General Body Considerations

FLUID VOLUME AND STRENGTH: ADOLESCENT AND ADULT

2-3 % ARTERIAL SOLUTION IS IDEAL (NORMAL CASE) 2.3 - 3.0% IS RECOMMENDED FOR CONTAGIOUS DISEASE CASES NO LESS THAN A 2% ARTERIAL SOLUTION SOME EMBALMERS START WITH A MILD SOLUTION THE FIRST GALLON AND THEN INCREASE THE CONCENTRATE IN THE SUBSEQUENT GALLONS OF SOLUTION

ADOLESCENT AND ADULT

AGE- 13 - 75 YEARS OLD CAUSES OF DEATH HEART DISEASE MALIGNANCIES ACCIDENTS

EMBALMING THE ELDERLY PERSON

AVERAGE LIFE EXPECTANCY IS 72.6 YEARS FOR MEN AND 77.6 YEARS FOR WOMEN. THE NUMBER OF PERSONS LIVING INTO THEIR EIGHTIES AND NINETIES IS EXPECTED TO DOUBLE WITHIN SEVERAL YEARS.

Ideal pressure for embalming the "normal" adult body.

An "ideal" pressure setting to 5 to 20 lbs. using a centrifugal machine. Some embalmers may use a standard pressure of 140 psi.

Ideal rate of flow for embalming the "normal" adult body.

An "ideal" rate of flow of 10 to 15 minutes per gallon. A health body can accept fluid at this rate of speed without distention

Discuss the following complications in embalming of the elderly

Arthritic Condition i. These condition create a number of positioning problems. b. Mouth Closure problems i. Atrophy of the maxillae and mandible because of this problem, it would be difficult to use a needle injector method for mouth closure. c. Arteriosclerosis i. Occlusion of the arteries, Arteriosclerosis can bring about poor peripheral circulation. As a result of poor circulation, bedfast individuals tend to form bedsores (decubitus ulcers). d. Senile Pupura i. Causes discoloration that vary in size and not cleared during arterial injection. e. Malignancy i. Disseminated intravascular coagulation ii. Disruption of metabolism by uncontrolled secretion of hormones (This can greatly affect weight control, cell membrane activity and metabolism of sugars, fats and proteins. iii. Secretion of both peptides and steroid hormones by many tumors (some bring about sustained hypercalcemia) calcium can create a barrier at the cell wall making it difficult for the arterial fluid to enter the cell and preserve the protoplasm iv. Anemia -emaciated v. Cachexia (result in the wasting away of tissues) Skin can be dry and have an inability to take in proper amount of water vi. Edema - can result when local tumor exert pressure on veins and lymphatics f. Cardiac Disease i. Distribution and Drainage problems g. Diabetes Mellitus i. Obesity can be a problem i. Ketone present in blood and body tissues ii. Pathologic changes resulting from the disease include poor peripheral circulation brought about by accelerated arteriosclerosis and degenerative changes in small blood vessels that result in poor circulation particular in lower extremes

USE OF A PACEMAKER

BE SURE TO REMOVE IF CREMATION IS SELECTED ANGULAR DRAINAGE FORCEPS MAY BE NECESSARY DUE TO WIRE FROM PACEMAKER MAKING IT DIFFICULT TO INSERT DRAINAGE TUBE CONTACTS RUN FROM THE PACEMAKER INTO THE RT. INTERNAL JUGULAR VEIN AND THEN INTO THE HEART.

PREPARATION OF AUTOPSIED INFANT

BLOOD VESSEL SELECTION - SIZE WILL BE THE BIG DIFFERENCE HYPODERMIC TREATMENT IF VESSELS CAN'T BE LOCATED SURFACE PACK APPLICATIONS IN ADDITION TO HYPODERMIC TREATMENT USE ARTERIAL FLUID OF SUFFICIENT STRENGTH

IN THE CASE OF CARDIAC DISEASE

BY-PASS OR VALVE REPLACEMENT SURGERY MULTIPLE INCISIONS (ONE OR BOTH LEGS-CHEST WALL, AND POSSIBLY ABDOMINAL WALL EDEMA IN THE FACIAL TISSUES

