*Embalming Term 4

As an embalmer, you are injecting an arterial solution via the carotid artery into a body that had an aneurysm. Shortly after starting the procedure, you notice distension of the abdomen and you are not able to establish drainage. What is your next step?

With an aneurysm, if you cannot get drainage and you notice that the abdomen is distending, you must stop injecting. What has happened is that the aneurysm has caused a break in a major artery of the body (most likely the thoracic or abdominal aorta) and arterial fluid is leaking out of the aorta and accumulating causing pressure to build up and the abdomen to swell. Your next step has to be sectional embalming, most likely a six point injection. There is no use continuing injecting in the common carotid artery because you are just loosing fluid into the abdominal cavity. Preservation is not taking place.

What situation would you most expect to encounter in a body that has type 3 arteriosclerosis in the femoral artery?

With type 3 arteriosclerosis, the artery is completely blocked and cannot be used for arterial injection. Injection via the right common carotid artery should be done to embalm the rest of the body, but will not be sufficient to preserve the leg since the artery is occluded. Raising the popliteal artery, the anterior tibial artery or the dorsalis pedis are other options to consider. They may be sclerotic as well, but you would not know unless the vessel is raised. Hypodermic injection will be required if no other vessels are raised - or if all other vessels are not suitable for injection. You can also supplement the hypoinjection procedure with surface embalming.

Case Scenario: Mr. Barry Karloff is an 78 year old who male who died yesterday in a personal care home. Mr. Karloff is approximately 140 pounds and is 5 feet 11 inches tall. His features are slightly sunken in and his skin appears to be dry. What type of arterial solution is most recommended to use when embalming Mr. Karloff to minimize postembalming dehydration?

large volume of a mild solution

According to Mayer, there are certain precautions that should be used when embalming bodies exposed to radiation treatment. What are the three best approaches to take?

limit your time of exposure to the deceased wearing rubber gloves and a rubber apron (in addition to PPE) keep your distance from the body when possible

What is the proper position of an adjustable bed or mattress for a casket that is to be shipped?

lowest position

What embalming problem is commonly encountered with bodies with valvular heart disease?

lung purge

What procedure should be performed on all bodies that are to be shipped?

pack all external body orifices

On the medical registration of death, you observe that Mr. Weston also experienced ascites and hydrothorax. What treatment is most effective for these conditions?

perform thorough cavity aspiration and cavity injection

Les Gibson is a 65 year old male who died several days ago. Mr. Gibson is on your embalming table and must be embalmed. In the preembalming analysis, you observe that Mr. Gibson has gas in his abdomen which is distended. What is the recommended preembalming treatment for Mr. Gibson's distended abdomen?

pierce the upper area of the abdomen with the trocar to relieve the pressure and proceed with arterial injection

What is the greatest problem the embalmer encounters in a body as a direct result of arteriosclerosis?

poor fluid distribution

Which of the following treatments is not recommended to perform on edemic bodies?

surface preservation using a humectant fluid

Mr. Weston's hands are also swollen and edemic. What basic problem would you expect to encounter after the successful treatment of his edemic hands?

the back of his hands would become wrinkled

What are the two most common ways that drugs will inactivate the embalming fluid?

they create a build-up of nitrogenous wastes they decrease the permeability of the cell membrane of cells

When embalming a diabetic patient, you would expect that the tissues would have difficulty in firming. What is the reason?

tissues would not firm since the pH values would be abnormal due to acidosis

Mrs. Kathleen Winterton needs to be embalmed. She appears to be a "normal" case with normal body moisture. There are no signs of dehydration or edema. Which technique can be used to help maintain a good balance of moisture in her body?

use a hypotonic solution

An embalmer injects 1 gallon into a body and encounters poor blood drainage. The embalmer continues with arterial injection and observes that the body becomes distended and discoloured. What condition is the embalmer most likely dealing with?

venous coagula

emboli

•A free moving blood clot.

cerebrovascular accident

•A stroke

edema

•Abnormal collection of fluid in the tissue spaces, serous cavities or both

brain purge

•Appears as a white semisolid.

lung purge

•Appears foamy and frothy.

thrombi

•Blood clot that is attached to the wall of a blood vessel.

congestive heart failure

•Decreased heart function

ascites

•Edema of the abdominal cavity

hydrocephalus

•Edema of the cranial cavity

hydropericardium

•Edema of the pericardial sac

hydrothorax

•Edema of the pleural cavity

hydrocele

•Edema of the scrotum

desiccation

•Extreme dehydration

intercellular edema

•Fluid accumulates between the cells of the body. •Also called pitting edema. •Forms a depression when pushed upon. •Responds well to embalming treatments.

