post mortem Flashcards
3 types of autopsies are:
- Hospital/Consented Autopsy (Next of KinConsent Required) - 5%
- Coroners Autopsy (Next of Kin consent not required) - 95%
- Forensic Autopsy
value of hospital autopsy:
- Good audit of hospital service
- 20% of cases will show pathology not suspected even in a well investigated patient
- If next of kin are unhappy with management of patient, the autopsy can provide evidence of how well or badly the patient was managed
hospital autopsy:
- done by —- at the request of the —- or the next of —
- Must get —- from next of kin
- consent taken by —-
- Must get —- to retain tissue/organs for diagnosis , teaching , research
pathologist
clinician
kin
written permission
senior clinician
written permission
hospital autopsy:
* Must —- to next of kin what autopsy involves and
must be sure they understand what is said to them
* We explain that tissue/organs may be retained and that
after these have been examined the next of kin will be informed
* We explain to them how the tissue/organs might be
disposed of/retained and that their wishes will be carried
out
explain
coroners autopsies in hospitals:
- ordered by —
- are all —- cases
- Required when a death cert cannot be signed because the cause
of death is —
- coroners role is:
coroner
legal
not known
cause and place of death
indications of coroners autopsys:
- All drownings
- All poisonings
- All suicides
- All road traffic accidents
- All deaths in institutions (prison, long stay nursing homes,
hospitals etc.) - All deaths within 24 hours of admission to hospital
- All deaths within 24 hours of an invasive procedure
- All deaths where MRSA, clinical difficile are implicated
- All deaths due to notifiable diseases
- Other cases to be reported to the Coroner are “online” on
Beaumont Hospital computer system
- Do not require permission from the next of kin
- They must not be asked
- Permission to retain organs for diagnosis is not necessary
from next of kin - Permission to retain organs for research and teaching is required
are all under:
coroners autopsies
Where next of kin agree only to a partial autopsy
(hospital autopsy) is known as —
* —– is never limited or partial
limited autopsies
coroners autopsies
- Where a criminal cause of death is suspected
- Carried out by Forensic Pathologist
known as:
forensic autopsies
before commencing a autopsy :
- gather as much — as possible before starting from hospital staff next of kin or police etc
- Leave drains, IV lines, catheters,
endotracheal tubes in situ for pathologist to
examine
info
external examination include:
- Is rigor mortis present?
- Is lividity present?
- Check name band to ensure correct body
- Ethnicity
- Approximate age
- Weight/BMI
- Jaundice?
- External marks/wounds/scars
- Nicotine staining
- Petechiae and around eyes or in skin
- Signs of trauma
what is involved in an autopsy:
- — opened
- — removed
- all organs will be —
skull
brain
removed, weighed, dissected and examined
- It is essential to —- all organs for microscopy
- Sometimes the cause of death can only be identified at —-
sampled
microscopical assessment
- The State Laboratory provides a forensic toxicology service to assist pathologist in identifying a cause of death by confirming presence or absence of:
- —– will be used
- The chemistry is complex, using —-
- A report is given to the —-
Ethanol
Legal drugs and medications
Illegal drugs
Toxic substances (e.g.: carbon monoxide
- Blood, urine and sometimes vitreous fluid and gastric fluid are used
- mass spectrometry
- Pathologist and the Coroner
In case of possible sepsis, sterile techniques must be used for taking samples of blood, urine,
pulmonary secretions this is known as:
microbiology
