Embalming - Chapter 2 Questions

Four types of embalming treatment classifications:

1. Vascular 2. Cavity 3. Hypodermic 4. Surface

Define embalming

Embalming is the chemical treatment of the dead human body to reduce the presence and growth of microorganisms, to temporarily inhibit organic decomposition, and to restore the dead human body to an acceptable physical appearance

Explain how you may need to use all the methods of embalming for the preparation of a right arm, which is swollen and black due to a condition of gangrene resulting from diabetes

Raise axillary, a high index waterless injection. Do a cavity pack on top of arm with gangrene. If you cannot get it done arterial then hypodermic injection and surface preservation techniques at this stage.

Define preservation

The science of treating the dead human body chemically so as to temporarily inhibit decomposition

Define arterial embalming

Vascular (arterial) embalming is the use of the blood vascular system of the body to accomplish temporary preservation, sanitation, and restoration of the dead human body; this is accomplished through injection of an embalming chemical solution into the arteries and drainage of blood from the veins. This method of embalming can be used to preserve the entire body, large body sections, or localized body areas

The pathology department at your local hospital requests to meet with your embalming staff: what suggestions might your staff make to the pathology department with respect to procedures that may be done to assist with the embalming of the autopsied body

make sure they leave good arteries and make a good cranial incision that can be hidden.

Outline a basic sequence of steps for embalming an unautopsied body

1.) Remove all clothing from the body. Clothing should be sanitized by application of disinfectant spray prior to removal. The mouth can be covered with a mask or cotton placed in oral cavity, so purge will not escape. 2.) Examine and document any valuables such as watches, rings, rosary beads, etc. Valuables should be removed and documented, and stored in secure place. 3.) Disinfect the body using a droplet spray or a disinfectant solution that is sponged onto the body. Allow time for disinfectant to work. Disinfect, clean and pack all body orifices. A nasal tube aspirator may assist with cleansing of the mouth, throat and nasal passages. 4.) Position the body. Limbs, hands, and facial tissues can be massaged, flexed, bent, rotated, and exercised to relieve the rigor mortis. Elevate head above the chest and elevate the chest above abdomen. Slightly tilt the head to the right. Leave hands down over the table so that gravitation of blood into the hands, which helps to expand vessels. Once hands get fluid, position in correct position, head block or towels. Attempt to straighten arthritic limbs by wrapping them with cloth strips. 5.) Wash body surface using a germicidal warm-water soapy solution, giving particular attention to face and hands. Shampoo the hair and clean and trim fingernails. 6.) Shave facial hair. If there is a mustache, goatee, or beard on the deceased, check to see it is to be groomed or removed. If any doubt, don't touch it, it can be done later once the family has been consulted. 7.) Close the mouth, using an appropriate method such as a needle injector or sutures. If the decedents dentures are to be used they should be cleaned and disinfected. If dentures or teeth are absent, a mouth former, cotton, or mastic compound can be used as filler. 8.) Clean and close the eyes using cotton or an "eye cap" 9.) Select and expose the artery to be used for injection and the vein to be used for drainage. 10.) Select the arterial fluids and prepare the embalming solution. 11.) Inject the embalming solution-->Which body areas are getting or not getting fluid-->Should the strength of the solution be increased?-->Has the body area received sufficient arterial solution? 12.) When arterial solution is completed, make a visual and palpable (by touch) analysis of the body to determine whether all areas have received sufficient arterial solution.-->Hypodermic injection may be necessary for any out of reach areas. 13.) Remove arterial tubes and drainage instruments. Dry and tightly suture incisions. 14.) Using a trocar, aspirate the body cavities. Some embalmers prefer to delay aspiration for several hours. 15.) Following aspiration, inject an undiluted cavity fluid into the cavities using the trocar. Size and condition of the body determine the amount of fluid to inject. For an average body, 32 to 48 oz of cavity fluid is satisfactory. 16.) Remove all surgical drains, if present and close the openings by suture or trocar button. Remove all intravenous lines. If cremation is going to take place remove pacemaker if necessary. 17.) Again Shampoo the hair and wash the body. Dry body thoroughly, being certain to roll the body side to side. 18.) Dress the body in plastic garments, pants, capri pants, coveralls, stockings, unionalls). Place emblaming powder inside. 19.) Should respiration of the cavities be necessary, it is usually performed several hours after completion of the embalming. 20.) Flush and clean the emblaming machine with clean water. Clean and disinfect instruments. Dispose of all waste in appropriate covered containers. 21.) Cosmetic treatment can follow.

