merah terang

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    28/35

    %xamination of the exterior of the body"afted of tonsils

    1yanosis of the face and lips foam out of

    the mouth and bruised corpse lightcolored

    Surgical examination of the corpse "afted of the spesi#c tonsils distinctive"hen opening the chest cavity stomach,brain and also blood, muscle, and bodysections color seems red bright

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    29/35

    KUH !

    (rticle >;:

    (rticle A:E

    (rticle AD;

    KUH"

    (rticle

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    30/35

    #a$ %um&er ' ear *** "&out

    Consumer rotection! (rticle :

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    31/35

    Six eople is &eing poisoned &y Cyanide"cid in 5i$ul (a food from cassa.a 6our)

    Tue, January ;?!, (( A!, ( :!, M-

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    32/35

    #eaf

    andCassa.a

    5u&er

    ;e

    poisoned

    Case

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    33/35

    Toxicology can be de#ned as

    a substance that can cause bad e$ect "hen itgets into a livingbody, either accidentally or "ith intent.2 )ne typeof poisoning that occurs is cyanide poisoning, because the cyanide salt in a small dose isenough to cause death in someone 7uickly like asuicide.2 +oisoning can through parenteral administration,

    inhalation, ingestion or skin absorption dermal!.2 Signs and symptoms depend on the mechanism,source and 7uantity of cyanide that gets into thebody.

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    34/35

    2 Forensic through the post0

    mortem examination and toxicologytests can prove the existenceof cyanide in thebody, or any changes and abnormalities c

    onsistent "ith cyanide poisoning.2 (spect medikolegal about cyanide poisoning regulated in U-+ articles>;:, A:E, AD;O U-(+

  • 7/25/2019 54556213 Intoksikasi Sianida Inggris

    35/35

    5udiyanto (, 3idiatmaka 3, Sudiono S,et al. Ilmu Kedokteran

    Forensik. Jakarta * 5agian edokteran Forensik Fakultas edokteranUniversitas 6ndonesia.