Curriculum

Introduction – Basic Autopsy Procedure

Welcome
What you’ll need

1 -Safety

1-1 Autopsy Safety
1-2 Lab: Case-viewing skills – introduction – 1
1-3 Lab: Case-viewing skills – introduction – 2
1-4 Lab: Case-viewing skills
1-5 Personal protective equipment
1-6 More about personal protective equipment
1-7 Lab: Case-viewing skills
1-8 Putting on the gown and gloves
1-9 Taking off the gown and gloves
1-10 Lab: Case-viewing skills
1-11 Putting on the scapel bade
1-12 Taking off the scapel bade
1-13 More about preventing scapel sticks
1-14 Lab: Case-viewing skills
1-15 Long knives
1-16 Preventing needle sticks
1-17 Lab: Case-viewing skills
1-18 Sharp ribs
1-19 Pacemakers
1-20 Lab: Case-viewing skills
1-21 Take care of your back
1-22 Splashes
1-23 Lab: Case-viewing skills
1-24 Attitude

2 – Before you begin

2-1 The consent
2-2 Lab: Case-viewing skills
2-3 The medical history
2-4 More about medical records
2-5 Lab: Case-viewing skills
2-6 Stay grounded, stay cautious
2-7 Get into your mindset
2-8 Lab: Case-viewing skills
2-9 Basic set-up: Safety and working space
2-10 Basic set-up: Tools
2-11 Lab: Case-viewing skills
2-12 Basic set-up: Tabel and patient position
2-13 Lab: Case-viewing skills
2-14 Documentation

3 – Starting the case

3-1 Identifying the body
3-2 Lab: Identifying the body – 1
3-3 Lab: Identifying the body – 2
3-4 Lab: Identifying the body – 3
3-5 Obtain any required samples – introduction
3-6 Obtain any required samples – vitreous
3-7 Obtain any required samples – blood
3-8 Obtain any required samples – urine
3-9 Obtain any required samples – other
4 – External exam
4-1 External Exam
4-2 General body assessment
4-3 Lab: General body assessment: Body habitus
4-4 Lab: General body assessment: Livor mortis
4-5 Lab: General body assessment: Postmortem change – 1
4-6 Lab: General body assessment: Postmortem change – 2
4-7 Lab: General body assessment: Postmortem change – 3
4-8 Skin – general
4-9 Lab: Get ready to assess your patients – 1
4-10 Lab: Get ready to assess your patients – 2
4-11 Feet
4-12 Lab: Here are your 5 patients to assess: Start with the feet
4-13 Legs
4-14 Lab: Your five patients – assess the legs
4-15 Genitals/groin
4-16 Lab: Your five patients – assess the genitals/groin
4-17 Abdomen
4-18 Lab: Your five patients – assess the abdomen
4-19 Chest
4-20 Lab: Your five patients – assess the chest
4-21 Neck
4-22 Lab: Your five patients – assess the neck
4-23 Head
4-24 Lab: Your five patients – assess the head
4-25 Arms
4-26 Lab: Your five patients – assess the arms
4-27 Back and buttocks
4-28 Lab: Your five patients – assess the back and buttocks
4-29 Lab: Summary activity

5 – The skin incision – basics

5-1 Reminder: Follow the consent!
5-2 Take care of yourself. Be comfortable.
5-3 Principles of incision. You can’t hurt the body, but you can hurt the family and your career.
5-4 Y-shaped incision: chest and abdomen
5-5 Head incision
5-6 Lab: Head incision
5-7 Partial autopsies

6 – After the Y-shaped incision

6-1 Expose the chest pate
6-2 Expose the abdominal cavity
6-3 Expose the structures of the neck
6-4 Remove the chest pate
6-5 Safety: Protection from sharp ribs
6-6 Survey the chest and abdomen
6-7 Assess any surgical changes that require in situ assessment

7 – After the head incision

7-1 Accessing the cranial cavity – reflect the temporalis muscle
7-2 Accessing the cranial cavity – remove the calvarial cap

8 – Before the organs come out

8-1 Draw blood
8-2 Take cultures
8-3 Open the pericardial sac
8-4 Check for pulmonary embolism
8-5 Tie off the carotids and femoral arteries – help the funeral director

9 – Taking the organs out

9-1 Introduction
9-2 Common procedures: removing the bowel
9-3 Common procedures: releasing the neck organs

10 – Removing the brain

10-1 Removing the brain
10-2 Assessing the base of skull, calvarial cap and dura
10-3 Removing the pituitary

11 – Separating the organs

11-1 Introduction
11-2 Tips

12 – Microscopy

12-1 Standard sections

13 – Ending the case

13-1 Returning the organs to the body
13-2 Closing the body
13-3 Safety
13-4 Cean up
13-5 Safety (again!)
13-6 After the case

14 – After the work is done

14-1 After the work is done

Example Lessons:

1-5 Personal Protective Equipment

8-1 Draw blood

Example Lessons

1-5 Personal Protective Equipment

Here is a list of personal protective equipment you’ll need during the case:

-Gloves
-Plastic gown
-Mask
-Eye protection
-Head cover
-Shoe covers
-Scrubs
-Chainmail gloves (for HIV and other infectious disease cases)

For the body (below the head):

1 – Shoe covers
2 – Plastic gown*
3 – Scrubs
4 – Gloves**

*The plastic gown should include sleeves covering the arms rather than “apron format” (with exposed arms). There should be a thumb loop at the end of the sleeve.

**Use double gloves (two on each hand).

8-1 Draw blood

Drawing blood from the heart:

Lift the heart with one hand to expose the posterior surface.

Find the inferior vena cava as it enters the right atrium.

Place your syringe needle with your other hand into the inferior vena cava/posterior right atrium region.

Here’s where to put the needle:

Draw back with the plunger of the syringe.

You may need to slightly pull back the needle and re-angle it to find blood.

The blood can clot and, even in the heart, it can be difficult to retrieve.

Consider lowering the head of the table to allow blood to drain towards the heart.

Drawing peripheral blood:

Find the common iliac vein in the body cavity.

Insert a your needle into it.

Draw the blood.

Like this:

It may be helpful to lift the leg to allow the blood to fill the vein. You should see it swell as blood enters the vein.

Other:

Remember, you can always try to draw femoral vein blood through the skin before the start of the case. See Lesson 3-7.