anasarca

•Generalized edema in all body tissues

arteriosclerosis

•Hardening of the arteries

stomach purge

•Has a foul odour. •Type of purge that will dehydrate tissue the most due to its acidic nature. •Has a "coffee ground" appearance.

phlebitis

•Inflammation of a vein.

arteritis

•Inflammation of an artery

ischemia

•Lack of blood supply to an area

aneurysm

•Localized dilation of an artery.

vasoconstriction

•Narrowing of a blood vessel.

According to the textbook by Mayer, which two problems are commonly seen in embalmed bodies that must be held for long periods?

•desiccation •mould

Preinjection solutions should be used for cases with arteriosclerosis and arterial coagula since this will prepare the vascular system to receive the arterial solution. - T/F

FALSE - According to Mayer, preinjection solutions should only be used with cases that have good circulation. You do not want to waste any injection solution with a preinjection solution. You want to make sure that you start injecting a preservative solution right from the start. Preinjection solutions will also break up blood coagula causing blockages in smaller vessels. Mayer believes that by using preinjection solutions - it will only worsen the situation with clots

When embalming a body with valvular heart disease, the only successful injection procedure is to perform a six-point injection. - T/F

FALSE - Valvular heart disease does not mean that you can only embalm the body using a 6-point injection. It would depend on the severity of the disease and how many valves it affects. Normally, the aortic valve prevents arterial fluid from entering into the heart (the left ventricle). If this valve does not function properly, it is not a concern since the arterial fluid would just flow into the left ventricle. Arterial fluid would not go any further as long as the mitral valve is properly functioning. If the mitral valve is not properly functioning, then arterial fluid will go into the capillaries of the lungs and possibly cause lung purge

Additional safety precautions should be practiced when embalming a body that has had treatment with corticosteroids and anti-inflammatory drugs. - T/F

False

Excessive massaging of Mr. Karloff's hands, neck, and face will assist in minimizing postembalming dehydration.

False

Mr. Karloff's fingertips are desiccated and appear dark brown and wrinkled. True or False - This condition can be successfully restored with hypodermic injection of an arterial fluid.

False

The most effective treatment for ascites is to inject a very strong arterial solution. T/F

False

Thoroughly embalmed tissues dehydrate more than underembalmed tissues. T/F

False

When embalming Mr. Karloff, in order to minimize postembalming dehydration, it is best not to use co-injection fluids as they tend to lead to dehydration. True or False?

False

A body requires a 20% increase in total body water before being considered to be edemic. T/F

False - The average normal male contains 55-65% total body water, while females have 45-55%. When your body increases by 10% of the normal body water - you will have edema.

cellular edema

Feels firm when pushed upon. •Does not respond to embalming treatments. Fluid accumulates in the cells. •Also called solid edema.

Subcutaneous emphysema

Subcutaneous emphysema is a type of gas found in tissues. It is commonly caused by a puncture or tear in the lung or lining of the lung of a living person. Before the person dies, they would gasp for air. The air inside the lungs would escape for the punctured lung and fill the surrounding tissues with air. Subcutaneous emphysema can result due to rib fractures that puncture a lung, puncture wounds of the thorax, thoracic surgical procedures, CPR compression causing a puncture of a lung or pleural sac from a fractured rib, or tracheotomy surgery. It is recognized by the presence of gas in the tissues and swelling. The gas will move to the higher parts of the body and can move a fair distance in the body. It does not have an odour since it is not caused by microbial growth. Skin slip and blebs (blisters) are not present. The embalmer can also look for signs of CPR, surgery or trauma that may have caused the puncture of a lung.

Facial edema is commonly seen in a person that has experienced surgical repair of an aneurysm. - T/F

T- Extreme facial edema seems to occur often with surgical repair of this condition. This would be due to the surgical procedures, medications and IV that the patient would get

Arterial coagula causes more complications for the embalmer than venous coagula - T/F

TRUE - Arterial coagula may be pushed through the vascular system into smaller vessels causing blockages. Venous coagula usually get pushed into larger veins and into the drainage fluid.

