[Puncture of central veins in homicide cases]

Puncture of a major cervical veins for insertion of a central venous catheter is a standard-method in resuscitation performed in emergency conditions. Even extensive lesion-marks due to punction are customarily seen by medico-legal practitioners, but in detail they may cause difficulties in differential diagnosis, when lesion marks caused by acts of violence directed straight against the neck are to be differentiated. Especially in the primary phase of inquiry about crimes of homicide these injuries due to punction are forensically important. Therefore frequency and methods of resuscitation efforts were evaluated in 453 crimes of homicide, committed in Göttingen and Berlin (subjects given by the Free University). Findings of the present study were that resuscitation measures were taken merely to a rate of 25%, and in proceeding a central venous catheter was not obligatorily inserted, moreover proceeding being regionally different. In Berlin a central venous catheter was inserted in 17 cases out of 77 resuscitated homicidal injuries, the rate being 24 cases out of 36 cases in Göttingen. In altogether 8 crimes of homicide committed by immediate attacks against the neck, a cervical vena was punctured, findings later being extensive effusions of blood marked around the tapped spot. The different ways to perform resuscitation may justify to point also at the forensic interest to discover the facts together with complete diagnosis in cases of crimes of homicide. That is why it may be vindicated to try to find out a proceeding, which does not lessen the effectiveness of resuscitative manoeuvres, yet by means of which forensical concerns are taken into consideration, too.(ABSTRACT TRUNCATED AT 250 WORDS)