Forensic Science: The Role of an Anatomical Pathology Technician

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    • 00:07

      [Forensic Science: The Role of an Anatomical PathologyTechnician]

    • 00:11

      CARLA VALENTINE: My name's Carla Valentine,and I'm a pathology museum curator.[Carla Valentine, Technical Curator, Bart's PathologyMuseum] I used to be an anatomical pathologytechnician, which means I assist the pathologist at autopsies,so I still educate about forensics and postmortems.[The Role of an Anatomical Pathology Technician]The anatomical pathology technicianis the person who assists the pathologists with the autopsy.

    • 00:32

      CARLA VALENTINE [continued]: So this means basically doing the dissection,the evisceration, and taking the specimens.But it also means running the mortuary,dealing with relatives, and teaching medical studentsas well.On a day to day basis, you'd arrive at the mortuary,and you would see to any of the deaths that came in overnight,make sure the register was all up to date with those cases,and then find out which autopsies

    • 00:52

      CARLA VALENTINE [continued]: you've actually had to do.You would go through that with the doctor,identifying the correct deceased patients,carrying out the examination, and then reconstructing.And then the rest of the afternoonmight be, for example, viewings with familiesand releasing bodies to funeral directors,making sure that you've got all the stock that youneed before you basically do the whole thing again the next day.

    • 01:16

      CARLA VALENTINE [continued]: The general process of a postmortemwill begin with making sure that you have all the correct toolsthat you'll need.Then the doctor will come and youwill both identify the patient ready to be autopsied.At that point, the APT will take out all the organs,and the doctor will do an examination of themwhile the APT maybe takes the rest of the specimens--say bile, or urine, or blood.

    • 01:38

      CARLA VALENTINE [continued]: Once the organs have gone back into the bodybecause the doctor is satisfied they know the cause of death,the APT completely reconstructs the deceased.Then they go back into the cold storeand the whole of the PM room is completely disinfectedso that it's ready for the next postmortem.I'm setting up for a postmortem in the coroner's mortuary,so we're in the PM room at the moment.

    • 01:58

      CARLA VALENTINE [continued]: And I'm just trying to get out all the instrumentsthat I'm going to use as part of the examination.So I've got a brain knife here.There's also a ruler, which is to measure things like tattoosor birthmarks or injuries.Got some rib shears so that we can get through the ribsand into the chest cavity.

    • 02:19

      CARLA VALENTINE [continued]: The ladle here is for body fluids,so we can scoop them and remove them.We've also got some scissors and some forceps.These tools here are for opening the head,or the top of the skull.So you would slide this into the gapthat you've made with the saw and then you can turn it.It's called a skull key.

    • 02:42

      CARLA VALENTINE [continued]: And this one here is a scalpel.So it's one of the blades that we use .[The Postmortem Procedure ]There will be an external examination first.That's where things like bruises, cuts, tattoos,birthmarks are noted.Then there will be the evisceration,which the APT will do, and all the organs will come out--and it's usually in the order of thoracic and abdominal.

    • 03:04

      CARLA VALENTINE [continued]: As the doctor is busy dissecting those organs,the APT then moves onto the head and removes the brain.When the doctor is satisfied that there'snothing wrong with the bones inside the skull,the APT can then go ahead and begin reconstructing the head.And then eventually the rest of the organswill go back in the body, and thatwill be reconstructed as well.We reconstruct the body by making sure

    • 03:25

      CARLA VALENTINE [continued]: that most of the organs go back into the deceased.I say most because sometimes the doctorwill want to keep a small piece of perhaps the kidneyor liver as a histology sample-- in which casehe gets the consent from the coroner.The rest of it will go into what we call viscera bag.These are a biodegradable plastic bags,and even the brain goes into the viscera bag.

    • 03:46

      CARLA VALENTINE [continued]: And there's a reason for this.Once you've actually sliced into the brain,it loses its physical integrity.It becomes very sloppy-- for want of a better word--so you don't put the brain back into the head.It would be a sort of hygiene disaster.So even the brain goes into the viscera bag.That goes back into the empty abdominal cavity,and then the skin is sewed up.

