Entering Postmortem and Antemortem Records

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Entering Postmortem and Antemortem Records

• Dental Training Module III

Richard M. Scanlon, D.M.D.

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A special thanks to Linda Himmelberger for her
skills in editing the modules and for reviewing
the content for clarity in the presentation of
this topic.
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Introduction
This training module will deal with the creation
of a WinID3 database and the entry of antemortem
and postmortem non-graphic data into WinID3.
These procedures are essential since consistency
and accuracy are paramount when compiling the
database for use in the comparison process. The
data entered during an actual disaster will be
entered and checked by no less than two members
so to be absolutely certain accurate data is
utilized during the comparison. Remember Jim
McGivneys axiom, JIJO (Junk In, Junk Out)
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Required Skill
Entry of antemortem and postmortem dental records
into WinID3 is considered a required dental team
member skill. All members of the dental team
must be able to accomplish this task, since it is
essential for operation of WinID3. Other skills
within WinID3 and Dexis are optional skills that
can be delegated to specific team members
however the entry of the antemortem and
postmortem dental records remains an essential
requirement for all dental team members.
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Participation Training
When viewing this slide presentation, from time
to time you will see a small WinID3 Icon with a
Stop Sign. This icon represents a reminder that
while reviewing this presentation you should stop
and open WinID3 to the viewing screen and attempt
the procedure or action that is being explained
in the PowerPoint module at that time. This will
make the training much more beneficial than
reading the slides alone. Remember, when you see
this icon, stop and open WinID3.
You should also print the slides for reference,
by right clicking on the screen in PowerPoint
viewer and selecting Print.
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First Creation of A New Database
The creation of a new database is required when
beginning a disaster operation. Each disaster
should have one and only one database. To create
a new database, first access WinID3. To access
the program you go to the START button on the
lower left of your computer screen, and click it.
Immediately above the START button is another
button called ALL PROGRAMS. Click this and
look for the WinID3 icon click on it and the
WinID3 Database selection screen will open.
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Second Select a Database to Open WinID3
Before a new WinID3 database can be created, you
must open any WinID3 database. To open WinID3 a
database it must be selected and opened. Click
on Sample to open WinID3.
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Third New Database
After selection of a database, the main screen of
WinID3 will open. To create a new database,
click the button
File on the upper right bar. A drop down
window will open. Now click New Database.
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New Database
When the Create New Database command is selected
the window below opens. A blinking cursor is
present in the File Name Box
Type the name of your new database and when
complete, click on Open. This will create a
database with the name you have chosen.
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Adding Records to a Database
Each time a new database is created, a postmortem
and antemortem dummy record is created. Do not
delete these records until
you have entered at least one antemortem and
postmortem record. Now lets review what data
must be entered for either a postmortem or
antemortem record.
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Data Entry

