Embalming Ch 24 Slides
Gas gangrene — The bacteria enter the blood just before death (the incubation period is_____).
1 to 5 days
Decomposition source
Bacterial breakdown of body tissues; autolytic breakdown of body tissues
Tissue gas — The gas spreads rather rapidly through the tissue, causing ____ to form on the surface.
Blebs
esophageal varices purge contents
Blood Arterial solution
Esophageal varies purge description
Bloody liquid
Brain purge contents
Brain tissue Blood Arterial solution
_____ is the most common of the Clostridium bacteria responsible for gas gangrene
C. perfringens
Tissue gas is caused primarily by
C. perfringens.
Cavity fluid purge contents
Cavity fluid
Embalming solution purge description
Color of arterial solution injected
Cavity fluid purge description
Color of cavity fluid Blood present is brown in color
Gas causes the tissue to crackle when touched — what is this called?
Crepitation
A more common complication associated with embalming today is due to ____. Improvements in medicine and long-term drug therapy have increased the life span of persons with terminal diseases.
kidney failure
A rib can be broken and the pleural sac or the lung itself torn if cardiopulmonary resuscitation (CPR) is not administered with care, permitting a...
large amount of air to escape into the tissues.
When purge occurs prior to or during arterial injection from the nose or the mouth, the surrounding tissues of the face should be protected by an application of
massage cream.
Gas gangrene — the danger involved, as an embalming complication, lies in the fact that if death occurs shortly after injury, the gas gangrene...
may not be visible
Subcutaneous emphysema is not caused by a...
microbe and does not continue to intensify after death.
Tightly packing with cotton or webbed cotton the throat, the nostrils, the ears, and the anus _____ embalming should greatly reduce the possibility of a purge during or after embalming.
prior to
When does purge occur?
prior to, during, and after embalming.
During and after embalming, if tissues fail to respond (by firming), the embalmer may suspect
renal failure
If skeletal edema is extensive and a large volume of strong arterial solution must be injected, ____injection is recommended.
restricted cervical
Why is renal failure associated with edema?
retention of sodium by the kidneys leads to increased retention of water
If embalming treatment is not sufficient to control the spread of the organisms or their by-products, the symptoms of gas gangrene may show up...
several hours after embalming.
Gas gangrene usually occurs after...
severe trauma, especially farm or automobile accidents and close-range shotgun discharges, where the wound may be contaminated with filth, manure, or surface soil.
Liver failure can also cause edema in the
skeletal tissues or the cavities (ascites, hydrothorax).
Tissue gas — As the condition progresses, the blebs grow and burst, releasing the gas and putrefactive fluids and causing
skin-slip.
Purge is generally described by its...
source—stomach, lung, brain, and anal
If arterial fluid is contained in the purge material, the dye from the fluid can...
stain the skin.
Tissue gas — Being lighter than the liquids it displaces; the gas rises to the highest receptive parts of the body. In addition, the gas is larger in volume than the liquid it displaces, and thus...
tears and distends the tissues.
After death, tissue gas may result from the contamination of tissues by...
the gas bacillus, which has translocated from the intestinal tract.
Purge
the postmortem evacuation of any substance from any external orifice of the body as a result of pressure.
Subcutaneous emphysema— The gas, however, moves from the dependent areas to the...
upper body areas such as the neck and the face.
Renal failure — Sallow color to the skin as a result of____ buildup.
urochrome
Gas gangrene —Because of the destructive action of the exotoxins and the enzymes produced, tissue involvement and spread are...
very rapid.
Conditions predisposing to tissue gas
•Recent abdominal surgery •Presence of gangrene at the time of death •Intestinal ulcerations or perforations •Contaminated skin wounds or punctures •Intestinal obstruction or hemorrhage •Unsatisfactory embalming •Contact with contaminated instruments
Conditions Causing ACE
•Rib fractures that puncture the pleura or a lung •Puncture wounds of the thorax •CPR compression causing a fractured rib or sternum to puncture a lung or pleura •Tracheotomy surgery
Anal purge contents
Fecal matter Blood Arterial solution
Alcoholism — ____ may be difficult to establish.
Firming
Air from embalming apparatus characteristics
First evidence in eyelids; no odors; no skin-slip; amount depends on injection time
Gas gangrene characteristics
Foul odor, infection
Brain purge orifice
Fracture in skull Nose Fractured ethmoid Fractured ear Temporal bone Surgical opening
Lung purge description
Frothy Blood remains red Little odor
____ in the abdominal cavity or in the hollow intestinal tract can create sufficient pressure on the stomach to force the contents of the stomach through the mouth or the nose.
