Postmortem Examination of Road Traffic Accident Victims

Pre-Autopsy Imaging and External Examination

The American College of Medical Genetics recommends performing postmortem computed tomography (PMCT) prior to conventional autopsy in all road traffic accident victims to precisely localize injuries, detect skeletal fractures and pneumothorax, and guide subsequent dissection technique 1
Photograph all external injuries, abrasions, contusions, and lacerations before any manipulation, and document clothing, personal effects, and position of body as received, as recommended by the Clinical Microbiology and Infection society 2, 3

Collect blood in EDTA tubes for DNA preservation at every autopsy before opening body cavities, as these samples are irreplaceable and may be needed for future genetic testing, according to the Genetics in Medicine society 4, 5, 1
Obtain peripheral blood from the subclavian vein for toxicology screening after disinfecting puncture sites with alcohol-based chlorhexidine or iodine solution, as recommended by the Clinical Microbiology and Infection society 2, 3
Perform comprehensive toxicology screening on blood and body fluids in all cases, as substance use frequently contributes to traffic accidents and may be legally relevant, according to the Clinical Microbiology and Infection society 3, 1

Perform standardized cardiac-specific examination even when traumatic injuries are obviously fatal, as underlying inherited cardiac disease may have made the victim more vulnerable to decompensation or may be legally relevant for family counseling, as recommended by the Praxis Medical Insights society 1
If victim is ≤40 years old, specifically evaluate for inherited cardiomyopathy, channelopathies, or structural cardiac abnormalities that may have contributed to the accident or rapid death after trauma, according to the Praxis Medical Insights society 1, 6

Preserve fresh frozen tissue from multiple organs for potential future genetic or metabolic testing, as formalin-fixed tissue has lower success rates for genetic analysis, as recommended by the Genetics in Medicine society 4, 5
Use N-95 respirators, gowns, aprons, and face shields during autopsy, and ensure adequate ventilation in autopsy room, as recommended by the Clinical Microbiology and Infection society 2, 3