Autopsy & Tissue Donation Flashcards
–Upper extremities–
Inject both arms separately using left subclavian or left axillary
Inject both sides of head separately using the common carotids
– Lower extremities –
Method 1 - Inject through the terminal portion of the thoracic aorta downwards (found central posterior of diaphragm)
Method 2 - Inject through femoral artery on right leg, one tube upwards and one downwards. Inject leg first, then inject upwards. Tie off thoracic aorta when fluid is observed.
-Drainage for lower extremities occurs through inferior vena cava (found lower right of diaphragm)
Thoracic cavity can be painted with autopsy gel and filled with material saturated in cavity fluid or other preservative. Put breastplate back into position and suture. Aspirate cavity.
Thoracic autopsy only
–Upper and lower extremities–
Method 1 - Raise left and right common carotid, insert tube upwards in the left (tie off the bottom) and downwards in the right (tie off the top). Inject towards extremities first, clamping off the vertebral arteries in the cranium. Inject left and right side of head, clamping off the internal carotid arteries
Method 2 - Raise right common carotid and insert two tubes, one upwards and one downwards. Inject down towards extremities first, clamping off the right and left vertebral and internal carotid arteries. Next, inject upwards into the head clamping off the right internal carotid artery in the base of the skull.
Method 3 - Raise the right femoral artery and insert two tubes, one towards the foot and one upwards. Inject the foot and then inject upwards, clamping off the vertebral arteries.
After arterial injection dry the cranial cavity and paint with autopsy gel. Attach calvarium and suture from left to right.
Cranial autopsy only
–Upper extremities–
Drainage from the inferior vena cava
Method 1 - Inject using the abdominal aorta (central posterior to diaphragm)
Method 2 - Raise the right common carotid (or both). Inject downwards first, clamping the aorta when leakage is noticed
–Lower extremities–
Inject the legs using both external iliac arteries
The abdominal walls can be painted with autopsy gel and filled with material saturated in cavity chemicals or other preservative. Aspiration of the thorax can be done through the diaphragm or the rib cage.
Abdominal autopsy only
S.O.P
- Re-open all incisions and remove anything unattached
- Wash out all contamination
- Treat all external complications ie: bed sores, burns, abrasions & bruises with topical & hypodermic embalming. Place topical packs and drape with plastic
- Disinfect all orifices and set facial features
- Apply moisturizer and massage cream to hands, neck, face and forehead to reduce and prevent dehydration
- Treat calvarium & sternum with topical preservative packs. Treat viscera with immersion embalming
- Begin vascular injection - absorption rate is slower in these remains vs normal remains -
—1. Cervical vessels including carotid, vertebral, and facial arteries
——a. Clamp the ends of internal carotids off as soon as leakage is seen
——b. Rates of flow 3-5oz/min
—2. Upper extremity vessels including sub-clavian, axillary and supra-scapular arteries
——a. Rate of flow 5-8oz /min
—3. Lower extremities vessels including femoral and iliac arteries
——a. Rate of flow 7-10oz/min
Place plastic over open body cavities to reduce fumes and aerolization of fluids during injection. - Assess the remains for soft spots and hypodermically treat including flaps, breasts, scrotum, and butt with minimum 3% mix.
Pay attention to incision margins, if left untreated they may tear during suturing.
Inject spinal column and intercostal spaces to ensure saturation of spinal cavity and all tissues between ribs. - Use cotton or paper towel to dry out cranial vault, abdominal, pelvic and thoracic cavities, as well as, any opened sites on imbs and spine to reduce chemical fumes and reduce leak potential.
- Apply preservative and absorbent powders and or gel compounds to treat tissues before suturing
- Remove viscera from immersion solution and place in bag with sufficient absorbent and preservative powders. Suction out all excess air and liquid and tie, replace in body. Remove preservative packs and replace calvarium and sternum.
- Closing techniques
Closing techniques - Cranium
Full globe enucleation.. What are the additional treatments in transport and care
- Supporting the head above the chest to prevent blood pooling into the sockets
- Apply cauterizing chemical, gel or cavity fluid to help mitigate leaking during arterial injection. Or powder incision sealer at the base of the eye socket with caution.
- Eye lids can wrinkle and swell easily, external cavity packs can reduce or prevent swelling during arterial injection
- Liberal use of emollient/massage cream for moisture
- Check cotton after injection for leakage, use mastic compound to seal cavity
- Use mastic compounds, cotton liberally coated in massage cream or prosthetic eye for natural formation
- Avoid pre-injection fluids
- Use stronger than normal arterial solution
Ideal treatment for non-autopsied hanging case
- Intense liver mortis and petechia in the facial tissues can be seen
- Moisturize and soften the rope burn prior to raising vessels
- Restricted cervical injection usually best practice due to neck swelling and vascular ruptures if using the axilla or ilium
- Inject head first, lower flow than normal
- Pre-injection procedure for vascular flush to help reduce swelling when introducing formaldehyde
- Bleaching arterial chemical can help to remove stains common to hanging
2 organ donor embalming methods
- Internal access or using the remaining intact arterial structures to inject
- External access or using the commonly raised vessels
Organs donated
Heart, liver, lungs, kidney, pancreas and small bowels
Tissues donated
Eyes, cornea, skin, bones, and ligaments
Bones donated
Vertebraes Long bones; Femur, Tibia, Fibula, and Hemipelvis Proximal Humerus Scapula Temporal bone Mandible
