Embalming 1 Flashcards
1
Q
Why do we embalm?
A
“We embalm to disinfect the body and protect the living.”
2
Q
What is embalming?
A
o EM - in, or about
o Balm - resinous substance or balsamic agents.
3
Q
embalming is a process of chemically treating the dead human body to reduce the presence and growth of microorganisms, to retard (slow down) organic decomposition, and to restore an acceptable physical appearance.
A
non-legal definition of embalming
4
Q
The process of disinfecting, temporary preserving and restoring the dead human body by the injection into the arteries, a suitable amount of a proper chemical. –is based upon fluid distribution - movement of arterial fluid from point of injection to the capillaries.
A
vascular embalming
5
Q
We inject into the arteries because
A
the fluid goes away from the heart The chemical is arterial fluid 16.oz - one gallon/50 lbs. of body weight.
6
Q
movement of arterial fluid from point of injection to the capillaries.
A
fluid distribution
7
Q
movement of arterial fluid through the capillaries to the tissues from intravascular to extravascular (inside to outside)
A
fluid diffusion
8
Q
retain the fluid within the body.
A
retention
9
Q
a. Direct treatment -other than vascular embalming of the content of the body cavities and the lumen of the hollow viscera.
A
cavity embalming
10
Q
cavity embalming Accomplished by two major steps:
A
Aspiration of the contents of the cavities and viscera. andThe injection of a suitable amount of a proper chemical
11
Q
Has the maximum amount of disinfecting and preservation with the minimum amount of fluid.
A
undiluted cavity fluid
12
Q
A rule of thumb on a normal case, for undiluted cavity fluid is
A
16 ounces in the thoracic cavity and 16 ounces in the abdominal cavity.
13
Q
: injection of embalming chemicals directly into tissues through the use of needle, syringe, Trocar.The disinfecting and temporary preservation of a local area by the subcuticular injection of a suitable chemical.
A
hyperdermic embalming
14
Q
types of disinfecting
A
- Primary disinfecting 2. Concurrent disinfecting 3. Terminal disinfecting
15
Q
• The disinfecting and temporary preservation of a local area by the external application of a compress of a suitable material. This is a supplement to vascular and arterial embalming
A
Surface (pack or absorption) Embalming:
16
Q
reasons for embalming
A
- The primary reason (need) we embalm - To disinfect. The destruction or inhibiting of pathogenic bacteria and their products in or on the body.2. * Temporary preservation - Treating the dead human body chemically so as to inhibit (slow down) decomposition.3. * Restoration - The care of the deceased to recreate natural form and color.
17
Q
disinfecting carried out prior to the embalming process. Washing the body.
A
primary disinfecting
18
Q
disinfecting carried out during the embalming process.
A
concurrent disinfecting
19
Q
disinfecting and decontamination measures after the preparation of the remains. Also include cleaning the prep room and instruments, etc. Also, the re washing of the body.
A
terminal disinfecting
20
Q
credited with being the father of embalming
A
Dr. Frederick Ruysch
21
Q
Father of modern US embalming / invented hand pump / disaster pouch
A
Dr. Thomas Holmes
22
Q
wrote the “History of Embalming” in French.
A
Jean Gannal
23
Q
translated Gannal’s book to English.—1st to realize value of embalming from disease standpoint— performed research of bubonic plaque while at Penn State
A
Dr. Richard Harlan
24
Q
was the first to produce formaldehyde (HCHO) Chemical formula - HCHO. Primary formula for embalming, free state gas.
A
• August Wilhelm vonHofman
25
NOTES
• Always show respect to the deceased.• Always maintain the highest standards.
26
PREP ROOM
o Limit admission to the preparation room during preparation.o Licensed funeral service professional and registered trainees.o Those authorized by law / authorized by familyAuthorized persons can be in the prep room when no embalming.o Maintenance employees.o Hairdresser, cosmetologist, etc.o Staff members for dressing and casketing remains.
27
Identify and secure the prep room
• Place a sign on the preparation room door indicating private; authorized persons only.• State of Texas indicates that it must be private and have no general passageway through it.• Keep the door locked.
