Autopsy, embalming, care of dead body

AUTOPSY, EMBALMING

1. AUTOPSY, EMBALMING, CARE
OF DEAD BODY
PREPARED BY
MR. ARUN. S. ANGADI
M.Sc. MSN (CCN). CHARUSAT. CHANGA

2. Autopsy
Apostmortem
examination
preformed to
determinethecause
ofdeath.
Causeofdeath
deemedsuspicious,
orinvolvescriminal
action.

3. Classification
•In a forensic autopsy,
a medical examineror
coronerdeclares the death
to be:
–Natural
–Accident
–Homicide
–Suicide
or
–Unknown

4. Natural Death
•Caused bya
known disease:
cancer, heart
disease,stroke,
geneticdisorders,
etc.
•Oftenjustsimply
“oldage”

5. Accidental Death
•Caused by
mistakeorfreak
occurrence.
•Death not
planned,butcan
beexplainedby
circumstances.

6. Homicidal Death
•Killinganotherperson.
•Closetoyou?
–Infanticide,Fratricide,
Sororicide,Parricide,
Patricide,Matricide,
Mariticide,Uxoricide
•Lotsofpeople…
–Genocide–Killinga
national,ethnic,racial
orreligiousgroup
Homicideisthemost
investigated death,
thereforethe most
autopsied.

7. Suicidal Death
•Killingofself.
•Oftentheeasiest
toidentifywrt
cause.
•Canbeelaborated
furtherinthe
report…
–Toxic,firearm,
blunt force
trauma,
asphyxiation,etc.

8. Unknown Death
•Deaths in absentia
–At sea
–Badly decayed bodies

9. Members to perform Autopsies
•Forensic Pathologist, a Medical Examiner
–4 years Undergraduate
–4 years Medical School
–4 years Pathology “Residency”

10. Protocol for Performing
A Forensic Autopsy?
•Corpse brought to M.E.
•In a new body bag/clean sheets
–Avoids cross-transfer of evidence
•Placed on dissection table

11. Physical Examination
•2 Parts:
–External
•Physical outer layer –
for injuries / cause of
death
–Internal
•Internal organs & tissue
-evidence of disease,
trauma, toxic
substances, organ
failure

12. External
Examination
Steps:
1.Photographed
2.Samples taken: hair, nails
3.Undressed, examined for wounds
--Lacerations, abrasions, bruises
4.Measured, weighed, cleaned

13. •In addition…Major
Systems looked at
–Cardio-Vascular (Heart &
Lungs)
–Central Nervous System
(CNS)
Internal Examination

14. Vitreous Humor
•Not much?
= Dead longer…
•More Potassium?
= Dead longer…
•Broken blood vessels?
= likely strangulation

15. CARE OF THE BODY AFTER DEATH
Body changes
•Rigor Mortis –Defined as ‘Stiffness of Death’
•AlgorMortis –Defined as ‘Coolness of Death
•LivorMortis-Meaning…‘Color of Death

16. CARE OF THE BODY AFTER DEATH
Body changes
RigorMortis–Definedas‘StiffnessofDeath’.
•Thestiffeningofthebodythatoccursabout2-4hrs
afterdeath.
•ItresultfromthelackofAdenosineTriphosphate
(ATP),whichisnotsynthesizedbecauseofthelack
ofglycogeninthebody.
•Itslackcausesthemusclestocontract,whichin
turnimmobilizesthejoints.

17. •Rigormortisstartsintheinvoluntarymuscles
(heart,bladder,andsoon)thenprogressesto
thehead,neckandtrunk,andfinallyreaches
theextremities.
•Becausethedeceasedfamiliesoftenwantsto
viewthebody,andbecauseitisimportantthat
thedeceasedappearnaturalandcomfortable,
nursesneedtopositionthebody,place
denturesinmouth,andclosetheeyesand
mouthbeforerigormortissetsin.
•Rigormortisusuallyleavesthebodyabout
96hrs.afterdeath.

18. AlgorMortis –Defined as ‘Coolness
of Death
•Itisthegradualdecreaseofbodytemperature
afterdeath.
•When bloodcirculationterminatesand
hypothalamusceasestofunction,body
temperaturefallsabout1degreecentigrade(1.8
F)perhouruntilitreachesroomtemperature.
•Simultaneously,theskinlosesitselasticityand
caneasilybebrokenwhenremovingdressingor
adhesivetape.

19. LivorMortisMeaning…‘Color of
Death
•Meaning…‘Color of Death’.
•Coloration of the skin.
✓Death=theheartstops=
bloodstopscycling.
✓Redbloodcells,plasmagather
onthebottompartofthebody,
closesttothefloor.
✓Alineformsafter8hoursifthe
bodyhasn’tbeenmoved.If
moved,anewlineforms.
✓Thethickertheline,thelonger
thebodyheldthatposition.