• Initial Identification
• Data

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Antemortem and Postmortem Record Differences
The data entry fields for Postmortem and
Antemortem records differ in some areas. In the
lower right corner of a slide you will see
designation AM, PM or AM PM. This will
assist you in determining how to complete an
Antemortem or Postmortem record. If you see an
AM, this field is only in an antemortem record,
PM for only postmortem records, and AM PM, when
the field is the same in both antemortem and
postmortem records.
AM PM
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Entry Differences for Antemortem Records
There are some differences in the entry of data
for antemortem dental records during the initial
entry of data. As with postmortem data,
antemortem data has a unique identifier that must
be entered when first adding a new record. This
identifier can be the last name and first and
middle name initials or the first 12 letters of
the last name. For continuity or security, a
number with the prefix A starting at 001 may be
used in place of the name. This is option will
be determined by the specifics of the incident.
Examples Scanlon, RM or A018
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New Record Command
To add a new record to an existing database, or
to begin adding records to a new database, you
click on the Add New Button. A drop down menu
will appear, click on either postmortem or
antemortem depending on which record you wish to
enter.
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Entering the ID Number
The first information entered into either a
postmortem or antemortem record is the ID . For
disasters, follow the prescribed format for
numbering , here we will enter all postmortem
numbers with a P prefix, with the first number
starting with 001. Therefore, our first entry is
P001.
Each successive record will be increased by one
so the second record will be P002. This number
is a tracking number and not a coroner or body
bag number. Enter your name as the person
entering the record. Click OK to finish.
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Entering Data
After clicking Ok the following screen will
appear. The ID entered will appear in the first
entry box on this screen.
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NCIC
The NCIC will not be utilized in a disaster
deployment unless the coroner or ME requests NCIC
entry of unknowns. It pertains to the use of the
NCIC 2000 database for missing or unidentified
persons.
AM PM
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Entering Data Originating
Now that we have entered the unique ID (P001),
we need to consider entering further postmortem
data. The next areas to consider are
Originating Agency and Originating agency .
Both are normally left blank, unless working
with an agency in conjunction with a medical
examiner or coroner such as the FBI, and they
have a unique tracking number.
AM PM
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Entry of Name for Antemortem Records
After the unique identifier, enter the Last Name,
First Name and MI. 25 spaces are available for
the First and Last name. Date of birth, if known
may be entered.
AM Only
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MedExam/Coroner
The next postmortem entries that may be entered
are the MedExam/Cor block and MedExam/Cor
block. These are self-explanatory. The county
or state identifier with the jurisdiction should
be entered in this block i.e. Somerset
County. In the MedExam/Cor block enter the
coroner or medical examiner number in this area.
This will help cross reference the data for the
coroner or medical examiner i.e.. A-04-2347
PM Only
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Date Body Found Estimated Age
The Date Body Found is self-explanatory. The
date must be in the format 2/3/2004. The
estimated age entry is optional based on the
condition of the remains, and may be entered
later, if the medical autopsy has not been
completed prior to the dental postmortem
examination. For EstAge a range of ages is
used.
PM Only
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Body Parts Not Recovered
To enter body parts not recovered, click on the
small triangle at the end of the entry box. Then
click on the part not recovered. If multiple
parts are not recovered, hold down the Ctrl Key
and click the parts not recovered in the list on
the right. When finished press the Tab Key.
This data entry may not be utilized in incidents
with fragmented remains.
PM Only
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Antemortem Records DateLastContact
The next entry is for Date Last Contact. As part
of our Region III protocol, we will enter the
date of the last radiographs or, if no
radiographs are available, then date of last
treatment. This entry will be apparent when
conducting comparisons, and will be discussed
later.
AM Only
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Disposition Entry
Disposition is the next AM and PM entry. As with
the Postmortem entry, this denotes the status of
the identification as it relates to the current
disaster. Either Active or Identified will
be used.
AM PM
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Disposition - Identified
If Identified is selected, a secondary data
entry box opens to permit the linking of this
identity to a specific postmortem record. To
complete the link click on the appropriate
Postmortem record number. This designation does
not remove the records from the either AM or PM
database, allowing them to still be available for
subsequent comparisons. It will show both the AM
and PM records as identified when using the
Status Button.
PM AM
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Post Mortem Condition
The Post Mortem Condition data box is used to
describe the condition of the remains at the
dental postmortem examination. After clicking on
the data entry box, you can either enter you own
description or you can by click on one of the
descriptions on the list.
PM Only
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Linked Graphic
The Linked Graphic and Add Graphic Button will be
explained in a later module dealing with the
linking of digital graphics to a specific dental
record.
PM AM
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Type of Case
The Type of Case data entry box when selected,
will display a list of various manner of death
descriptors. One of the descriptors on the list
may be chosen by clicking on it, or you may type
in your own descriptor. Only 15 spaces are
available for an optional entry.
PM AM
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Data Entry

• Physical Identifiers

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Physical Identifiers
Once data entry is complete for the Name Data on
a specific entry, the next area that will be
displayed (after pressing the Tab Key in the
final field of the Name screen) is the
Identifiers screen. This screen can also be
accessed at anytime by clicking the Identifiers
tab at the top of either the AM or PM record
This screen permits physical identifiers to be
entered for both antemortem and postmortem
records. These identifiers may not be apparent
for many dental postmortem examinations and entry
of this data may be deferred to the pathologist
or anthropologist during their previous or
subsequent examinations.
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Physical Identifiers
The Identifiers screen is identical for both
antemortem and postmortem entry. Each field has
a drop down list accessed by clicking on the
small black triangle at the far right of each
entry box. When clicked, the box opens and gives
the options available for that particular field.
Height and Weight are entered as a range of
values in postmortem entries
PM AM
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User Designated Fields
User designated fields will not be used for most
WinID3 data entry. They are user determined
optional data fields.
PM AM
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Data Entry
Dental Descriptors
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Data Entry Dental
This next area of data entry is the most critical
for the WinID3 operator. The data entered into
this area is what the WinID3 algorithms use to
sort and prioritize the antemortem or postmortem
records. While a mistake or misinterpretation of
the dental charting is not fatal, it does lower
the possibility that a particular antemortem or
postmortem record will be placed high on the list
of Best Matches. Therefore, it is important to
be careful when entering the dental data. It
will be Region III protocol to have this
accomplished by two members, who will cross check
and verify each entry.
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WinID3 Dental Descriptors
Before proceeding, it is important that you are
familiar with the WinID3 descriptors and how they
are used to chart dental restorations and
conditions. Please use this opportunity to study
the attached chart with the WinID3 descriptors
before continuing. It is advisable to have the
chart available at your computer when completing
the next section. After this module, we will be
sending a list of dental restorations and
conditions for you to chart with WinID3 and then
a series of dental exams in order to practice
data entry before going to the next module.
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Accessing the Dental Screen
The Dental Screen is accessed by clicking on the
Dental tab at the top of either the Antemortem
or Postmortem Record.
PM AM
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WinID3 Descriptors
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Standard Comments for WinID3