Drug therapy in a patient will commonly affect liver and kidney function. - T/F

TRUE - Liver and kidney malfunction can cause many complications that the embalmer will encounter. It is not the kind of drug that is the main concern, but the conditions that it will cause to the body, end eventually to the embalming procedure. For example - liver malfunction will often cause jaundice while kidney malfunction will increase nitrogenous wastes in the body affecting tissue preservation and increasing formaldehyde demand

What is the best treatment to prevent the growth of mould on an embalmed body?

The best preventative treatment is to apply a mould retardant chemical. Do not store the body in a closed and sealed container. Do not store the body in a dark environment. Applying massage cream is a good idea to protect the body from dehydration, but it will not prevent the formation of mould.

After arterial injection you observe anal purge from Mr. Gibson. What is the recommended treatment for anal purge?

The best treatment is to apply firm pressure on the lower abdomen. You should be able to remove a large amount of fecal material with this technique. This can be done before arterial injection and after arterial injection. You would then carefully wash the anal area to flush and clean the area, being careful not to splash or spray. You then have to pack the anal orifice with cotton saturated in cavity chemical to prevent any further problems. Thorough cavity aspiration is required but is not sufficient enough to correct the purge. You still have to apply pressure to the abdomen to remove fecal material and pack the anal orifice.

What is the most effective treatment for subcutaneous emphysema?

The main problem with subcutaneous emphysema is the gas that is trapped inside the tissues. You must remove the gas through open incisions and channelling of the tissues. It is also recommended to embalm using restricted cervical injection and to use a stronger solution for the head

Which injection technique would be wise to perform when treating Mr. Weston's edema?

The textbook recommends injecting arterial solution then stopping for a while. This will maximize the chemical reaction and allow more time for moisture to be drawn away from the tissues and for preservation of the tissues to take place

Immediately after the embalming procedure you observe that Mr. Karloff has small nicks on his chin and neck. You realize that they are razor burns. What is the best treatment for razor burns?

This type of surface abrasion is best left to dry completely so that proper cosmetizing may take place

Tissue gas

Tissue gas is a condition that generally affects dead bodies. It can result from a living person who had gas gangrene prior to death. It is caused by a spore-forming bacterium called Clostridium perfringens. The bacteria can enter the body through a wound infection (such as in gas gangrene). This bacteria normally lives in the intestinal tract of humans, therefore any condition that would allow the bacteria to leave the normal environment of the intestinal tract (translocation) can result in tissue gas. Examples would include perforated bowels (gun shot wounds, stab wounds, abdominal surgery etc.), decomposition, cavity treatment. Tissue gas can also be caused by contamination of tissues through contaminated equipment (autopsy instruments, embalming instruments and equipment.) In this method, contaminated instruments can transmit the tissue gas microbe from one body to the next. Poor embalming can also lead to tissue gas. Clostridium perfringens produces a lot of gas inside the tissues which spreads very quickly and leads to distension, blebs (blisters), and skin slip. It is associated with microbial growth therefore is associated with a very strong odour and rapid decomposition.

What is the most practical way for an embalmer to prepare him or herself to treat bodies that have been affected by drugs?

Treat each case differently through case analysis, and proceed with the conditions that you encounter step by step. In other words, don't worry about the drugs, just properly embalm the body with the conditions that you encounter.

Decomposition occurs more slowly in dehydrated bodies. T/F

True

Humectants can be used as a dehydrating chemical. T/F

True

The longer that a patient is under drug therapy, the more intense are the embalming problems encountered. - T/F

True

To minimize postembalming dehydration on Mr. Karloff, it is best to perform intermittent or alternate drainage.

True

Using warm water with the arterial solution increases fluid reactions while cold solutions slow the formaldehyde reaction. T/F

True

When embalming a body that has been exposed to radiation, there should be a flow of constant running water on the embalming table. - T/F

True

When embalming a body with "normal" moisture content (no dehydration, no edema), such as Mrs. Winterton, the embalmer needs to add moisture.

True

Ten minutes after you start arterial injection, you observe purge from Mr. Gibson's nose and mouth. Which technique should you immediately perform?

Two simple techniques to perform are to immediately apply massage cream to the face to protect the skin and to elevate the head. Elevation of the head may be enough to stop purging. The embalmer can also aspirate the nose and mouth with a nasal tube aspirator, then asses the purge material and continue according to case analysis. It may not be necessary to aspirate at this point or to start raising other vessels.

