Death by railway accident: incidence of traumatic asphyxia

Eleven people were killed in a railway accident. Four of them died of severe blunt injury, three of moderate injuries combined with traumatic asphyxia and suffocation. Four of the victims were only slightly injured but showed distinct signs of traumatic asphyxia. An extensive pulmonary microembolism syndrome consisting of bone-marrow and fat embolism was found in these cases. Comparing the morphologic findings after suffocation by thoracic compression and traumatic asphyxia the authors attribute independent pathophysiologic significance to traumatic asphyxia. The importance of autopsies and histologic examinations in railway accidents is emphasized.