28
instruct and maintain the highest standards
• Keep the body covered as practical - genital area always.• Guard against loose talk and remarks.• Repeat nothing outside the preparation room.• Disclose no confidential facts as to conditions, deformities or diseases causing death.
29
authorization to embalm
Not a state law to embalm. 1. Verbal permission. (Do we have your permission to embalm?) 2. Written permission.
30
Identification procedures
• Personal effects - inventory a must. (House Call)• Proper remains - the body itself - identify by the family - especially a body to be cremated.• Make sure you remove jewelry that the family has requested after the funeral service.• There may be cases that you need to inform authorities, police, ME, Coroner’s office (JP is used in Texas), if something is found. It is your duty to follow OSHA requirements and inform all employees to follow required procedures and train employees. Help protect your employees.
31
embalming report
complete an embalming report for every case, on which you perform any embalming procedure. This is your documentation as to the embalming procedure you have performed. (see pages 13-17 for example forms).
32
Vascular embalming is based upon
Fluid distributionFluid diffusionRetention
33
Irreversible cessation (a stop, pause, or interruption, especially a permanent discontinuation) of all vital functions. Such as: respiration - breathing heart action - circulation brain action - waves
non legal definition of death
34
the noise made by a moribund (dying) person caused by air passing through a residue of mucous in the trachea and posterior oral cavity
death rattle
35
time immediately preceding death
agonal period
36
the semi-convulsive twitches which often occur before death.
death struggle
37
conditions in which the manifestations of life are feebly maintained. (think the person is dead, coma state)Respiration, heart action, brain action are shallow and sometime hard to detect.
apparent death
38
body of a deceased person including cremated remains
human remains
39
those elements remaining after cremation of a dead human body.
cremated remains
40
dead human body used for medical purposes, including anatomical dissection and study.
cadaver
41
the study of death
thanatology
42
death of an organism (body) as a whole. Pronouncement of death. Historically it is recognized by the failure of one of three organs. (heart, brain, lungs)
somatic death
43
death of the heart
syncope
44
death of the brain
coma
45
death of the lungs
asphyxia
46
Death of the individual cells of the body
post mortem cellular death
47
Final cause of post mortem cellular death is
oxygen starvation
48
Post mortem cellular death will occur _____ somatic death
after
49
Somatic death will occur ______ or _______to post morten cellular death.
before or prior
50
Factors influencing onset of postmortem cellular death
Cause of deathEnvironmental conditions – temperature can be a factor, coolers help slow down decompositionCondition of BodyMedication preceding death – meds can alter body chemistry
51
death occurring in a living body
anti-mortem
52
Can cellular death occur anti-mortem?
Yes
53
these cells will die quicker after somatic death.
specialized cells
54
Brain cells live about
5 to 8 minutes
55
muscle cells live about
3 hours
56
cornea and blood cells live about
6 to 8 hours
57
The major element remaining after cremation is?
calcium (bone).
58
Those manifestations of death by which we may recognize its presence in the body.
signs of death
59
the separation of compounds into simpler substances by the action of microbial and/or autolytic enzymes.
decompostion
60
self destruction of body compounds.
autolytic enzymes
61
most reliable sign of death
decomposition
62
the stopping of blood flowing through the body.
cessation of circulation
63
the stopping of breathing
cessation of respiration
64
Post mortem cooling of the body to the surrounding temperature.
algor mortis
65
Also referred to as CADAVERIC lividity. The post mortem, intravascular, red-blue discoloration resulting from the hypostasis of blood.
liver mortis
66
inside the vessels
intravascular
67
the gravitation of the blood into the lower part of the body.
hypostasis
68
Can livor mortis be removed with normal arterial injection and venous drainage? Yes or No? Why?
Yes, because it is intravascular
69
the post mortem temporary stiffening of the body muscles due to natural chemicals the body process.
rigor mortis
70
At death the muscles do not function. O sign and Q sign – reflecting muscle relaxation.
complete muscular relaxation
71
name the changes of the eye in regards to the signs of death
Clouding of the cornea and loss of luster. Flattening of the eyeball. Pupil does not respond to light.
