In a healthy adult electrocuted at 230 volts AC with the current path from the left hand to the right foot, the usual immediate mechanism of death is:

• A Respiratory paralysis from medullary involvement
• B Massive cerebral venous sinus thrombosis
• C Asystole due to direct myocardial standstill
• D Ventricular fibrillation from current passing through the heart ✓

Explanation

At low domestic voltages, alternating current passing through the chest triggers ventricular fibrillation, which is the standard mechanism of death in household electrocution. Respiratory centre paralysis becomes the dominant mechanism with very high voltage currents or when the current path traverses the brain stem, such as head to limb paths. Asystole is characteristic of direct current exposure rather than low voltage AC.

Reference: Knight's Forensic Pathology, 4th ed.

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Written and medically reviewed by the StethoPrep medical team.