Traumatic injuries may be evident in natural deaths if the individual experienced a loss of consciousness that resulted in a more violent circumstance surrounding death, such as a fall with signi—cant blunt traumatic injuries, an automobile accident, or drowning. In some instances, it may be dižcult to discern these injuries from inŒicted trauma. e presence or absence of associated bruising and hemorrhage may help to determine if trauma occurred antemortem or postmortem. Resuscitative injuries should be distinguished from traumatic injuries. Needle punctures, de—brillator marks, anterior rib and sternal fractures, and neck injuries are commonly present. Rib and sternal fractures associated with resuscitation are typically seen in adults and generally have minimal associated hemorrhage. Occasionally, intubation injuries to the cricopharyngeal region, vallecula, and piriform sinuses may simulate strangulation injuries.