Historically, when was arterial embalming first employed - with evisceration - for preservation of the dead human body? When was arterial embalming - without evisceration - first used for preservation of the dead human body?

1.) Hunter Brothers France 650-1830 CE 2.)Gabriel Clauderus 1695

Outline a basic sequence of steps for embalming an autopsied body

1.) Place the autopsied body on the center of the preparation table. Spray the remains with a concentrated droplet surface disinfectant. Wash the body with an antiseptic, liquid soap using warm water. Remove any blood on the skin surface. Carefully clean the hands and fingernails. The hair can be rinsed; however, because of the cranial autopsy, the hair will need rewashing after embalming. 2.) Open the autopsy temporary sutures and aspirate any liquids that have accumulated within the cavities. Spray the inside walls of cavities with a droplet disinfectant spray. 3.) Examine the extent of the autopsy. Should be evaluated for partial autopsy. Rigor mortis can be relieved by flexing, bending, and massaging the limbs. Position the body. 4.) Shave facial hair 5.) Clean the oral cavity and replace dentures or, if they are not available, replace missing teeth or dentures with cotton or a "mouth former." The mouth can be held by a needle injector wires and sutures. 6.) Clean the areas of the eyes. The eyes can be close using cotton or an "eyecap."(If the corneas have been removed, the orbits should be cleaned and a preservative gel or liquid preservative on cotton can be placed into the orbits and the eyelids closed. 7.) Prepare the arterial solution. Strength and quantity depend on the condition of the body. 8.) During arterial injection, fluids that accumulate in the cavities should be aspirated. This will help to protect the embalmer from formaldehyde fumes. 9.) Expose the arteries that will be used to inject the legs and their respective veins. Place the arterial tubes into arteries. Drainage will be done by letting the drainage collect in the body cavities. 10.) Inject the legs. Give attention to distribution of the fluid. Increase pressure or rate of flow to establish a uniform distribution. A hemostat can be used to clamp an accompanying vein to control drainage in the hand and help retain the arterial fluid. 11.) Expose the arteries that will be used to inject the arms and if possible their accompanying veins--the subclavian arteries or the right and left axillary arteries. 12.) Inject the arms. If distribution is not complete, the radial or ulnar arteries can be raised and injected at this time. 13.) Expose and place arterial fluid tubes in the right and left common carotid arteries. Inject the left side of the head FIRST and then inject the right side. 14.) Prepare a strong preservative solution in the embalming machine. Using a small parietal, infant, or hypo-valve trocar, inject the buttocks, trunk walls, shoulders, and back of the neck. 15.) Aspirate any accumulated fluids and dry the cranial, abdominal, thoracic, and pelvic cavities. 16.) Fill the cavities with an absorbent sheeting. A concentrated preservative such as cavity fluid can be applied to the surface of the filler.-->When viscera are returned to the thoracic and abdominal cavities, they may be placed in a plastic biohazard bag. The viscera need to be preserved by pouring a concentrated preservative over the organs. 17.) Suture the abdominal and thoracic cavities closed. The baseball suture provides an airtight suture. 18.) Fill the cranial cavity with an absorbent material. Anchor the calvarium into position. Suture scalp closed beginning on the right side of the head and ending on the left. 19.) Bathe the body and shampoo the hair. 20.) Apply a surface sealer to the autopsy sutures of the thorax and the abdomen. 21.) Glue the mouth and the eyes 22.) Dress the body in plastic garments. Place some embalming powder into the garments. 23.) The body is now ready for cosmetic application and dressing.

Why is cavity embalming necessary when embalming an unautopsied body? What are the purposes of cavity embalming? Why is re-aspiration of the body often recommended?