    • 04:06

      CARLA VALENTINE [continued]: Most postmortem rooms are set up the same.They're classed as a "dirty area."They're not really dirty.That's because in mortuary buildings,you'll have a clean area-- like an office,or a staff room-- then a transition area-- whereyou get changed-- and then what'sclassed as the dirty area.So for this reason, for example, the fridge is over here.These have got the deceased patients

    • 04:26

      CARLA VALENTINE [continued]: in but they're double-ended, so they'vecome in from the other side by the funeral directorsor the ambulance.They're placed into the fridge and thenwe can open the fridge in the dirty area.Then the patient is simply rolledacross the postmortem room and thenonto one of these PM tables.And this just means that we keep themon the same tray from the fridge as we

    • 04:48

      CARLA VALENTINE [continued]: do in the postmortem room.You can tell by a lot of these bits and piecesthat the table is adjustable.So for example, when you're cleaning,you can adjust the table to go on an inclineand then that way you can wash the deceased and drain.So, the idea is to make sure that you've got a good watersupply whatever you're doing, which is also

    • 05:08

      CARLA VALENTINE [continued]: why there tends to be a sink right at the head of the PMtable.And a place where you can do dissectionsand weigh the organs and, obviously, not maketoo much of a mess.During the PM, we tend to mark downthe weights of the different organs.So, for example the brain, the heart, the kidneys, the liver,

    • 05:29

      CARLA VALENTINE [continued]: and spleen.And then we'll also mark down things that we notice.So it could be maybe a birthmark,or it could be something like fractureor any other type of injury.[The Differences With a Forensic Postmortem ]When anybody is found dead, the police will be called,and it's the police who make a decision-- basedon what they say, what the evidence is-- whether or not

    • 05:49

      CARLA VALENTINE [continued]: it's natural.And if they think it's maybe somethinglike a crime's been committed, then they'llrefer it to somebody else within the police,and a decision will be made as to whether or notit is forensic.All postmortems are referred by the coroner,but in the case of a forensic postmortem,there will usually be a slightly different, forensicallyqualified pathologist who does it, and we know from the startthat the procedure will be completely different.

    • 06:11

      CARLA VALENTINE [continued]: When a person dies in the UK, if they've notbeen seen by a doctor within two weeks of their death,and if the cause of death isn't natural,then they will usually have a coronial postmortem.And that's different from a forensic postmortem.It's not a crime.So what we do in a coronial postmortemis we attempt to find out cause of deathand any underlying conditions or diseases.Forensic postmortems differ from ordinary postmortems

    • 06:33

      CARLA VALENTINE [continued]: because there is a lot more people in the room.There will be scenes of crime officers.There will be police.Often there will be two APTs.Another difference is the pathologist themselfactually does the evisceration, and thisis because they're the ones who will stand in court.Police are always present at the postmortem so,again, pathologists will say, yes, Ibelieve this person was shot.

    • 06:53

      CARLA VALENTINE [continued]: But there will be a report, which will thenbe sent on to the relevant people,and that will be used in court, for example.In some forensic cases it's obvious how the person died.Of course, all cases are to be treated exactly the same.They are still an investigation.If it isn't clear how the person died,then as many tests as possible will be carried out.There is a lot of evidence that needsto be amassed to be used in court at a much later date.

    • 07:16

      CARLA VALENTINE [continued]: And also, every single stage of the postmortem is photographed.In a forensics case, our role reallydoesn't differ all that much to our usual role.The main thing is that we don't do the evisceration.But we still need to make sure all the tools are set out.We help the exhibits officers.We construct the body afterwards as well.And the difference is, it just takes an awful long time,

    • 07:38

      CARLA VALENTINE [continued]: so we're there to give the pathologist a bit of reliefas well.Everybody's role is absolutely crucial,because people need to verify each other.There needs to be witnesses to things that have been foundand the pathologist needs just as much help as hewould in an ordinary case.never the APT's job to assess the cause of death.What we can do is we can support the pathologist.

    • 07:58

      CARLA VALENTINE [continued]: We can give him our opinions and show him our findings.But it will be the pathologist who actually decideson the cause of death and then takesthe responsibility of writing the death certificate.

