AAPT Conference 2007

Available lecture abstracts

The Role of the Autopsy in the Investigation of fatal Aircraft Accidents

Wing Commander Graeme Maidment
Department of Aviation Pathology, RAF Centre of Aviation Medicine, Henlow

In addition to assisting the Coroner or procurator Fiscal in fulfilling their duties to identify the deceased and arrive at a verdict as to how they have died, the pathological findings from the autopsy of the victims of a fatal aircraft accident provide an essential component of the overall investigation of the accident. The findings may assist in determining the cause of the accident, or may provide information on the survivability issues which may promote flight safety. The demonstration of natural disease, patterns of injury, toxicological findings and assessments of interaction with flying clothing, the aircraft controls or the flight environment may all contribute to the understanding of the accident and the prevention of similar deaths in the future. Close cooperation between the pathologist, the legal authorities and the air accident investigators is essential. Ideally, the autopsies should be performed or the findings reviewed by a pathologist with experience of aviation pathology.

Tissue donation after death – 'Saving Lives. Changing Lives'

Amanda Ranson BSc (Hons)
Tissue Bank Manager

Tissue transplantation offers huge benefits to many people, relieving pain, helping them to see, or walk again, or return to work. A tissue transplant can even save lives. Donation of tissues, especially in cases when organ donation is not possible, can offer the opportunity for families to fulfil their loved one’s wishes. Many bereaved families take comfort in the knowledge that their loved one has helped in this way.

NHSBT Tissue Services supports tissue donation after death throughout England and Wales from 2 centres (London and Liverpool).

Any newly deceased can be considered for tissue donation, but through rigorous medical and behavioural/lifestyle screening, the potential donor pool reduces significantly. The number of potential tissues that can be donated also vary dependent on the donor, these can include (but are not limited to) donor age, sex, medical/behavioural lifestyle contraindications. The consent and medical history are all undertaken by our highly trained Nurse Practitioners and are performed and documented in accordance with the Human Tissue Act 2004 and the Human Tissue Authority (HTA) Codes of Practice 2006.

Tissues that are currently donated within NHSBT include musculoskeletal tissue, skin, cardiovascular tissue and eyes (for corneal transplantation). All are donated within 48 hours of death, a blood sample must be obtained within 24 hours of death. The tissues donated by one donor may enable up to 40 people to benefit from tissue transplant surgery.

The donation process is undertaken by our highly skilled scientific donation teams that are trained in accordance with GMP/aseptic techniques, the Human Tissue Act 2004, HTA Codes of Practice 2006 and EU Directive for Cells and Tissues. Post donation the tissue is quarantined until the donor has been reviewed and authorised for its final fate by one of our Medical Officers. Tissue that has been approved for transplantation is processed within our GMP processing facilities through rigorous validated processes and undergoes an independent quality review to provide clinical grafts that can be used at Hospitals for transplantation.

Training and Education for APTs

Terry Johnson
Mortuary Manager, Hull & East Riding Public Mortuary, Hull Royal Infirmary

Training and education for APTs must be identified as an area of significant weakness. For many years both mortuaries and those that work in them have endured a significant lack of investment and as a result the training and development of APTs has suffered.

In recent times AAPT has managed to convince organisations such as the Royal College of Pathologists that APTs have been overlooked for far too long. This resulted in the formation of the “Workforce Review Group” and it is this body that identified the principle drivers for change that include:

• The need to develop additional, extended and advanced roles for APTs
• The implementation of the Knowledge and Skills framework
• The need for statutory regulation
• The licensing of mortuaries via the HTA

The list could in fact go on to include things such as public expectation of the standard and level of services, the need to develop adequate bereavement services, etc

AAPT is working with “Skills for Health” to develop training, education and qualification for APTs. This is complex and detailed work and is very much based on what is practical and reasonable rather than a “wish list”. This is important because ultimately DOH will need to sanction the work that has been undertaken. It is likely that as a result of this work APTs will have a new qualification that is fit for purpose in terms of ensuring that those that qualify are competent practitioners. At the moment no-one can predict exactly what the qualification will be or what form it will take. A learning Pack has been developed for submission to external education providers for evaluation and accreditation

The Role of the Consular Officer (When Britons die overseas)

Jon O’Shaughnessy
Desk Officer for the Middle East in Consular Directorate of the Foreign and Commonwealth Office

I hope to explain how the Foreign and Commonwealth Office organises its consular network through its Embassies, High Commissions and Consulates around the globe. Why we feel the need to have a consular presence overseas and then go on to explain what the role of our officers is when British nationals die abroad. When somebody dies far from home there are often several obstacles that are faced by our officers as we try to help the families back in the UK. I hope to give you a small taste of some of these issues with examples that colleagues from around the world have sent me.

Some of these are desperately sad whilst others have more than a hint of humour. It is very rare for anyone from my line of work to speak to a group of people that understand the need to handle these issues carefully but always with humour as a pressure valve.

From ICTY to AAPT – a Bosnian’s progress between the titles

Muhidin Tabakovic
Trainee Mortuary Technician (APT)

From being a young Bosnian in the 1990s and living through a country at war, from becoming involved in the gathering of pathology evidence from that conflict, and from moving on to assist in the identification of those killed and the successful return of their bodies to families, I am now, 12 years on, learning new skills in a new country, and discovering how it is to be an APT in the UK.

This presentation will be my own account and observations of working alongside international APTs in Bosnia in the late 1990s and early 2000s, and my later role in the identification and repatriation process. I will compare these responsibilities with those I am now learning about as a trainee in the UK, working in a busy forensic mortuary and dealing with the newly dead, as opposed to those who have been dead for many years.

The AAPT would like to thank the following (in alphabetical order) for their generous support of this event:

Chemsol Limited
HCL Eurosite Medical
Morquip Limited
Steel Line Limited