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Dental Chart Entry
The Dental Chart Entry is identical in both the
antemortem and postmortem records. It contains a
written chart and an odontogram for
visualization of the dental antemortem record or
postmortem examination
PM AM
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Dental Data Entry
The entry screen also has a rapid entry area for
individuals with dentures, all missing teeth or
all virgin teeth. If your record has these
specific conditions you may use these shortcuts
to save time and ensure an accurate entry
PM AM
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Dental Data Entry
To begin the entry of dental data, click on the
small box with the number 1 at the top left of
the screen. It represent tooth number 1 or the
maxillary right third molar. Always start with
tooth number 1, even if not present. Unless
you have used the shortcuts to pre-enter all the
maxillary conditions.
If editing an existing record, just click on the
tooth or teeth to be edited.
PM AM
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Dental Data Entry
When you click on the box 1, an Enter Dental box
opens and displays the dental entry screen. A
small rectangle on the left side of the Enter
Dental box is highlighted. In the center is a
series of boxes with letters that represents
dental conditions and
tooth surfaces. To enter data, click on the
appropriate lettered box or type the entry in the
highlighted rectangle.
PM AM
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Dental Data Entry
To aid the entry of data, a list of Primary and
Secondary codes is displayed on the right of the
Enter Dental screen. The primary and secondary
codes shown are the only codes that will be
accepted by WinID3.
To enter an MOD amalgam on tooth 3, you may
either type in MODS or click on the M , O, D,
square and then type an S.
PM AM
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Dental Data Entry
Notice the format is SMOD in the entry box.
Confirm that this is the correct designator, and
if you need to enter further descriptors click
Next Tooth. If you are only editing one tooth
or are finished entry, click OK. To cancel,
click cancel.
If you click Next Tooth, you will see a new
screen to enter data for the next tooth in
numerical sequence.
PM AM
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Dental Data Entry
When you click OK at the end of the entry of
data, the original screen appears. Note the
SMOD is now in the correct format MOD S and
the odontogram is appropriately filled out and
labeled with an S for amalgam.
Now click on any other tooth number and enter a
sequence of restorations or conditions to
practice.
PM AM
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Data Entry

• Comments

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Data Entry Comments
WinID3 standard codes as you can see do not cover
all possible treatment options that may be
present in a dental examination or translation
of a dental chart. To accommodate the other
category of treatment and pathology options, one
has the ability to enter a Comment for each
individual tooth. Comments are to be used
sparingly. Standard comments are available
however, any type of comment can be entered.
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Data Entry - Comments
To enter a comment for a particular tooth, enter
an A for Annote. After entering an A
descriptor, click on the Next box. With the A
entered , a message will come up asking if you
wish to enter a Standard Code. Click Yes if
you wish to
enter a code.
PM AM
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Data Entry Comments
This is the Standard Comments Screen that appears
when you click YES. Enter a single or multiple
comment by clicking on the box to the right of
the comment. Only standard comments should be
entered, unless approval for non-standard
comments has been granted by either the AM or PM
Section Leader. To enter date of x-rays click
the box and enter a date.
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Data Entry Comments
When you click Ok at the bottom of the Standard
Code Box it will automatically enter the tooth
number and code in Comment Section. The comment
section can be viewed by clicking on the Comments
Tab.
PM AM
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Data Entry Module Review

• Now lets review the areas that we have covered
  in this module. Along with this review, members
  should practice the translation of common dental
  charting into WinID3 descriptors and practice
  entering those newly charted descriptors into
  WinID3. Only with actual practice will members
  become proficient.
• Team exercises will be also sent to aid in
  practicing WinID3 Dental Data Entry.

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Data Entry Module Review
The following are WinID3 skills that you should
be able to accomplish after completing this
module.

• Creation of a new Database
• Adding a New AM or PM record.
• Entry of Identifier Data for a new record.
• Body Parts Not Recovered Entry
• Disposition of a Record Identified

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Data Entry Module Review Continued

• WinID3 Entry Descriptors
• Physical Identifiers Entry
• Entry of Dental Data
• Entry of Standard Dental Comments

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Data Entry Conclusions
This concludes the data entry module for WinID3.
This is an important module and should be
reviewed regularly to maintain your proficiency.
This one section outlines the single most
important aspect of dental data entry at a
disaster. All dental team members must be
proficient in the entry of antemortem and
postmortem data before deployment to a disaster
area. This is a mission critical skill and will
be used as a basis for determining the deployment
of dental team members when Region III is
alerted.
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Home Study
Now that you have completed this module, further
study to be come accomplished in this important
task is necessary. A list of dental restorations
and conditions will be sent to allow you to hone
you translation skills. You should also
prepare by entering into the WinID3 Sample
database 10-20 dental patient records from your
office. This will give you experience in data
entry and WinID3 translation. As always, if you
have any questions concerning WinId3 please let
me know. Rich Scanlon
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The End Module III-Entering AM and PMDental
Records