DIABETES MELLITUS

CHARACTERIZED BY HYPERGLYCEMIA (EXCESS OF SUGAR IN THE BLOOD RESULTING IN A DEFICIENCY OF INSULIN) COUNT ON POOR CIRCULATION ACCELERATED BY HARDENING OF THE ARTERIES, PARTICULARLY IN THE LOWER EXTREMITIES GANGRENE, KIDNEY FAILURE, LIVER PROBLEMS, AND FUNGAL INFESTATIONS OF THE LUNGS RESTRICTED CERVICAL INJECTION RECOMMENDED HYPO AREAS THAT DO NOT RECEIVE ADEQUATE DISTRIBUTION AND USE PLASTIC GARMENTS PERFORM CAVITY TREATMENT IMMEDIATELY AFTER ARTERIAL INJECTION. SUFFICIENT CAVITY FLUID IN THE LUNGS AND LIVER

IF COLOSTOMY HAS BEEN PERFORMED

COLLECTING BAG CAN EITHER BE REMOVED OR REMAIN IN PLACE DURING THE ARTERIAL INJECTION SOMETIME THE BAG SHOULD BE REMOVED AND ITS CONTENTS DISINFECTED WITH CAVITY FLUID. COTTON SATURATED WITH CAVITY FLUID IS INSERTED INTO THE OPENING OF THE ABDOMINAL WALL CLOSURE OF THE COLOSTOMY OPENING IS CLOSED WITH A "PURSE STRING SUTURE

BLOOD VESSEL SELECTION INFANT

COMMON CAROTID ARTERY FEMORAL (EXTERNAL ILIAC) ARTERY - ALWAYS INJECT THE DISTAL LEG FIRST ABDOMINAL AORTA ARTERY ASCENDING AORTA

CLOSURE OF CAVITIES

DEALING WITH THE FONTANELS (FILL THE CRANIAL CAVITY WITH COTTON. THEN SUTURE THE FONTANELS TOGETHER WITH DENTAL FLOSS. THEN USE A MASTIC COMPOUND TO FILL THE AREA) USE OF CALVARIUM CLAMPS IF THE CRANIUM IS CALCIFIED

AGE AND GENERAL BODY CONDITIONS

EMBALMER SHOULD NOT STEREOTYPE BODIES BY AGE EVERY BODY MUST BE INDIVIDUALLY JUDGED IN MAKING A PREEMBALMING ANALYSIS

PRESSURE AND RATE OF FLOW: ADOLESCENT AND ADULT

FIRST INJECTION SHOULD BE SLOW WHILE THE ARTERIES ARE FILLING. USUALLY 10-15 MINUTES PER GALLON SKIN OF ADOLESCENTS IS MUCH FIRMER AND DRYER THAN THAT OF ADULTS, INDICATING A GOOD PROTEIN LEVEL. (LESS APT TO SWELL THAN THE ELDERLY, WHOSE SKIN SUPPORT IS OFTEN WEAK.)

TREATMENT OF AREAS NOT REACHED BY ARTERIAL INJECTION

HYPODERMIC INJECTION INTERNAL COMPRESSES PRESERVATIVE GELS EXTERNAL COMPRESSES

INFANTS AND CHILDREN

INFANTS - BIRTH TO 4 YEARS USE REGULAR ARTERIAL FLUIDS AND STRENGTHS ONLY SLIGHTLY REDUCED FROM THOSE OF THE ADULT

CARDIAC DISEASE TREATMENT

INJECT COMMON CAROTID ARTERY AND INTERNAL JUGULAR VEIN MODERATE TO STRONG SOLUTION SECTIONAL EMBALMING IS LOCAL OBSTRUCTIONS EXIST RESTRICTED CERVICAL INJECTION IF EDEMA OF THE FACE EXISTS IF METAL STAPLES ARE USED, REMOVE THEM WITH A HEMOSTAT DRY INCISIONS AND HYPODERMICALLY INJECT WITH A CAUTERIZING CHEMICAL SUTURE INCISIONS TIGHTLY USING BASEBALL STITCH USING INCISION SEAL POWDER AFTER WASHING BODY, APPLY GLUE

MOUTH CLOSURE PROBLEMS ELDERLY PERSON

MANY TIMES THE MANDIBLE OR THE MAXILLA HAVE ATROPHIED. MIGHT NEED TO USE THE MUSCULAR OR MANDIBULAR SUTURE IF DENTURES ARE BEING USED, THE MANDIBULAR SUTURE HOLDS THE DENTURES FORWARD AND IN A TIGHT POSITION IN THE MOUTH.

