Collection of blood

Collection of blood – The cellular barrier of mucous and serous membranes breakdown after death, due to which substances in the stomach and intestine can migrate to the organs in the thorax and abdomen, causing false rise in the blood level.

Before autopsy, 10 to 20 ml of blood can be drawn from the femoral vein by a syringe. The flow may be increased by massaging the leg to drive blood proximally. The jugular or sub-clavian vein can also be used. After removal of the viscera, blood can be collected by raising the arm, and holding a small container under the cut end of a sub-clavian vein.

The arm can be elevated and massaged towards the shoulder, if the flow is slow. Similarly, blood can be collected from cutting the iliac veins at the brim of the pelvis, or from the jugular vein.

Collection of blood should never be done from the pleural or the abdominal cavities, as it can be contaminated with gastric or intestinal contents, lymph, mucus, urine, pus, or serous fluid. Alcohol and barbiturates can diffuse passively after death from the stomach and intestines into adjacent organs or cavities leading to erroneous results.

For grouping, a piece of filter paper or clean cotton gauze can be used to soak up some blood and dried.

C.S.F.

Collection of blood is done by lumbar puncture or from the cisterna magna by inserting a long needle between the atlas and the occipital bone. Direct aspiration of CSF can be done from the lateral ventricles or third ventricle after removal of the brain.

ENDOSCOPIC TECHNIQUE OF POSTMORTEM DIAGNOSIS

The method requires the use of rigid Hopkins-endoscope of 4 mm and 8 mm diameters with 0°, 90°, and 1300 view angles having a light source from fiberglass cable. The endoscope is fitted with zoom lens camera for photographic documentation.

Sinuses, fundus, external auditory meatus, larynx, etc. can be directly visualized. Bullet tracts in the body can be traced accurately. Hepatic, splenic and diaphragmatic injuries and intraperitoneal and thoracic hemorrhages can be visualized. Natural orifices can be clearly examined.

VITREOUS HUMOR

A fine hypodermic needle is inserted through the outer canthus into the posterior chamber of the eye, (center of the globe), after pulling the eyelid aside followed by aspiration with a syringe. One to two ml. of fluid can be aspirated from each eye. Water can be re-introduced through the needle to restore the tension in the globe for cosmetic reasons.

LUNGS

In solvent abuse and death from gaseous or volatile substances, a lung is mobilized and the main bronchus tied off tightly with a ligature. The hilum is then divided and immediately the lung is put into a nylon bag, which is sealed. Plastic (polythene) bags are not suitable as they are permeable to volatile substances.

After completing the autopsy, the body cavities should be cleaned of blood, fluid, etc. The organs are replaced in the body, and any excess space is packed with cotton, cloth, etc. especially in the pelvis and the throat, where blood tends to leak. The dissected flaps are brought close together and well sutured by using thin twine and large curved needle.

The skull should be filled with cotton or other absorbent material, and the skull cap fitted in place. The scalp is pulled back over the calvarium and the scalp stitched with thin strong twine. The body should be washed with water, dried and covered with clothes. The body is handed over to the police constable accompanying it for disposal.

Whoever offers any indignity to any human corpse shall be punished with imprisonment for a term which may extend to one year or with fine or with both.

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