Embalming Infants, Toddlers and Young Children

Mouth Closure

-NEVER use a needle injector -muscular or sublingual suture (under the tongue) -suture through the mandible and maxilla instead of around -adhesives -may leave lips open/leaving it as a natural close with a gentle gap of the lips when suturing the mouth you will go through the bone due to child's bones being softer than adults If you use a natural mouth closure make sure you generously use massage cream on the tongue and mouth, to avoid dehydration and darkening colorations

Eye Closure

-cut down eye caps, use vaseline or putty -massage cream, Stay Cream/Fix It or vaseline can be applied DO use massage cream generously due to dehydration after embalming

Infant Skin

-distends easily -wrinkles easily -burns easily

Positioning

-do what is customary at your FH -hands across chest to hold a toy -one hand up behind head, one across chest -turn head all the way onto right cheek -legs may be viewed

Unautopsied Infants

-raise vessels prior to feature setting -rolled towel under shoulders helps to better expose small vessels

Instrumentation and Sundry Items

-small cannulas -infant trocar -dental floss -rolled towel instead of headblock -hypodermic needles and syringes -diapers -baby wash, shampoo and lotions -one piece under garment -bandages -bedding

Child to young adult

18-48 months (age 4 to age 12)

Fat Content at One Year

30% of total body weight

Water Content at One Year

About 60%, or that of a normal adult

Case analysis for infants, young adults

Age Size and weight Cause of death Moisture considerations Postmortem changes Discolorations

Fat Content at Birth

Approximately 12% of total body weight

Water Content at Birth

Approximately 75% of total body weight, the excess water can cause pre-disposing decomp

Transfer of Care for Infant-young adult

Ask the parents if they want us to cover the face of the child. If parent wants to carry the child out of the house that is perfectly ok, ask if they would like to do this.

Infant to child

Birth to age 4 or 18 months

First and Best Artery to Raise on an Unautopsied Infant

Common carotid - largest, non-aortic vessel, and the most superficial

Treating Infant Viscera

Dry pack - less plastic

Bed

During embalming, utilize toweling as a "____" to prevent disfiguring or flattening of remains (area of soft material, to help maintain normal curvature instead of a flat surface, if you laid them flat the body would take on that flat shape)

Securing the Infant Cranium

Suture the cranial cap in place - don't use calvarium clamps (too big, too heavy) -use dental floss and a worm suture for the cranial incision go into the bone -Use putty, pack the calvarium with cotton and powders to add weight and prevent leakage

Infant Fluid Strength

Use the same fluids as a routine/normal adult, or stronger, because of high water content of the tissue -disease, bacteria and/or delay results in higher preservative demand -waterless or low water (low volume, inject appropriately for size of infant)

Selecting Vessels in an Autopsied Infant

Vessel selection and order of embalming the same as an adult (legs, arms, head, left to right) -legs (Common iliacs, External common iliacs, femoral) -arms (subclavian, axillary, brachial, radial, ulnar) -head (common carotid, external carotid)

Prior to Embalming

When should medical appliances and tubing in viewable areas be removed?

Post-Embalming

When should tubing/medical appliances in non-viewable areas be removed?

If you have a full-term infant or older

you can almost always arterially inject versus submerging embalming

12 years old

Many 12-year old's will be tall enough to fit into an adult casket

Axillary Arteries

May be too small to inject efficiently and drainage is difficult to establish in an unautopsied infant

Body Make-Up

Relationship of body water to body fat, both of which contributing to total body weight. High water content High fat content. Low muscle mass. High demand for preservation due to these three things.

Fat Content at 6 Months

Roughly 25% of total body weight Reason why predispose for decomposition

Femoral Artery

Second choice for an unautopsied infant; second largest, non-aortic vessel -inject distal leg first to see how fluid reacts

Muscle Mass in Infants

Significantly reduced, when compared to older children and/or adults Reason for predispose for decomposition, and inadequate preservation due to little muscle mass

Abdominal Aorta

Incision is made to the left of the median plane in an unautopsied infant -deep seated, resting on anterior surface of the spine -may be considered extreme -intestines must be moved aside -inject down, then up, for better control -treat viscera if expansion occurs Largest vessel however not the first

Higher Demand for Preservation

High fat content, high water content and low muscle mass equals a _________________ for infants