FLUID STRENGTH AND VOLUME 4 TO 12 YEAR OLD

MEDIUM INDEX 18-25 CASES OF TRAUMA OR DISEASES SUCH AS EDEMA OR RENAL FAILURE, STRONGER STRENGTH SOLUTIONS MAY BE INDICATED INSURE THAT THE RATE OF FLOW IS ADEQUATE BUT NOT TOO FAST AS TO CAUSE DISTENTION

ARTHRITIC CONDITIONS ELDERLY PERSON

MOST OFTEN FOUND IN PATIENTS RESTRICTED TO BEDREST. LEGS DRAWN UP, SPINE CURVED, FINGERS CLENCHED, ARMS DRAWN UP POSITIONING - PLACE HEAD BLOCKS UNDER THE THIGHS, TIE THE BODY IN POSITION APPLICATION OF PRESSURE TO ARTHRITIC LIMBS AND ARMS MAY CHANGE THEIR POSITION, BUT USUALLY ONLY IF TENDONS AND MUSCLES ARE TORN. FAMILY IS WELL AWARE OF THE CONDITION CASKET BLANKET CAN HIDE CLENCHED FINGERS USE COMMON CAROTID ARTERY. USE OF THE FEMORAL WOULD BE DIFFICULT IN CASES IN THE FETAL POSITION. POSSIBLY USE THE POPLITEAL HYPODERMIC INJECTION AND PLASTIC GARMENTS OFTEN UTILIZED

FEATURE SETTING AND POSITIONING 4 TO 12 YEAR OLD

MOUTH CLOSURE - MAY BE DIFFICULT IF CHILD HAS BRACES OR BUCK TEETH PLACE A SMALL LAYER OF COTTON OVER THE LOWER TEETH AND GUM. THIS WILL PUSH THE LOWER LIP FORWARD LIPS CAN NOW BE GLUED PRIOR TO INJECTION OR WAIT UNTIL INJECTION IS COMPLETED TO SEE IF LIPS "ROUND OUT" DURING THE INJECTION

Explain why it may be necessary to use the same strength arterial solution for embalming an infant or a child and an adult

Moisture, disease process and medications can increases moisture in the body. Renal and liver failure can bring about the accumulation of toxic waste can greatly increase the preservative demand of the body.

EMBALMING THE INFANT

NORMAL TOPICAL DISINFECTION EYE CLOSURE - NEED TO BE CUT DOWN MOUTH CLOSURE - SUTURE OR POSSIBLY LEAVE OPEN POSITIONING - PLACE BABY ON TOWEL OR BED OF COTTON

IN TREATMENT OF SENILE PURPURA (ECCHYMOSIS)

OFTEN APPEARS ON THE ARMS AND BACKS OF HANDS WILL NOT CLEAR DURING ARTERIAL INJECTION, AND OFTEN WILL SWELL DURING EMBALMING SKIN TEARS EASILY, MANY TIMES DURING REMOVAL USE SLOW RATE OF FLOW TO AVOID FURTHER CAPILLARY RUPTURE IF THE SKIN OVER THE DISCOLORED AREA HAS BEEN TORN OR BROKEN OPEN, ALL LOOSE SKIN SHOULD BE REMOVED AT THE BEGINNING OF THE EMBALMING. USE SURFACE COMPRESSES WITH CAVITY FLUID, PHENOL, OR AUTOPSY GEL CAN BE USED. THEN DRY THE AFFECTED AREA AND COSMETIZE NOTE: WHENEVER YOU HAVE A CASE WHERE THE TISSUE IS FRAGILE AND IS PRONE TO TEARING, BE EXTRA CAREFUL WHEN YOU MASSAGE THE BODY.

