How to Perform an Autopsy

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    16-Oct-2015

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Do you wonder whether you could have what it takes to perform an autopsy? Are you simply interested in the process? This guide offers a thorough understanding of the process involved in performing an autopsy on a deceased human.

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An autopsy is the sort of thing you see on television surprisingly often, particularly if you have an interest in crime drama or medical drama, and yet those television autopsies arent often all that accurate. There are two types of autopsy; medical and investigative. In both cases the target is of course to understand the cause of death, but in some cases this is done as part of medical training or before donating organs. Regardless of the reason for the autopsy the process is a fascinating one. Of course you must be a licenced coroner or medical student with a licenced supervisor in order to legally perform an autopsy on a human. Failure to meet these requirements means that you are not performing an autopsy in the eyes of the law, but performing mutilation of the deceased, which is a crime. The Equipment;Start by gathering the equipment you will need; and there is a lot of it. To prevent your equipment for tampering with any evidence, particularly if youre performing an investigative autopsy which may reveal evidence as to the identity of a murderer, then youre going to need to ensure that any medical equipment you use is sterile. Things like a voice recorder (it is very hard to write down physical notes while performing an autopsy, it is much easier to record the process and findings verbally and write them up after the autopsy). You will also need a camera, photographic evidence can be invaluable in many circumstances, particularly if a closed case is being reinvestigated or the findings are being submitted as part of medical research. A dissecting knife, brain knife, scissors, saws, skull key, scalpels, forceps, chisels and mallet could all be needed, however; fingers are often much easier to work with than forceps, skull keys and brain knives will also only be needed if opening the skull and dissecting the brain, which is not often included in the process. You will also find that scalpels are not often used, as the dissecting knife does the job particularly well. Youll also need the typical things to ensure a cleaner and easier environment; autopsy table, body block, appropriate drainage, gloves, goggles and so on and so forth. External Examination;So; to start with you have a body. Still clothed and probably fresh out of the plastic bag. Now for a medical autopsy you probably dont need to concern yourself too much with their clothing, chances are they passed away in a hospital gown that contains no real evidence as to the cause of death. However, for an investigative autopsy you will need to concern yourself much more with the clothing. Everything needs to be closely inspected and recorded, as you have much more time and flexibility for checking these than the investigators and officers that were on the scene. You will already have some idea as to what happened, so you may be looking for blood or other DNA that could have been from the criminal, such as hair or skin samples on the clothing. DNA samples over the fingernails if there is reason to believe that your victim may have has a physical struggle with the attacker. Clothing fibres, paint, gunpowder residue and other such deposits can also be helpful hints that allow you to understand a little more of what happened at the crime scene. Photograph the body from as many different angles as possible, with close ups on any areas that may be of interest such as blood stains, suspected paint chips etc. Ensure photographic evidence is complete before removing the clothing then send clothing for further study if required. Once youve removed the suspects clothes you take note of any distinctive features; physical characteristics such as height, weight, eye colour, hair colour, ethnicity, gender, age, tattoos and scars, then you explain any externally visible symptoms that may be related to the cause of death. Open wounds, bruises, scratches, needle marks, burns and so on will be listen, with their locations, severity and estimated age being listed as you go. Now you should take X-Rays, which will indicate any bone abnormalities, or the location of objects within the body; particularly useful if the victim has been shot. Of course, depending on the reason for the autopsy and the condition of the body the X-Ray may not be required. Most autopsies will, at this stage, take hair, nail, saliva and blood samples some will also take fingerprints and dental records, particularly true of investigative autopsies. Then you need to take the photographs again. Again the photographs should be taken from lots of angles, with close up shots of anything that may be considered to be of interest either in regards to the cause of death or identifying a criminal. Internal Examination;With everything on the inside dealt with you can now open up your body to take a close look at the insides. This is relatively common when it comes to investigative autopsies, but is not always needed with medial autopsies, depending on where the cause of death is known and what it was. A medical autopsy can not only help us to understand the cause of death, but also help us to understand the lesser known diseases, the damage they cause to the body, the process of the disease that causes death, which makes finding cures and preventative measures a much easier process. The first thing to do is, of course, open the torso. It is not as likely that you will need to perform dissection on the brain, and very unusual that the face, arms, hands or legs need to be internally examined. While most of your television autopsies do show the characteristic Y shape incision that is used to access the internal organs it is less often that they show this correctly. The arms of the Y should reach each shoulder, and the stem should run all the way down to the pubic region. As the heart is no longer beating the amount of blood shouldnt be too much, depending on how long the person has been dead, which means that the main thing youll have to deal with is the leakage of other such body fluids, which may vary depending on the cause of death. One of the common mistakes on TV is how to handle the area of the torso that is obscured by the breasts, while most of the television autopsies opt for the straight lines above the breasts it is actually supposed to curve around, under the breasts, as this makes the torso easier to lift out of the to open the chest. This type of incision is known as the trunk incision, and is one of the easiest ways of gaining access to the internal organs. Of course, once you have opened the torso you need to push the skin to the side, without causing any additional damage as this all has to be put back when youre done. If the incision was done correctly the skin will peel back rather easily, you might have to use some force to tear connections to the muscle or slide along the inside of the slabs with the dissection knife to cleanly pull the skin away from the organs. These will be heavy enough