72
Any procedure used to prove a sign of death.
test for death
73
how many expert tests are there for death
4
74
What are the four expert tests used for death?
a) Stethoscope - b) Ophthalmoscope - c) Electronic life detection devices EKG – Electrocardiogram – EEG – Encephalogram – ABR – auditory brainstem response – d) Injection of various dyes into the body to check for circulation -
75
a delicate instrument used to detect almost inaudible sounds produced in the body.
stethoscope
76
an optical instrument with an accompanying light that makes it possible to examine the retina and explore blood circulation in the eyes.
ophthalmoscope
77
check activity of the heart
EKG- electrocardiogram
78
check for brain wave activity.
EEG- encephalagram
79
checks for brain response responsible for vital acts of breathing and pulse.
ABR- auditory brainstem response
80
an expert test for test injects dye in the the body...2 cc of _______ is injected in the ________ _____If there is circulation what happens?
fluorescein upper armthe whites of the eyes turn green
81
how many inexpert tests for death are there?
3
82
Name the three inexpert test for death
ligature testammonia injection testfeel for the pulse
83
ligate a finger; if it becomes discolored and swells, life is present.
ligature test
84
hypodermically inject ammonia, if alive, the skin will show a reddish reaction
ammonia injection test
85
when you use 2 fingers press into neck area at jugular vein / artery area.
feeling for pulse
86
change occuring prior to the embalming process
pre-embalming changes
87
Those changes occurring prior to somatic death
Ante mortem (Agonal) changes
88
Thermal changes - ante mortem
Agonal AlgorAgonal fever
89
a decrease in the body temperature prior to somatic death. Due to a slow metabolism and poor circulation. Slows the onset of rigor mortis and decomposition
Agonal Algor
90
- an increase in body temperature prior to somatic death.Commonly found in infectious diseases.Speeds the rate of rigor mortis and decomposition.
Agonal fever
91
Blood changes - ante mortem
Hypostasis Coagulation
92
the settling of blood and/or other fluids to the dependent portions of the body.
hypostasis
93
(clots) congealing of the blood
coagulation
94
Moisture changes - ante mortem
Agonal edema Agonal dehydration
95
the escape of blood serum from an intravascular (inside the vein) to an extravascular location immediately before death. There is an increase in moisture in the tissues and cavities. Which results from capillary expansion. Therefore, it speeds the decomposition process.
agonal edema
96
If agonal edema is present, how will this affect the strength of your diluted arterial fluid?
Increase strength of the arterial solution.
97
the loss of moisture from the human body prior to somatic death.Could result in the thickening of the blood and dehydration of certain tissue.
agonal dehydration
98
The movement of microorganisms from one area of the body to another. An example is from the intestinal area to the blood vascular system due to capillary permeability changes. It occurs as organisms normally confined to a specific area of the body by natural body defenses are able to move as the body loses its ability to keep them in check. The movement may be the results of the organism. (1) Having natural motility, (2) entering the blood stream and circulating to other parts of the body, or (3) gravitating to other parts of the body during hypostasis or shift in tissue moisture.
translocation of microorganisms
99
a type of gas in tissues-- It has no odor, no skin slip; rises to highest body areas; can create intense swelling.Results from the puncture of the lungs or pleural sac.Seen in cardiopulmonary resuscitation treatments; puncture wounds to the thorax; rib fractures
Antemortem (prior to death) Subcutaneous emphysema
100
Treatments in the embalming aspects for gas in tissues include
channel tissue after arterial injection to release gas. Establish good arterial preservation. The gas may escape through incision in the anterior cervical triangle, but it will not spread to other bodies
101
A series of physical and chemical changes that occur between the period of somatic death and embalming
post mortem interval
102
The ________ the time between death and embalming, the ______ changes will occur:
longermore
103
changes in form of state of matter w/o any change in chemical composition.
post mortem physical changes
104
the cooling of the body. Post mortem cooling of the body to the surrounding temperature
algor mortis
105
The internal organs will cool ______ than the surface tissue
slower
106
Intrinsic factors (within the body) influencing the rate of algor mortis
Corpulence Age Cause of death
107
(the amount of adipose tissue)
Corpulence
108
why is age an intrinsic factor influencing the rate of algor mortis?