Case Scenario: Mrs. Chavez is a 57 year-old female who died in the hospital from congestive heart failure. She has been refrigerated for 12 hours before being released and transferred to your funeral home. Upon removal of the shroud, you notice that Mrs. Chavez's neck and face is distended and discoloured, especially her right side. Her lips, ears and fingertips are cyanotic. Her legs are edemic, and her abdomen is distended, indicating ascites. Task: Describe all possible embalming treatments for Mrs. Chavez.

Use restricted cervical injection and drain from the right internal jugular vein. You may also drain from the left internal jugular vein as well to assist in removing facial discolourations. Inject a mild solution at first to clear blood discolourations and blood congestion. Once drainage is established, inject with a stronger solution. Raise the femoral arteries and inject a very strong solution into the legs. (You may also use a co-injection solution specially formulated for edema). If you are not using a specialty edema fluid - you must also hypoinject the legs, raise the legs for gravity, and apply cotton at the femoral incision site to wick moisture. Assess the situation the following day. Surface treatment will be required if there are still signs of moisture or lack of preservation. Lower the hands over the table and massage to establish good circulation and to remove discolourations Inject with sufficient pressure and rate-of-flow to overcome intravascular resistance and establish good distribution. Use continuous drainage technique to clear discolourations. (You may have to perform a direct heart tap to establish drainage if the blood is too thick and congested to drain from the internal jugular vein) You must perform thorough cavity aspiration immediately after arterial injection to remove and clear congested blood and to remove distension in the neck which is commonly found in cases with congestive heart failure. Ascites is also present, therefore must be properly treated. With ascites, the additional moisture will dilute the cavity fluid. Use at least 16 ounces of cavity fluid per cavity, and reaspirate the following day.

When embalming a body with arterial coagula, what is the best injection protocol to use?

inject with a slow rate-of-flow without a preinjection fluid

•What method of drainage is best to perform on dehydrated bodies?

intermittent or alternate drainage

Which type of person is more at risk for having arteriosclerosis?

diabetic

Mr. Weston also shows evidence of hydrocele. What is the best treatment for this condition?

direct the trocar into the scrotum during cavity treatment, aspirate, and then add undiluted cavity fluid

Which of the following diseases or conditions can cause edema?

diseases that affect cardiac function and result in increased venous pressures diseases that affect the renal system and results in small amounts of plasma proteins second degree burns where skin damage will indirectly cause renal failure liver disease

What is the best approach to take when embalming a body that has been treated with radiation?

do not embalm unless a radiation safety officer says it is safe to do so

When considering the effects of drugs on the embalming process, which statement is true?

drugs will affect the kidneys resulting in the accumulation of nitrogenous wastes which will then neutralize formaldehyde

In which of the following ways will drugs affect the preservation of tissue cells?

drugs will change the permeability of a cell membrane thereby reducing the chance of a preservative solution entering into the cell

Which of the following is a cause of antemortem dehydration?

febrile disease

Which type of fluid is least recommended to use for the arterial injection of Mr. Karloff's dehydrated body?

high index arterial fluids

As a result of Mr. Karloff's body being in a state of dehydration, what would you expect the condition of his blood to be in?

his blood would generally be thicker, congealed and clotted

What type of coinjection fluid will be most beneficial to use to prevent postembalming dehydration on Mr. Karloff?

humectant

List and describe general procedures or considerations in embalming a body that must be held for a delayed viewing.

1) Use restricted cervical injection. This allows you to inject a larger volume of arterial solution without overembalming and distending the face. 2) Perform intermittent or restricted drainage. This reduces the amount of arterial solution that leaves the body through drainage thereby allowing more arterial solution to be retained in the body, which then allows for better preservation. 3) Perform aspiration and cavity treatment after a delay. This delay allows time for the saturation of arterial chemical into the tissues and organs. 4) Place positioning blocks under the body so that there is little contact of the body surface with the table. This reduces the chance of contact pressure on the dorsal surface thereby allowing for better distribution to the areas. This will result in more thorough preservation. During storage, this allows for better airflow under the body which will reduce the chance of mold growth. 5) Do not elevate the head too high. The elevation of the head may allow more arterial solution to gravitate to the neck area thereby leading to a sunken appearance in the facial area. 6) Perform hypodermic tissue building after the embalming procedure to retain the contours of the face. Since dehydration is a concern with long term preservation, hypodermic treatment of the face with tissue filler will reduce the chance of the face from getting dehydrated and sunken in. 7) Treat all bruises with hypodermic injection of a bleaching compound. Bruises over time will turn dark in colour (perhaps black) and bleaching them will reduce this effect. 8) Apply massage cream to the face, neck, hands and wrists. You can also cover with cotton or plastic. This will reduct the chance of dehydration and the evaporation of massage cream. 9) Spray the body with a mold inhibitor. A chemical containing phenol is able to prevent the growth of mold since mold is a concern with long term storage of an embalmed body. 10) Do not place the body in a closed, sealed container or environment. Storage of the body in a room that seals tight is not a good idea - even if the body is not in a container. This sealed environment promotes the growth of mold. 11) Inspect the body often - every day or every 2-3 days so that you can notice any changes and fix them before it is too late. This allows you to monitor the body on a regular basis and to correct problems when you see them.

