NOVEL, SAFE, INDIGENOUS COST-EFFECTIVE INFECTION CONTAINMENT CHAMBER FOR HIGH-RISK AUTOPSIES: THE NEED OF THE HOUR

Authors

  • Latif Rajesh Johnson Assistant Professor, Department of Forensic Medicine & Toxicology Christian Medical College Vellore, Tamil Nadu, Indi
  • Ranjit Immanuel James Assistant Professor, Department of Forensic Medicine & Toxicology Christian Medical College Vellore, Tamil Nadu, India
  • Rajapandian Technician, Department of Forensic Medicine & Toxicology Christian Medical College Vellore, Tamil Nadu, India
  • Prem Chander Engineer, Department of Refrigeration & Air Conditioning, Christian Medical College Vellore, Tamil Nadu, India
  • Hema Eunice Paul Department of Microbiology, Member, Hospital Infection Control Committee Christian Medical College Vellore, Tamil Nadu, India
  • Daniel Manoj Assistant Professor Department of Forensic Medicine & Toxicology, Christian Medical College Vellore, Tamil Nadu, India

Keywords:

coronavirus, protective equipment, Autopsies

Abstract

In view of the ongoing pandemic, healthcare workers are rightfully concerned about performing autopsies, due to the risk of infection. An autopsy surgeon and his/her team can inadvertently be exposed to infectious diseases. Use of appropriate personal protective equipment (PPE) and Autopsies are conducted to determine the cause of death either for medicolegal purposes or for medical diagnosis. Available information at a clinical autopsy could vary from very detailed history (including presumptive clinical diagnoses and investigation reports) to absolutely no information regarding the disease or clinical signs of the patient. Thus, during an autopsy, the autopsy surgeon should expect the unexpected. Often, due to the lack of adequate information at the time of autopsy, it is possible that the autopsy surgeon and the team involved in the autopsy are exposed to deadly infectious agents like Rabies, Ebola, Nipah Virus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV-2), etc.1-3 Therefore, it is preferable that the autopsy surgeon and team be protected from potential exposure to infected bodies, bodily fluids, tissues, contaminated objects, or other contaminated environmental surfaces.4 This would require use of appropriate personal protective equipment (PPE) and performing the autopsy in a autopsy chamber with negative pressure.

References

1. Kantor HS, Poblete R, Pusateri SL. Nosocomial transmission of tuberculosis from unsuspected disease. Am J Med. 1988;84(5):833–838.

2. Posthaus H, Bodmer T, Alves L, et al. Accidental infection of veterinary personnel with Mycobacterium tuberculosis at necropsy: a case study. Vet Microbiol. 2011;149(3–4):374–380.

3. Templeton GL, Illing LA, Young L, et al. The risk for transmission of Mycobacterium tuberculosis at the bedside and during autopsy. Ann Intern Med. 1995;122(12):922–925.

4. Finegan O, Fonseca S, Guyomarc’h P, Morcillo Mendez MD, Rodriguez Gonzalez J, Tidball-Binz M, et al. International Committee of the red Cross (ICRC): general guidance for the management of the dead related to COVID-19. Forensic Sci Int. 2020;2: 129–37.

5. College of American Pathologists, 2021. AMENDED COVID-19 AUTOPSY GUIDELINE STATEMENT FROM THE CAP AUTOPSY COMMITTEE. [online] https://www.cap.org/member-resources/councils committees/cancer-topic-center/autopsy-topic-center. Available at: https://documents.cap.org/documents/ COVID-Autopsy-Statement.pdf [Accessed 29 January 2022].

6. Zhang J, Zhang L, Yin Y, et al. Best practice for infection prevention in pediatric respiratory clinics during the COVID-19 epidemic. World J Pediatr 2020:1– 7.

7. Centers for Disease Control and Prevention. Interim infection prevention and control recommendations for healthcare personnel during the coronavirus disease 2019 (COVID-19) pandemic, 2019. Available: https:// www.cdc.gov/coronavirus/2019-ncov/hcp/infection control-recommendations.html [Accessed 24 Jan 2022].

8. Liu Y, Ning Z, Chen Y, et al. Aerodynamic analysis of

SARS-CoV-2 in two Wuhan hospitals. Nature 2020;582:557–60.

9. Jamieson DJ, Steinberg JP, Martinello RA, et al. Obstetricians on the coronavirus disease 2019 (COVID-19) front lines and the confusing world of personal protective equipment. Obstet Gynecol 2020;135:1257–63.

10. Evanoff BA, Strickland JR, Dale AM, et al. Work Related and personal factors associated with mental well-being during the COVID-19 response: survey of healthcare and other workers. J Med Internet Res 2020;22:e21366.

11. Jensen PA, Lambert LA, Iademarco MF, et al. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005. MMWR Recomm Rep. 2005;54(RR–17):1–141.

12. Newsom SW, Rowlands C, Matthews J, et al. Aerosols in the mortuary. J Clin Pathol. 1983;36(2):127–132.

Burton JL. Health and safety at necropsy. J Clin Pathol. 2003;56(4):254–260.

14. Green FH, Yoshida K. Characteristics of aerosols generated during autopsy procedures and their potential role as carriers of infectious agents. Appl Occup Environm Hyg. 1990;5(12):853–858.

15. Newsom SW, Rowlands C, Matthews J, et al. Aerosols in the mortuary. J Clin Pathol. 1983;36(2):127–132. 16. World Health Organization. Infection prevention and control during health care when COVID-19 is suspected: interim guidance, 2020. Available: https:// apps.who.int/ iris/bitstream/handle/10665/331495/ WHO-2019-nCoV-IPC-2020.3-eng.pdf [Accessed 24 Jan 2022].

17. Indian Council of Medical Research. Standard guidelines for Medico-legal autopsy in COVID-19 deaths in India. New Delhi; [Internet] 2020 [Accessed 24 Jan 2022] Available from: https://eaaf.org/wp c o n t e n t / u p l o a d s / c o v i d 1 9 - P D F s / I n d i a / COVID19_AUTOPSY_GUIDELINES_2020_10052020.pdf

18. James RI, Kumar M, Devnath GP, Johnson LR, Amarnath A, Manoj D. Death in the time of corona: Are we prepared?. Journal of South India Medicolegal Association. 2020;12(2):108-117.

Published

2021-07-30

How to Cite

NOVEL, SAFE, INDIGENOUS COST-EFFECTIVE INFECTION CONTAINMENT CHAMBER FOR HIGH-RISK AUTOPSIES: THE NEED OF THE HOUR . (2021). Journal of Forensic Medicine & Toxicology, 38(1), 102–106. Retrieved from https://acspublisher.com/journals/index.php/jfmt/article/view/17912