Et2 Embalming Partial Autopsy Cases

VEHICULAR ACCIDENTS and done to determine if neck was broke and for muscle damage and STRANGULATIONS

Why Posterior neck incision is done?

Leaking of neck

biggest problem for posterior neck incisions

Posterior neck incision procedure

Must be rolled onto side or face to suture (hold head or use a pillow); TIGHT suture (baseball) with ample amounts of putty and or drying, incision powder (to prevent leaking); glue and cotton sutures; place in plastic garment (Unionall); use EMMERICH CRANIAL CAP with ABSORBANT CRANIAL INSERT (neck portion tucks into plastic garment/unionall)

Partial Autopsy: CRANIAL METHOD 1

Restricted cervical method uses 3 cannulas; 1 cannula up the RCCA; 1 cannula down the RCCA; 1 cannula up the LCCA (tie off lower portion of LCCA); Use RIJV for drainage; inject down first to embalm trunk and extremities; inject LCCA second; clamp off LICA; inject RCCA last; clamp off RICA

RCCA

Right common carotid artery

LCCA

Left common carotid artery

RICA

Right internal carotid artery

LICA

Left internal carotid artery

Donate brain to research; Alzheimer's; stroke

Why just do a cranial autopsy?

Better control of the fluid going to the head (ISOLATES THE HEAD) reduces swelling to head and face

Why do a restrictive cervical?

Restrictive cervical

If there is swelling, a potential for swelling, or trauma to the head or face, do a _____________

Partial Autopsy: CRANIAL METHOD 2

Normal or 1 point injection method using 2 cannulas; 1 cannula up the RCCA; 1 cannula down the RCCA; clamp off LICA and right and left VERTEBRAL ARTERIES; use RIJV for drainage; inject down first to embalm trunk and extremities and left side of head; inject up the RCCA LAST; clamp off RICA

Partial Autopsy: CRANIAL METHOD 3

Femoral Injection using 2 cannulas; 1 cannula up the RFA; 1 cannula down the RFA; use RFV for drainage; inject down the right leg first; inject up the RFA to embalm the rest of the body; clamp off right and left ICA's and right and left VA to stop leakage during injection

RFA

Right femoral artery

LFA

left femoral artery

RFV

right femoral vein

LFV

left femoral vein

Heart attack; aneurism; lung disease

Why would one just have a thoracic autopsy?

First step to Thoracic Autopsy

INJECT THROUGH THE INFERIOR PORTION OF THE THORACIC AORTA IF AVALIABLE (DOWN TO LEGS FIRST); Injecting the arms and head; one or more thoracic organs have been removed (neck left undisturbed) drainage taken via SVC if neck is undisturbed; arms and head can be injected the same as normal autopsy; left and right subclavian artery for arms; LCCA and RCCA for head (clamp the internal carotid artery)

Partial Autopsy: THORACIC METHOD 1 FOR ABDOMEN AND LEGS

use the thoracic aorta (near diaphragm); place large cannula down the aorta to embalm abdominal walls, abdominal contents/organs and lower extremities; clamp off leaks as located (possibly the R and L inferior and superior epigastric arteries) close thoracic cavity as you would any autopsy; aspirate abdomen and inject with cavity fluid

Partial Autopsy: THORACIC METHOD 2 FOR ABDOMEN AND LEGS

Using the right femoral artery and 2 cannulas; inject down the right femoral artery first to embalm the right leg; inject up the right femoral artery to embalm the left leg, abdominal walls and abdominal contents/organs; clamp off the thoracic aorta to stop leaking; close thoracic cavity as you would any autopsy; aspirate abdomen and inject with cavity fluid

First step to Abdominal Autopsy

Injecting the Legs; abdominal organs are removed; drainage taken via IVC; legs are injected via the right and left common iliac arteries (CIA), per normal autopsy protocol

Partial Autopsy: ABDOMINAL METHOD 1 FOR INJECTING THE THORAX, UPPER EXTREMITIES AND HEAD

Inject up the abdominal aorta (inferior to the diaphragm); clamp leaks if/as necessary to stop fluid loss; treat abdominal cavity as any autopsy closure; aspirate the thorax and inject cavity fluid

Partial Autopsy: ABDOMINAL METHOD 2 FOR INJECTING THE THORAX, UPPER EXTREMITIES AND HEAD

Raise the RCCA and add 1 cannula up and 1 cannula down; inject down the RCCA to preserve arms, thorax, and left side of the head; inject up the RCCA to preserve the right side of the face; clamp leaks if/as necessary to stop fluid loss; treat abdominal cavity as any autopsy closure; aspirate the thorax and inject cavity fluid

Cavity treatment for Partial Autopsies

Which ever cavity has not been opened should be aspirated with a trocar and injected with cavity fluid; the cavity that was autopsied can be painted with gel, hardening compound or hypo injected with arterial fluid; cotton or sheeting soaked in cavity fluid (if viscera is not returned); close with baseball stich; do "final prep" (wash, dry, plastics, etc.); complete report