to keep themselves peeled back without getting in your way too much. Take a urine sample from the bladder and a blood sample directly from the heart while you have the torso open. These should be easy enough to access, and will provide you with valuable sources of testing, indicating the interference drugs or alcohol may have had on the cause of death. Once you have these samples you may want to take more photographs for reference before beginning to remove organs. You have two options with the ribs; a saw or rib cutter will get them out of the way with a bit of work; you need to be sure to cut between the ribs and the cartilage connected to the breast bone. Of course if you want a cleaner removal you can cut the sides of the chest cavity and leave the ribs attached to the breastbone, allowing you to remove the whole chest plate as a single piece. When it comes to the removal of organs there are two options to choose from; Virchow technique or Rokitansky technique. If time is limited go with Rokitansky, this clears up the body for cleaning and funeral preparation much faster, however for a more in-depth, detailed and time consuming analysis of the organs the Virchow technique would generally be the preferred selection. Removal & Dissection of Organs;Virchow this technique involves removing each of the organs individually. Usually this stars with removing the intestines by severing the attachment tissue. During this process each of the organs will be inspected carefully before, during and after removal, making it a more common option when the cause of death is not yet known at the time of organ removal or where one organ is known to have been effected by or during the death more than the others, as this can be removed and dissected immediately.Rokitansky this technique removes all of the organs as a connected group. The basic principle is simply to disturb the connections between the organs as little as possible, dissection of the organs are then done later. This doesnt introduce any artificial injuries to the organs as a result of the autopsy, this also makes it a preferable method with regards to many religious sentiments where these may be a concern. This is of course a difficult process and does require more experience, as the coroner needs to be able to recognise abnormalities in the organs. Letulle this technique is not as frequently used and is similar in aspects to Rokitansky. This is the best technique for preserving the vascular supply and the relationship between the organs, with the thoracic, cervical, abdominal and pelvic organs dissected into organ blocks after removal of the entire unit. This is one of the faster processes, making it a more popular option for grieving relatives who are eager to have the body released for funeral / cremation, particularly as this can actually improve the embalming process. Of course this is very difficult to manage alone, due to the mass of the organ block, and it is very difficult to put the organs back in their respective locations after removal, which makes additional autopsies difficult. Ghon this technique is another en masse / en bloc technique (like Rokitansky and Letulle) but there are various variations of this method. This is more common for medical study and maintains all of the connections between the organs to preserve the anatomical relationships. This is a fantastic way of performing a full autopsy and getting as much information as possible when dealing with a sudden death, however it does take a great deal of anatomical knowledge and skill to complete and it does take a considerable amount of time. Should dissection of the brain you will need to cut across the crown of the skull, creating a line from the bone bump behind one ear to the bump behind the other. The cranium with then be opened using a special saw that cuts through the bone but leaves the soft tissue undamaged. One problem with dissection of the brain is its natural consistency, which is a very soft, gooey texture, resembling tofu. This can be difficult to dissect easily because of this natural texture, however those who have a little more time and a particular desire to see the brain clearly (for example those using the organs for medical research, education or training) may want to treat it and make it easier to dissect before working on it. A few weeks in a fixative formalin will not only preserve the brain, but help to make the consistence and firmness something that is easier to handle and work with. During the process of removing the organs there are other tests and samples that can be and generally are take. Tissues samples from most of the organs are taken during the removal or dissection of the organs, depending on the technique that has been used. Should any of the organs be retained for study or research, of any kind they, can be placed in a fixative formalin much like the brain, to keep them well preserved and firm. The End of the Autopsy;You should conclude your autopsy by declaring your conclusion; summarise the items of evidence and points of interest that you discovered during the process (which you should have already recorded as of course you should have been dictating the process and discoveries as you went), explain the conclusion that this evidence brought you to and why. Ensure that you explain the cause of death clearly, pointing out any factors that might be specific to cause of death, as these may be relevant to an investigation. For example; if the victim was shot, rather than stating simply that the cause of death was a gun-shot wound you should explain the specifics, so you would state that it was a single gunshot wound to the lower left abdomen, with the bullet penetrating the left kidney and lodging in the muscle of the lower back, injury caused severe kidney trauma and damage to the blood supply, causing the victim to go into shock and lose consciousness. Death occurred approximately 45 minutes later as a result of blood loss. This ensures that the investigative sources have as much information as they could need to come to an educated decision. The more thoroughly you provide the information and reasoning the better. This is just as true when it comes to the progression of a disease as a murder, as it is important information is given clearly to allow future research to continue effectively. Once the autopsy and results are completed in full, you can begin the process of reconstituting the body. You will of course need to replace the organs, unless these are being retained for study. These can be difficult to place back into their respective locations, often if not all of the organs are being replaced in the body those that are will be placed in plastic bags, so as to ensure that the organs dont leak, and the extra space is packed with cotton wool. One of the most important things is of course to replace the chest plate, as this will support the torso flesh when it is replaced. With everything that needs to be back inside the body you can close the body, using the characteristic baseball stitch. The body will then be washed and dressed for the funeral and cremation.

Kate Critchlow is a freelance writer working with a variety of clients to provide interesting and useful resources, including medical suppliers of various products from dissection tools to bespoke needles.