What is the best injection approach when embalming Mr. Karloff in order to minimize postembalming dehydration?

inject at a very slow rate

Leukemia is a condition that causes extravascular resistance - T/F

F- Leukemia causes intravascular resistance. Leukemia is a type of cancer that affects the tissues that makes white blood cells. People with leukemia have a very high blood count due to an increase in the number of white blood cells. This increase in white blood cells causes the blood to be very thick and viscous, causing intravascular resistance. Embalming people with leukemia will show very poor distribution of arterial solution. Usually several injection points are required to properly embalm patients with leukemia

Gas gangrene

Gas gangrene is a fatal disease caused by contamination of a wound infection by a toxin-producing, spore-forming, anaerobic bacterium. This bacteria is usually Clostridium perfringens and is normally found in the soil and the intestines. Clostridium perfringens will grow in the tissues of the wound and releases exotoxins that will break down red blood cells in the bloodstream, resulting in damaged organs in the body. The bacteria also releases fermenting sugars that causes a build up of pressure from the accumulation of gases that tears the tissues apart. Clostridium perfringens also releases enzymes that break down collagen and allows the bacteria to spread through connective tissue expanding the affected area. Gas gangrene will result in necrotic tissue (dead tissue) that will decompose with the formation of blisters, skin slip and odours. Due to the release of enzymes and exotoxins, it spreads very quickly throughout the body.

What situation can generally be found in Mr. Weston's body as a result of the edema?

In edemic bodies there seems to be less clots and distribution of fluid is generally good. This is most likely due to the excess moisture that dilutes and thins the blood.

When drugs cause a major problem to the body, what is a common condition that may result?

Jaundice

Which condition is least likely to occur in a burn victim?

Liver failure

Mr. Banting is a 62 year old male with a history of diabetes mellitus. He is 5 foot 8 inches and weighs 285 pounds. Mr. Banting has poor peripheral circulation and arteriosclerosis. He has a fungal infection in the lungs and has pancreatic and liver problems. His legs are purplish in colour and his toes show signs of gangrene. His skin shows evidence of scratch marks and he has decubitus ulcers on his heels.Question: List the treatments when embalming Mr. Banting.

Mr. Banting has several conditions that will accelerate decomposition. You must use a strong solution. Use a coinjection fluid and a dye. The dye will assist in tracing the arterial solution throughout the body since distribution will be poor as a result of poor peripheral circulation and arteriosclerosis. Use restricted cervical injection. This will allow you to inject with increased pressure and rate-of-flow. This also allows you to inject a larger volume of arterial solution. Use intermittent drainage from the right internal jugular vein. Inject the first gallon using a milder solution in order to establish distribution and drainage, then increase the strength of the solution. Once distribution is established, inject with increased pressure and pulsation to assist in distributing the fluid since the arterial system has poor peripheral circulation. Ensure that cavity treatment is thorough. Proper cavity treatment will be required due to fungal infection in the lungs, and pancreatic and liver problems. Use at least 16 ounces of cavity fluid per cavity. The affected legs with gangrene should be injected via the femoral artery. Arteriosclerosis may prevent arterial injection from this site. Gangrenous tissue should be hypodermically injected followed by a surface pack. Treat decubitis ulcers by topical disinfection, then hypoinjection and conclude with surface compresses.

Which arterial solution is least recommended to use when embalming Mr. Weston's edemic body?

Preinjection fluid should never be used with edemic cases. All the other types of solutions are recommended by Mayer.

What is the greatest challenge that embalmers face with dehydrated bodies?

