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The Mortuary and Anatomic Pathology unit forms part of the Pathology Department. It is linked to the Mater Dei Hospital complex via an underground service corridor through which bodies will be transported in a more dignified manner. It is also situated in an isolated part of the Mater Dei complex in order to allow for a more dignified preparation of our dear departed in the quieter part of the Hospital.
The mortuary offers various other services which include:
Receiving bodies from the Hospital and other institutions and sources such as the community.
Preparing bodies for their funeral rites. In the mortuary, besides there being a room for preparation of bodies of people who believed in the Roman Catholic faith, there is also a room saved for preparation of bodies for people who believed in other religions and have different religious rites with regard to preparation of the dead
The mortuary offers an autopsy service for the various Hospitals that require a post mortem examination. The mortuary at Mater Dei is also equipped to cater for forensic post mortem studies.
In order to provide these services, the mortuary contains many facilities and machines. These facilities and machines include a cold storage, body fridges, a post mortem area and a laboratory, an embalming room and a body preparation room. Viewing rooms are also present to enable relatives and friends to pay their last respects to the departed in a more private atmosphere. There is also a Mortuary Chapel where relatives and friends can find time for moments of silence and reflection and participate in the final prayers recited just before the body is transferred to an awaiting hearse for its last voyage to the cemetery.
Duties of the Scientist at the Mortuary
The main duties of the scientist at the mortuary and anatomic pathology unit are the administration and management of assets and procedures available at the mortuary. These duties include:
Administration: This role incorporates the logistical and scientific aspects relevant to a modern Mortuary and Anatomic pathology unit. This role also includes rendering a service to clients so it is imperative that good customer service is offered. All release forms, death certificates, general morgue forms and client information has to be documented and filed properly by the administrative staff.
Post mortem examinations, which can be ordered either by the Consultant within the state Hospitals in what is known as a hospital post mortem or by the Magistrate on duty if the person died under suspicious circumstances. In this case a forensic post mortem is used. The autopsy is also essential in determining the cause of death of investigated individuals.
Histology. The samples obtained from the body during the autopsy must be subjected to histopathological investigation. The samples obtained from the body during the autopsy receive the same treatment as those obtained from a living patient in an operating theatre.
Other procedures such as Health and safety, procurement of specimens, chain of custody, documentation and many more procedures.
The Relevance of a Post Mortem Examination.
A post mortem examination is a careful examination of the departed individual. It can offer valuable clues as to how the person died as well as information regarding the illness and its effects on the body. It may also give a more precise indication with regard to how the individual died. Sometimes, even the best and most detailed post mortem examinations may not uncover the cause of death and may also leave certain questions unanswered. These investigations are usually carried out by a pathologist. A pathologist is a person who specialises in the laboratory study of disease and of diseased tissue. The pathologist is assisted by a scientist with specialist training in this particular field. Post mortems are carried out in special facilities located in the Hospital Mortuary.
Post mortem examinations are a benefit to the medical profession as they provide information regarding health and illness that would not be discovered anywhere else. These examinations paved the way for both anatomical discoveries and new information regarding illnesses. Post mortem examinations help identify the cause of death of an individual, confirm the nature of the illness and also the extent of the disease and are capable of identifying other undiagnosed conditions. Another use of post mortem examinations is to assess the effects of treatments and drugs and help identify complications or side effects. A post mortem is a valuable tool for loved ones as it helps them understand why the individual died. Families can occasionally ask questions that can only be answered by information acquired from a post mortem. Some of the information obtained from a post mortem examination can benefit future children in the family and patients who suffer from similar illnesses. (Post mortem examination ââ‚¬” information for relatives, 2007).
Steps Taken to Maintain Health and Safety Standards in the Mortuary
The Mortuary presents a number of health and safety risks for personnel. These risks include both health related, accidents due to working conditions and risks specific to working with human remains. These remains are a serious biohazard and are host to various pathogens and hazardous residues such as bacteria, infectious spores, infectious soft tissue and residues of military and industrial chemicals. These pathogens can be transmitted either by hand to mouth contact, contact with mucus membranes, or via the air in the autopsy room or body fluids such as blood. Additional risks to transmission of pathogens include the handling of heavy bodies and using unsanitary and unsafe equipment.