Cavity embalming is the direct treatment of the the contents of the bodies cavities (abdominal, pelvic and thoracic cavities). It is a very concentrated preservative.-Purpose - To supplement vascular embalming, by direct treatment of the contents of the hollow viscera and area between the organs - to reduce putrefactive changes caused by areas not receiving arterial fluid - Re-aspirating is important to insure against any purge of gas or liquid from the nose or the mouth

Define cavity embalming

Cavity embalming is the direct treatment, other than vascular injection, of the contents of the body cavities (thoracic, abdominal, and pelvic) and the lumina of the hollow viscera; it is usually accomplished in two phases (aspiration and injection) using a long, hollow instrument called a "trocar" It is performed after arterial embalming. This is carried out by first aspirating the cavities followed by injecting concentrated chemicals into the cavities. Both use a trocar It uses very concentrated preservatives; 32 to 48 oz of cavity fluid is used under most conditions

If a family requests viewing but not embalming, (1) what documents should be signed and (2) how would you prepare the deceased?

In the situation where a family requests a viewing but not an embalming, there is a document that needs to be signed by the family. This is called an Authorization to View a Non-Embalmed or Non-Restored Human Body. This document goes over in detail that the decedent will be sheltered in a climate controlled environment. The document states that it is not in the best interest of the family to view the deceased if they passed through means of suicide or any other traumatic event. The form also states that the family or people viewing the unembalmed body will not hold the funeral home responsible for emotional distress from the viewing. After matching the ID tag to the correct paperwork, I would disinfect and pack all orifices. Then remove all tubes, bandages along with any dressing. If permission was given, then the decedent will be shaved. After I have set the features, including closing the eyes and mouth, the decedent will be placed in a new gown with new sheets.

Define surface embalming

Is preservation of the body tissues by direct contact with embalming chemicals. Preservative gels or surface packs of absorbent materials saturated with preservative chemicals can be directly placed in contact with the body tissues. Surface embalming is considered a supplemental treatment to vascular injection and is used when vascular injection is unsuccessful or impossible The application of an embalming chemical directly to the surface of the tissues

Define hypodermic embalming

Is the injection of embalming chemicals directly into the tissues of the dead human body through the use of a syringe and needle (for small areas) or a trocar (for large body areas). This is generally a supplemental embalming procedure used when tissues in the adult body cannot be treated sufficiently by vascular injection

An individual in your town has willed his or her body to the nearest medical college for anatomical study. How do you proceed with such a request?

Seeing as the college will need to keep the remains of an individual for an extended period of time, the preservation as well as the sanitation of the tissues is priority. The embalming process you would need to proceed with, would depend on the medical school itself, as procedures vary. Normally, the body will need to be sanitized/disinfected and only one artery is used as an injection site for the preservative chemicals. The book states that those chemicals include a mixture, 4 to 9 gallons of, alcohol, formalin, wetting agent, phenol, and water. Cavity embalming is not done, as the college will re-embalm later. In order to expand the tissues, drainage is restricted, and additional chemicals will be added later.

The embalming process makes the following possible

Temporary preservation and sanitation of the deceased body Renders the body inoffensive by slowing postmortem changes Seeing the body allows the family and friends to accept the finality of death Allows time to organize ceremony and ritual with the body present Time for friends and relatives to gather for funeral ceremonies and if desired view the deceased remains Moving the deceased to a distant location for final disposition and if desired, viewing Restores a favorable body image by removing the adverse effects of disease, trauma, or postmortem changes Preservation for anatomical study and research by medical institutions A slow breakdown of the body over time; desiccation rather than putrefaction

Reverence for the dead

The basic ethical axion of the funeral service profession

List and define the three primary objectives accomplished by embalming

The three primary objectives of embalming are disinfection, preservation and restoration. 1. Disinfection is the sanitation of the deceased. Embalming allows for disinfection as the chemicals used in the embalming process make the tissues less likely to be broken down by bacteria and body enzymes are inactivated. 2. Preservation is when decay and decomposition are temporarily inhibited. This is important especially if the family wish to have an open casket or even a private viewing, as characteristics associated with decomposition, smell for example, can be contained. 3. Restoration is the attempt at recreating the deceased's natural, healthy appearance. Restoration of the deceased is an important part of embalming. The goal is not necessarily to make the deceased look life like, it is more to minimize any physical and observable damage to the body.