20. NURSING INTERVENTION
•Nursingpersonnelmayberesponsibleforthecareof
abodyafterdeath.
•Maketheenvironmentcleanandpleasantaspossible
andtomakethebodyappearnaturalandcomfortable.
•Removealltheequipmentsandsuppliesfromthe
bedside.
•Removethesoiledlineninordertomaketheroom
freefromodour.
•Careofthebodymaybeinfluencedbyreligiouslaw,
thenurseshouldchecktheclient’sreligionandmake
veryattempttocomply.

21. •Thebodyshouldbeplacedinasupinepositionwith
thearmeitheratthesides,palmsdown,oracross
theabdomen.
•Thewristbandshouldbeleftonunlessitistoo
tight.
•Apillowshouldbeplacedundertheheadandthe
shoulderstopreventbloodfromdiscolouringthe
facebysettlinginit.
•Theeyelidsareclosedandheldinplaceforafew
secondssothattheyremainclosed.
•Denturesareusuallyinsertedtohelpgivethefacea
naturalappearance.
•Themouthshouldbeclosed(aroletowelunderthe
chinwillholditclosed).

22. •Soiledareasofthebodyarewashedora
completebathshouldbegiven
•Absorbentpadsareplacedunderthebuttocks
totakeupanyfaecesandurinereleased
becauseoftherelaxationofthesphincter
muscles.
•Acleangownshouldbeplacedontheclient,
andthehairisbrushedandcombed.
•Allthejewelleriesareremovedexceptthe
bandinsomeinstances,whichistapedtothe
finger.

23. Thank you

24. EMBALMING

25. •Embalmingistheartandscienceof
preservinghumanremainsbytreatingthem
(initsmodernformwithchemicals)to
forestalldecomposition.
•Theintentionistokeepthemsuitablefor
publicdisplayatafuneral,forreligious
reasons,orformedicalandscientific
purposessuchastheiruseasanatomical
specimens.

26. The three goals of embalming are
➢Sanitization
➢Presentation and
➢preservation (or restoration).

27. •Anyclothingonthecorpseisremovedand
setasideandanypersonaleffectsuchas
jewelryisinventoried.Amodestyclothis
sometimesplacedoverthegenitalia.
•Thecorpseiswashedindisinfectantand
germicidalsolutions.Duringthisprocessthe
embalmerbends,flexesandmassagesthe
armsandlegstorelieverigormortis.

28. Theprocessofclosingthemouth,eyes,
shaving,etc.iscollectivelyknownassetting
thefeatures.
Theactualembalmingprocessusuallyinvolves
fourparts:
1.Arterialembalming
2.Cavityembalming
3.Hypodermic
4.Surfaceembalming

29. 1. Arterial embalming
•Arterialembalming,which
involvestheinjectionof
embalmingchemicalsinto
thebloodvessels,usually
viatherightcommoncarotid
artery.
•Bloodandinterstitialfluids
aredisplacedbythis
injectionand,alongwith
excessarterialsolution,are
expelled from the
rightjugularveinand
collectivelyreferredtoas
drainage.

30. Theembalmingsolutionis
injectedwithacentrifugal
pumpandtheembalmer
massagesthebodyto
breakupcirculatoryclots
astoensuretheproper
distributionof the
embalmingfluid.

31. 2. Cavity embalming
•Cavityembalmingreferstothe
replacementofinternalfluids
insidebodycavitieswith
embalmingchemicalsviathe
useofanaspiratorandtrocar.
•Theembalmermakesasmall
incisionjustabovethenavel
(twoinchessuperiorandtwo
inchestotheright)andpushes
thetrocarinthechestand
stomachcavitiestopuncturethe
holloworgansandaspiratetheir
contents.

32. •Hethenfillsthe
cavities with
concentrated
chemicals that
containformaldehyde.
•Theincisioniseither
suturedclosedora
"trocarbutton"is
securedintoplace.

33. 3. Hypodermic
Hypodermicembalmingisa
supplementalmethodwhich
referstotheinjectionof
embalming chemicalsinto
tissuewithahypodermic
needleandsyringe,whichis
generallyusedasneededona
casebycasebasistotreat
areaswherearterialfluidhas
not been successfully
distributedduringthemain
arterialinjection.

34. 4. Surface embalming
Surface embalming,
another supplemental
method,utilizesembalming
chemicalstopreserveand
restoreareasdirectlyonthe
skin'ssurfaceandother
superficialareasaswellas
areasofdamagesuchas
fromaccident,decomposition,
cancerousgrowthorskin
donation.

35. Chemicals used in embalming
Typical embalming fluid contains a mixture
of
✓Formaldehyde
✓Glutarldehyde
✓Ethanol