The Mortuary in the Mater Dei Hospital is split into two main areas, a clean area and a dirty area. These areas are separated by a transitional zone. The dirty areas include body stores at a temperature of 4Â°C. It has easy to clean, non-porous surfaces and a system of containment for any body fluids. On the other hand, the clean area consists of the viewing rooms, the chapel, offices and reception areas. It also has proper ambient climate controls to remove odours and vapours and is mainly where clean equipment is stored. Bodies, equipment and people working in these separate areas must never come into contact with one another whilst working. Also, a body should never go into the dry area before it has been properly cleaned and any soft tissue found is removed. Once the soft tissue is removed it is placed in a freezer. The rest of the human remains are then stored in a separate freezing area.
It is essential that all employees working at the Mater Dei Hospital mortuary wear personal protective equipment (PPE), which is designed to help protect the scientist from serious health and safety dangers. This equipment is found in the clean transitional area located in front of the autopsy room, to enable scientists to change into their safety equipment before entering. PPE worn by a scientist in the autopsy room of the mortuary include:
Overalls/scrubs (washable or disposable). It is imperative that this particular equipment be worn every day to protect the skin from any debris and body fluid which may cause infection.
Latex/nitrile gloves. Nitrile gloves are used by scientists who are allergic to latex and must be worn when handling bodies or body fluids. Double gloving is the procedure
Facemask. It is usually found as a visor. This is worn when cleaning bodies, clothing and artefacts and has to be regularly cleaned by the scientist using it. It prevents infection by protecting the face from splash back of body fluids.
Safety goggles/glasses. These are worn to prevent any debris from coming into contact with the eye, which could lead to a potentially serious injury and possibly infection.
Mortuary shoes/wellington boots. These are non-slip boots similar to those used in surgeries. They are waterproof and prevent entry of fluids.
All surgical equipment used must be sanitised and autoclaved properly after every use and has to be stored in a safe and secure cupboard when it is not being utilized. The most dangerous tool, the autopsy saw, can only be used by experienced personnel. Hands and exposed skin must be washed after the autopsy to remove any debris or body fluids of the dead individual as these may cause infections. It is also important not to touch bare skin while wearing gloves. The scientist working in the autopsy room must not touch his or her eyes, mouth or nose to prevent spread of any blood borne infections. Beyond the changing area there is also a shower which scientists can use after handling body samples. The autopsy and dissection tables are made up of stainless steel and are connected to a supply of low pressure water. This water is treated with chlorine to remove any infectious agents and is then discharged into the normal sewage system. A High Energy Particulate Air (HEPA) filter can also be found in the autopsy room to trap any viruses or airborne bacteria from exiting the facilities and circulating into the outside air. It is essential that outside clothing not be worn in the mortuary. Extra PPE should be worn in specific areas such as the biohazard room for extra protection and when samples are being taken for deoxyribonucleic acid (DNA) analysis. Finally, the mortuary is cleaned thoroughly and disinfected every night.
Working in the mortuary poses a serious health risk to scientists. Some of these potential risks include working in too hot or too cold conditions, bacterial related sickness, body fluid or tissue related sickness, lifting injuries and stress related sickness. That is why it is ensured that vaccinations for certain diseases such as tetanus, Hepatitis A and Hepatitis B ,Tuberculosis, Typhoid, Diphtheria and Rabies be accounted for in every scientist working in the autopsy room.
It is essential that every new employee undergoes a health and safety briefing and that risk assessments be carried out every time a new body arrives. The mortuary staff must be briefed on the new risks found. A first aid kit has to be present along with someone who knows how to give first aid. Anyone entering the mortuary has to follow general health and safety practices. Fragmentary bone may be sharp and bodies can be heavy, therefore the staff must undergo manual handling training.
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