Restoration

Case Scenario: Mrs. Marilyn Parker is a 62 year old female who died of chronic renal failure. She has been refrigerated and her service is set to take place in 4 days. Task: a) Describe the condition of Mrs. Parker's body due to chronic renal failure and the problems it will cause for the embalmer. b) List the recommended treatments for renal failure that must be performed when embalming Mrs. Parker.

a) Condition : Chronic renal failure will cause an increase in toxic wastes in the blood and the tissues of the body which can result in acidosis (acidic tissues). Eventually, congestive heart failure and pulmonary edema may result as well as gastric ulcers and gastrointestinal bleeding. The skin tends to turn sallow (pale yellow) due to the body retaining urochrome. Problems for the embalmer: The embalmer will have problems with firming, preservation and discolourations. These cases will decompose very quickly because the waste products (like ammonia) in the blood and tissues will neutralize the formaldehyde. The formaldehyde demand in these cases have increased drastically. Edema that is present will dilute the arterial solution and there may be the sallow discolouration caused by urochrome. Tissues in renal failure do not firm well since the proteins have been altered. The proteins do not react well with formaldehyde in an acid environment (acidosis). The GI bleeding and ulcers may cause a loss of arterial solution or purge and these patients may also have skin infections. (The embalmer may also encounter jaundice and emaciation). b) Treatments: Must use a very strong arterial solution (special purpose high index fluids) since there is a very high preservative demand. Restricted cervical injection with drainage from the right internal jugular vein would be the best procedure. Should use dye to trace the distribution of the fluid and to counterstain the sallow discolouration. Preinjection fluids should not be used. Cavity aspiration must be very thorough with the addition of more than 16 ounces of cavity fluid per cavity. Reaspiration and reinjection must also be done. Sectional embalming, hypoinjection and surface embalming should be done according to the condition and preservation of the tissues.

Mr. Gilbert Weston is a 64 year old male who died of liver failure. He has been on several types of medication and drug therapies. He also suffered from alcoholism and phlebitis. Mr. Weston is 190 pounds and 5 feet 8 inches. Due to his illness and various conditions, his body exhibits generalized edema. Task: a) Describe the problems you would expect to encounter created by the edema. b) For each problem that you identified, describe the specific treatment required to overcome it.

a) Mr. Weston would exhibit tissues swollen with fluid, which could lead to leakage issues. If the edema that is present gravitates or moves, Mr. Weston may show wrinkling or distortion or the skin in that area. During injection, the arterial solution would go through a secondary dilution due to the excess moisture present in the tissues. This moisture can also contribute in hastening the decomposition process, as well as contributing to skin slip and blisters. b) To treat Mr. Weston, the embalmer would want to use restricted cervical injection, or injection through multiple sites, which would allow for specific edematous areas to be treated directly. The fluid strength should be at least 5% if his edema is mild, and from 20-32% if severe. Waterless embalming can also be considered. The use of a hypertonic solution will allow for moisture to be removed through drainage, along with continuous drainage. This strong solution will reduce the effects of secondary dilution, as well as assist in stopping the decomposition process and reducing the chance of blistering and skin slip. Injection should also be interrupted, which allows for the solution to draw moisture out from the tissues to the capillaries. Coinjection should be used, either an edema corrective fluid, humectant in large quantities, or Epsom salts. To combat swelling in specific areas, the embalmer can use channeling with a trocar, followed by elevation of the area and drainage through the incision site. Gravitation can also be employed with wicking, as well as massage and pressure. To combat wrinkling of the skin after the edema has moved, or is drained, tissue builder can be used to fill the areas.

What would be the expected outcome when embalming a person that has had multiple-drug therapy?

an increase in the number of embalming problems

Which techniques are recommended to perform in order to help maintain a good balance of moisture in Mrs. Winterton' body?

apply massage cream to surface tissues use cool water to dilute the arterial chemical follow the manufacturer's recommended dilution

Mr. Karloff has dry facial skin which is "flaking" and peeling. What is the best treatment for this condition?

apply massage cream, then wipe the area with gauze saturated with solvent, then reapply massage cream

Which statement best describes the situation that chemotherapeutic drug therapy causes to the embalming procedure?

chemotherapeutic drugs affects certain body processes (physiological reactions), which in turn can cause embalming problems

Through case analysis, an embalmer notices distension of the neck, facial discolourations and a bluish colour to the lips, ears and fingers. What condition is being described?

congestive heart failure

•What method of drainage is best to perform on bodies with edema?

continuous or concurrent drainage

Mr. Karloff has abrasions on his hands that are dark brown in colour and hard. What is the best treatment for this condition?

cover with opaque cosmetics