In the sixth and final webinar, participants were introduced to the use of PMCT in the investigation of a variety of unnatural deaths not discussed in previous webinars. Topics included overdose deaths, select asphyxial mechanisms of death, and sharp force injury.
Common PMCT findings in overdose deaths include cerebral edema, pulmonary edema, and urinary bladder distension. Less commonly, pills or drug packets may be identified by PMCT. At the New Mexico OMI, PMCT in conjunction with a point-of-care urine drug screen (UDS) is used to determine which suspected overdose deaths require a full autopsy. Full autopsy examination may be deemed less necessary in cases with a positive UDS and PMCT negative for other causes of death, provided that other investigative criteria (e.g. scene findings, age, medical history) are satisfied.
The PMCT appearance of select asphyxial injuries, including choking, drowning, strangulation, and hanging, will be reviewed. Positive findings include foreign bodies in the airways in suspected choking cases, fluid collections in the lung fields or sinus cavities in cases of suspected drowning, or neck injuries such as a fractured hyoid or thyroid cartilage in cases of suspected strangulation. PMCT may also be used to rule out other pathologies or trauma in non-suspicious, suicidal hanging deaths.
Finally, participants were introduced to examples of the PMCT appearance of sharp force injuries, including soft tissue injury, underlying injuries to bone or cartilage, and in some cases, retained foreign bodies, such as knives or knife tips.
Detailed Learning Objectives:
1.) Participants will be familiar with common PMCT findings in overdose deaths.
2.) Participants will appreciate the limitations of PMCT evaluation of the airways in cases of suspected drowning and choking.
3.) Participants will have a basic understanding of how PMCT can be utilized to help evaluate sharp force injuries.
4.) Participants will be able to identify the benefits and limitations to the use of PMCT to identify potential injuries and focus autopsy examinations in unnatural deaths.
Presenter: Lauren Dvorscak, MD | Assistant Chief Medical Examiner, Assistant Professor of Pathology
Funding for this Forensic Technology Center of Excellence event has been provided by the National Institute of Justice.
Please contact us at ForensicCOE@rti.org for any questions.
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