Gas
subcutaneous emphysema treatment
Gas escape through incisions; establishment of good arterial preservation; channeling of tissues after arterial injection to release gases
_____ is a fatal disease caused by contamination of a wound infection by a toxin-producing, spore-forming, anaerobic bacterium
Gas gangrene
Gas gangrene treatment
Strong arterial solutions; local hypodermic injection of cavity chemical
The most frequently encountered gas condition
Subcutaneous emphysema
Scratch marks on the extremities indicates
Uremic pruritus — renal failure
True tissue gas characteristics
Very strong odor of decomposition; skin-slip; skin blebs; increase in intensity and amount of gas; possible transfer of spore-forming bacterium via cutting instruments to other bodies
Purge — Ascites and hydrothorax
When edema fills the thoracic or abdominal cavity prior to death, a great amount of pressure builds up and, on injection of arterial solution forces purge.
Brain purge description
White semisolid
Acidosis
excessive acidity of body fluids; associated with renal failure
Air is forced into the closed container that contains the embalming solution. The pressure from the air forces the fluid into the body. The problem is of most concern if the
face is being injected.
Tissue gas may begin prior to death as
gas gangrene.
Alcoholism — The primary goal is...
good preservation.
Stomach purge contains ___ and can desiccate and discolor the skin
hydrochloric acid
It has been estimated that ___ times more preservative chemical is needed to preserve tissues of bodies dead from the complications of renal failure
6
Air from embalming apparatus source
Air injected by embalming machine air pressure machines and hand pumps are in limited use today
True tissue gas source
Anaerobic bacteria (gas gangrene), C. perfringens
Gas gangrene source
Anaerobic bacteria, C. perfringens
Anal purge orifice
Anus
Decomposition treatment
Arterial injection of sufficient amount of the appropriate strong chemical; hypodermic and surface treatments; channeling to release gases
Embalming solution purge contents
Arterial solution
Gas causing purge can originate from...
Early decomposition or from partial digestion of foods or may be true tissue gas formed by Clostridium perfringens.
Renal failure is also associated with
Edema Anemia Gastrointestinal bleeding
When does embalming solution purge occur?
Embalming
The ____ are one of the first areas to distend, even if a very small amount of air is accidentally injected.
Eyelids
Air from embalming apparatus treatment
If distention is present, channeling after arterial injection to release gases
Alcoholism — Many of these bodies exhibit ____ as a result of liver failure.
Jaundice
Stomach purge description
Liquid/semisolid "Coffee grounds" appearance Foul odor Acids pH
Stomach purge orifice
Mouth & nose
Cavity fluid purge orifice
Mouth / nose Anal orifice
Embalming solution purge orifice
Mouth / nose Anus / ear
Esophageal varies purge orifice
Mouth& nose
Lung purge orifice
Mouth/nose
True tissue gas treatment
Special "tissue gas" arterial solutions; localized hypodermic injection of cavity fluid; channeling of tissues to release gases
Stomach purge contents
Stomach contents Blood Arterial solution
Does odor accompany subcutaneous emphysema?
No
Does skin slip or bless develop with subcutaneous emphysema?
No
Is the injection of air from the embalming machine a frequent problem today?
No
subcutaneous emphysema characteristics
No odor; no skin-slip; no blebs; gas can reach distal points, even toes; can create intense swelling; rises to highest body areas
Decomposition characteristics
Possible odor, skin slip in time, color changes, purging
When does cavity fluid purge occur?
Postembalming
When does anal purge occur?
Pre-embalming Embalming Postembalming
When does brain purge occur?
Pre-embalming Embalming Postembalming
When does esophageal varices purge occur?
Pre-embalming Embalming Postembalming
When does lung purge occur?
Pre-embalming Embalming Postembalming
When does stomach purge occur?
Pre-embalming Embalming Postembalming
subcutaneous emphysema source
Puncture of lung or pleural sac; seen after CPR; puncture wounds to thorax; rib fractures; tracheotomy
Lung purge contents
Respiratory tract liquids Residual air from lungs Blood
Anal purge description
Semisolid / liquid
In the male, the scrotum can distend to several times its normal size. It is best to remove the gas from the tissues when?
after the body is embalmed.
Most machines automatically shut off when the tank has been emptied. This condition is most likely to occur when an _____ is used for injection.
air pressure machine or hand pump
Subcutaneous emphysema is caused by
antemortem subcutaneous emphysema, brought about by a puncture or a tear in the pleural sac or the lung tissue.
Hepatic failure depletes the blood of...
clotting factors; therefore, good drainage can be expected if the body is prepared a reasonable time after death.
Alcoholism — Both the ____ & ____are good primary injection sites
common carotid artery and the femoral artery
Subcutaneous emphysema frequently follows...
compound fracture of a rib, tracheotomy, lung surgery, or projection of an object (such as a bullet) into the pleural sac.
Gas gangrene is particularly likely after...
compound fractures; the bone splinters provide foreign bodies that enhance the infection as well as permit entrance of embedded debris or dirt.
Gas gangrene — The gas causes swelling and death of tissues locally. The exotoxins break down red blood cells in the bloodstream and, thereby,....
damage various organs throughout the body.
Tissue gas — The gas is ordinarily formed more rapidly and with greater intensity in the...
dependent tissues and the organs