a child will cool faster than an adult. Also because of less adipose tissue
109
febrile diseases (fever) will _____the onset of rate of algor mortis
slow
110
wasting diseases (cancer) can _____ the onset of rate of algor mortis
speed
111
Extrinsic factors (outside the body) influencing the rate of algor mortis
The amount of clothing covering the body.The temperature and humidity.Embalming influence - cooling of the body will slow the onset of decomposition. (this is the reason for refrigeration)
112
can also occur post mortem. A reason for elevating of the head and feet during embalming.
hypostasis
113
Because of an increase of moisture, bacterial activity could be high. Why?
because of a warm moist environment increases bacteria activity
114
Increase moisture will _________ the preservative demands for body regions in which hypostasis had occurred
increase
115
Hypostatis will cause this. It is the settling of blood brings a discoloration that appears with 1/2 to 2 hours after death. This is a post-mortem intravascular blood discoloration that occurs as a result of hypostasis. Known as post- mortem lividity or cadaveric lividity. The discoloration may first be noticed as a dull reddish patches. As it becomes more established, it can take on a deep reddish-blue appearance. This occurs within the blood vascular system.
livor mortis
116
Can liver mortis be removed with normal arterial injection and venous drainage? Yes/No Why?
Yesbecause it's intravascular
117
At death blood will shift to the _________ of the vascular system. During embalming it is the exception to find blood in the _______ when opened.
venous sidearteries
118
also known as dessication - The loss of moisture or removal of water from the dead human body.
dehydration
119
The main cause of dehydration is either:
Surface evaporation Embalming solutions Hypostasis
120
Primary cause of dehydration because of air movement over the body causes the loss of moisture.(in particular the hands and face, lips, ears, and eye lids loose moisture the fastest. The reason to put moisturizer on the face and cover.)
surface evaporation
121
Why would embalming chemicals be a cause of dehydration?
they are a dehydrating chemicals
122
the gravitation of fluid
hypostasis
123
What are the ante mortem (agonal) changes that were discussed for this exam?
```
thermal changes
blood changes
moisture changes
trans location of microorganisms
gases in tissues
```
124
What are the post mortem physical changes?
```
algor mortis
hypostasis
livor mortis
dehydration
increase in viscosity
imbition
```
125
in reference to corpulence: the larger individuals cool _______; thin individuals cool ______ because of _____________
slowly
faster
adipose tissue (fat).
126
What is the reason for refrigeration?
to slow down the onset of decomposition
127
the increase in viscosity or thickness of blood, will result in?
the formation of blood clots
128
types of clots which form after death due to location of blood or increased viscosity of blood. They are usually easily removed in embalming
post mortem clots
129
a type of post mortem clot- they are long, dark red and stringy (look like currant jelly) - Fast forming and most common
Currant jelly clots
130
a type of post mortem clot- Slow in forming. Usually small and yellow in color formed after death. Usually more will be present in sudden death
Chicken fat clots
131
The (swelling of tissue) absorption of the fluid portion of blood by the tissues after death resulting in post mortem edema, excess fluid. Seen primarily in the organs of the body.
Imbibition - To imbibe
132
Post Mortem cooling of the body slows the onset of rigor mortis and decomposition. Helps keep the blood in a liquid state
Algor Mortis
133
responsible for livor mortis and later can cause post mortem stain. It also increases tissue moisture in dependent tissue
Hypostasis
134
causes a discoloration intravascular which possibly can be cleared up with normal arterial injection and venous drainage. It can also expand the capillaries. The fluid in the body gravitates as a result of hypostasis into the dependent parts causing discoloration because of an excessive amount of fluid. It has filled up the capillaries causing them to expand which will allow the fluid (mostly blood) to escape from inside the vessels (intravascular) to outside (extravascular) the vessels into the capillaries. Once outside the vessels (extravascular), it can cause post mortem stain and also cause edema (excess moisture).
Livor mortis
135
accompanied by increased blood viscosity. This forms blood clots. This darkens the skin surface and cannot be bleached. It also causes wrinkling and shriveling of the features. if extreme enough, can retard decomposition and preserve the body, but you have a bad restorative problem.