PREINJECTION AND COINJECTION: ADOLESCENT AND ADULT

PREINJECTION IS NOT RECOMMENDED WHEN THERE HAS BEEN A LONG DELAY BETWEEN DEATH AND EMBALMING PREINJECTION IS RECOMMENDED FOR REMOVAL OF INTRAVASCULAR DISCOLORATIONS AND JAUNDICE

OPTIONAL TREATMENTS (Infants)

PREMATURE INFANTS - EXTERNAL COMPRESSES INFANT IS WRAPPED IN COTTON SATURATED WITH ARTERIAL FLUID OR CAVITY FLUID LIMBS, TRUNK, AND HEAD ARE HYPODERMICALLY INJECTED

VESSEL SELECTION: ADOLESCENT AND ADULT

RESTRICTED CERVICAL INJECTION RIGHT COMMON CAROTID ARTERY RIGHT FEMORAL ARTERY INTERNAL JUGULAR VEIN FOR DRAINAGE

GENERAL TREATMENTS (Infants)

REWASH ENTIRE BODY AND HAIR CLEAN AND TRIM NAILS SEAL ALL INCISIONS APPLY COSMETICS AS NECESSARY

TREATMENT FOR RUPTURED ANEURYSM

RUPTURED AORTIC ANEURYSM WOULD CAUSE ARTERIAL FLUID TO COLLECT IN THE ABDOMINAL CAVITY AND SWELLING WOULD OCCUR. LITTLE OR NO DRAINAGE SIX POINT INJECTION WOULD BE NECESSARY TRUNK WALLS HYPODERMICALLY INJECTED

DECUBITUS ULCERS (BEDSORES) TREATMENT FOR ELDERLY PERSON

SATURATE COTTON WITH CAVITY FLUID AND APPLY TO THE BEDSORES HYPODERMICALLY TREAT THE AREA AROUND THE SORES USE OF PLASTIC GARMENTS AND PRESERVATIVE POWDERS

TREATMENT FOR LOSS OF A LIMB OR GANGRENE DUE TO POOR CIRCULATION

STUMP SHOULD BE HYPODERMICALLY INJECTED PLASTIC GARMENTS OVER THE STUMP HYPO AREAS AFFECTED BY GANGRENE WRAP IN COTTON SATURATED WITH CAVITY FLUID, PHENOL, OR AUTOPSY GEL & USE OF PLASTIC GARMENTS

ARTERIOSCLEROSIS TREATMENT FOR ELDERLY PERSON

THE VESSEL THAT MOST FREQUENTLY EXHIBITS HARDENING OF THE ARTERIES THAT WOULD BE USED FOR EMBALMING IS THE FEMORAL ARTERY. COMMON CAROTID ARTERY IS THE BEST CHOICE FOR INJECTION (RESTRICTED CERVICAL INJECTION) ARTERIOSCLEROSIS MAY ALSO PREDISPOSE TO DECUBITUS ULCERS

CANCER

TOPICAL AND VASCULAR CONCERNS EMACIATION OR EDEMA RENAL AND RESPIRATORY FAILURE EMACIATED FACIAL TISSUES - (RCI) LOCAL EDEMA IN THE EXTREMITIES (MPI) ARTERIOSCLEROSIS (HYPO-INJ)

INFANT CAVITY TREATMENT

USE AN INFANT TROCAR USE STANDARD POINT OF ENTRY OR LOWER POINT MAY BE USED AMOUNT OF CAVITY FLUID DEPENDS ON THE SIZE OF THE INFANT REASPIRATION IS RECOMMENDED

THE 4 TO 12 YEAR OLD

VESSEL SELECTION - COMMON CAROTID OR FEMORAL ARTERY MOST BODIES IN THIS AGE GROUP ARE AUTOPSIED MANY EMBALMERS PREFER THE FEMORAL IN THIS AGE GROUP DUE TO THE POSSIBLE USE OF CASUAL CLOTHING RESTRICTED CERVICAL INJECTION

Ideal fluid strength for embalming the "normal" adult body.

a. The answer for this question is 2-3% However, there is no ideal fluid in the sense that there is one for all "normal" adult body. There are other factors that need to be considered in the Embalming Analysis. There is the condition of the body, weight, and muscular build, moisture in tissues, effects of diseases, surgery or trauma and refrigeration as well as time between death and getting to the embalmer for preparation of disposition. Blood discoloration and the effects of long use of medications will determine the strength solution. So the idea fluid strength is the one that temporarily preserves, sanitizes and restores the dead human body based upon that analysis.