    • 08:18

      CARLA VALENTINE [continued]: The postmortem register is usuallyfilled in when a postmortem's taken place.It's specifically made and it's got a space for, for example,the patient's name, age, weight.It's got a space for their organ weights, whichare copied down from the board.And then it's also got a bit of spacefor the pathologist to write a cause of death,and maybe for the coroner's officer that'sdealing with the case as well.So that's just your kind of go-to Bible of all the cases

    • 08:42

      CARLA VALENTINE [continued]: that you've done.Some forensic cases can be a lot more complicatedbecause they may involve somethingthat's dangerous to the technician and the restof the staff.Say, for example, what we call CBRN cases-- whichis chemical, biological, radiological, and nuclear.And in those cases you have to wear specific suits thatmake sure that you are safe from any contaminants in the room.

    • 09:04

      CARLA VALENTINE [continued]: It's incredibly important to make surethat the PM is a hygienic and clean environmentbecause there are different infections thatcan exist within the deceased that we may not be aware of.So, for example, tuberculosis, hepatitis.These things can be be reactivated with the waterspray from the cleaning down.

    • 09:26

      CARLA VALENTINE [continued]: So, this is another reason that APTshave to get a lot of vaccinations as well.But you certainly don't tempt fateby keeping a dirty mortuary, and, for the same reason,we're very, very careful when we handle blades.When you carry out a postmortem, youget an array of PPE-- which is personal protective equipment--and you'll tend to tailor that to the situation.Most APTs don't wear a mask for every single postmortem.

    • 09:50

      CARLA VALENTINE [continued]: But you would do if you were doing a tuberculosiscase, for example, in a high riskroom, because that's classed as a high risk infection.Often, APTs will wear hair nets, surgical gownsas well, sometimes two pairs of gloves--because you're less likely to cut yourselfwith two pairs of gloves.And also goggles if you feel like you want to.

    • 10:14

      CARLA VALENTINE [continued]: You can actually wear glasses-- sayif you do wear glasses-- so you can wear one or the other.[Life as an Anatomical Pathology Technician]Life as an APT is always very exciting and very unique.Like, no two days are the same, and Ithink that's probably one of the main draws of the job.You could wake up one day and have a murder case,or you could have a mass fatality,

    • 10:35

      CARLA VALENTINE [continued]: or you could just simply have an old man who died in his sleep--and you just don't know.So I think the fact that there's no monotonyis really wonderful.And then, of course, if you're into forensics.If you're into any kind of science-- biology,biochemistry-- all of that is encompassedin pathology and postmortems.And it really just is a fascinating career.

    • 10:56

      CARLA VALENTINE [continued]: You learn a lot on the job-- but youdo have to learn on the job.[Becoming an Anatomical Pathology Technician]There's no amount of studying that can really prepare youfor being an APT.You can't actually become an APT by just doing a course either.You have to be employed as a trainee,and then you do the course and learn to dissect and eviscerateat the same time.And really it's because we all see the deceased on TV.

    • 11:18

      CARLA VALENTINE [continued]: We may see a deceased relative at a funeral,but we don't see the kind of thingsthat we see in a postmortem room.So, you really can't be prepared for it until you're actuallyinvolved in it.My advice to any students interestedin this career is to really look into it,see if you can visit a mortuary and seea postmortem-- for example-- and attend some pathology museums,

    • 11:40

      CARLA VALENTINE [continued]: and really just get started quite quickly,because it is a very popular career.The skills required are patience, quite good upper bodystrength.I think people don't realize quitehow heavy it can be to carry bowls of organsaround and move cadavers.Have to be very analytical, and you justhave to have a real interest and passion for pathology.

    • 12:01

      CARLA VALENTINE [continued]: If you're not interested, then youwill find some aspects of it quite revolting.So a strong stomach is another thing thatwould be good to have as well.

Forensic Science: The Role of an Anatomical Pathology Technician

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Abstract

Carla Valentine discusses the role and career pathway of an anatomical pathology technician. An anatomical pathology technician assists the pathologist at autopsies by doing the dissection and evisceration, and by taking the specimens. An anatomical pathology technician must have patience, upper body strength, and a strong stomach.

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Forensic Science: The Role of an Anatomical Pathology Technician

Carla Valentine discusses the role and career pathway of an anatomical pathology technician. An anatomical pathology technician assists the pathologist at autopsies by doing the dissection and evisceration, and by taking the specimens. An anatomical pathology technician must have patience, upper body strength, and a strong stomach.

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