Dehydration
136
Increase in blood viscosity does what? .and also Increases resistance to arterial injection and hampers drainage.
thickens the blood and coagulation
137
changes which occur in the body after death, which also result in a change in chemical composition.
Post mortem chemical changes
138
What are the post mortem chemical changes?
Post mortem stain Post mortem caloricity Rigor mortis Change in pH Decomposition
139
an extravascular color change that occurs when heme, released by hemoglobin of red blood cells, seeps through the vessel walls and into the tissue. The blood is breaking down and decomposing which begins within 6 to 10 hours. This cannot be removed because it is extravascular. results from hemolysis (blood break down) specifically, the red blood cells.
Post mortem stain
140
the destruction or bursting of red blood cells that liberates hemoglobin. begins approximately 6 - 10 hours after death (post mortem cellular death). Since post mortem stain is extravascular, it generally will not be removed with normal arterial injection and venous drainage.
Hemolysis -
141
What can you do to eliminate having to use a lot of opaque cosmetics on post mortem stain?
Post mortem stain may be bleached (with bleaching agents) as a form of treatment (cavity fluid or phenol placed on the affected area.)
142
most permanent blood discoloration that we, as embalmers face
Post mortem stain
143
The slight rise in the body temperature following somatic death. Results from continued cellular metabolism after somatic death. This occurs until the entire oxygen supply is used. Usually, found in cases of sudden death – heat is continually produced after death by metabolism of food products in tissues. Various methods of cooling the body, such as circulation have stopped. Therefore, heat accumulates & body temperature rises.
Post mortem caloricity
144
The post mortem, temporary, stiffening of the body muscles due to a natural chemical body process. (*NB define: Post mortem stiffening of body muscles by natural body process).
Rigor mortis
145
marks the end of muscle cell life. Generally appears in the average body 2 to 4 hours after death
Rigor mortis
146
the complete muscular relaxation
Flaccidity
147
the relaxation of the muscles immediately after somatic death. (Dead less than 4 hours)
Primary flaccidity (flaccid / soft)
148
the relaxation of the muscles after rigor mortis passes in an unembalmed body when the body relaxes for the second time. (Dead more than 4 hours) The pH has gone from lowest reading of 5 back to normal alkaline side.
Secondary flaccidity
149
*****Since rigor mortis, is defined as postmortem stiffening of body due to changes in ph. Maximum rigidity for rigor mortis would be ? on pH scale.
5
150
Order of appearance and disappearance of rigor mortis:
1. Eyes 2. Face 3. Neck 4. Upper extremities 5. Trunk 6. Lower extremities Rigor mortis will leave in the same order.
151
PHYSICAL METHODS OF REDUCING RIGOR MORTIS
Flexing the fingers, wrists, arms, and legs. Extending the arms and legs. Rotating the jaw and neck to loosen the muscles. Massaging- bathing and massage the body prior to embalming.
152
Rigor mortis - Influence on embalming
May be difficult in establishing a position of the body. May be difficult in posing the features. Gives a false sign of preserved tissue. May restrict fluid distribution - because arteries are surrounded by muscles which are restricted because of rigor mortis.
153
The (acidic or alkaline ???) pH does not provide a good medium for reaction with the arterial fluid after secondary flaccidity preservative demand increases.
acidic
154
Initial softness of the remains after death
Primary flaccidity
155
pH has gone from lowest reading of 5 back to normal alkaline side.
Secondary flaccidity
156
The order of rigor would be
primary flaccidity, maximum rigidity, and secondary flaccidity
157
Muscle in which rigor mortis is present will not decompose. Why?
The acid present inhibits bacterial activity. Rigor mortis causes the body to be more acidic which kill bacteria. Bacteria likes a slightly alkaline pH.
158
0-7 on pH scale
acidic
159
7-14 on pH scale
alkaline
160
Normal pH of the blood and tissue of the body
approximately 7.4
161
After death, lactic acid begins to accumulate in the muscle tissue (results in rigor mortis). The pH will drop to an acid level of 6 or below. As protein breaks down (decomposition), there is a gradual buildup in the tissue of nitrogen products such as ammonia. When decomposition occurs, the body goes to the acidic.The ammonia neutralizes the acids in the tissue. Therefore, the pH of the tissues becomes alkaline above 7. Because the ammonia present acts to neutralize formaldehyde, there is a greater preservative demand during decomposition. A greater strength of formaldehyde may be needed.
--
162
Separation of compounds into simpler compounds substances by the action of microbial and/or autolytic enzymes
Decomposition
163
Types of decomposition.
Proteolysis Lipolysis Fermentation Saccharolysis Hydrolysis Autolysis
164
decomposition or breaking down of any type of protein (prote-protein) (olysis- decomposition). Can occur in either the presence or absence of oxygen
Proteolysis
165
decomposition of proteins by action of enzymes from anaerobic (absence of free oxygen) bacteria. This form was named for the horrific smell that makes you puck. This form of proteolysis advances much quicker than the form in the presence of oxygen.
Putrefaction
166
decomposition of proteins by enzymes of aerobic (the presence of free oxygen) bacteria
Decay
167
The decomposition of fats (lipoi-fats) (olysis-decomposition). This will not have an effect on embalming. One substance formed as a result is adipocere (grave wax).
Lipolysis
168
begins within days of death and becomes visible in about 3 months. results from lipolysis - decomposition of fats
Adipocere
169
the bacterial decomposition of carbohydrates. The carbohydrates are breaking down.
Fermentation
170
the decomposition of sugars
Saccharolysis
171
For testing purposes the definition to use is the following: The splitting or tearing apart of compounds by the addition of water. This the key method in which decomposition occurs. (This is the definition on the slide--- A reaction in which water is one of the reactants and compounds are often broken down.)
Hydrolysis
172
self destruction of cells; decomposition of all tissues by enzymes of their own formation without microbial assistance.
Autolysis
173
(cell organelle that contains digestive enzymes) in autolysis.
lysosomes
174
When the pH of the tissue becomes acidic, what does it do? (associated with hydrolysis). In the presence of water, the released enzymes begin to digest ___________, __________, and ________
it causes the lysosomes to rupture
| carbohydrates, protein, and fats.
175
Signs of decomposition:
```
Color change
Odor
Purge
Accumulation of gas
Desquamation (skin slip)
```
176
first external sign of decomposition is
color change over the lower quadrant of the abdomen.
177
the odor of decomposition is ?
penetrating, nauseating
178
the post mortem evacuation of any substance from an external body orifice as a result of pressure.
purge
179
in decomposition, there will be an accumulation of gas where?
viscera, cavities and other body tissue.
180
a separation of the epidermis from the underlying dermis, resulting in a sloughing of the epidermis.
Desquamation (skin slip)
181
the building blocks of proteins
amino acids
182
the building blocks of fats
fatty acids
183
carbohydrates break down into?
simple sugars (monosaccharide, polysaccharide, disaccharide)
184
results from the breaking down of amino acids (initial breaking down of protein) within the intestinal tract
Ptomaines
185
types of ptomaines produced
Putrescine Cadaverine Indole Skatole
186
type of ptomaine produced that causes a terrible putrid odor
putrescine
187
type of ptomaine produced which is the smell from dead unembalmed bodies
cadaverine
188
End products of decomposition: (last or end products of decomposition)
Carbon dioxide – waste gases Water Ammonia Hydrogen Hydrogen sulfide Nitrogen Methane – marsh or swamp gas Phosphoric acid – element phosphorus Sulfuric acid Mercaptan
189
if there is a strong smell of urine, the arterial fluid strength must be __________. Why?
increasedNitrogen weakens arterial fluid
190
Order of decomposition of body compounds.
Carbohydrates - fermentation Protein - Putrefaction Fats - lypolisis Bones - longest to decompose, if at all.
191
regardless of age or sex, the first organs to decompose would be?
the lining membrane of the trachea and larynx, except for the brain of an infant and the pregnant uterus
192
last organs to decompose
Non-pregnant uterus or large blood vessels
193
intrinsic Factors governing decomposition
Corpulence -Cause and manner of death -AgeAmount of bacteria present in and on the body.SexPharmaceutical agents
194
A heavy person will decompose _____ than thin persons.
faster
195
a body with infectious diseases will decompose?
faster
196
young adults and adults would decompose _______ than infants and elderly.
slower
197
extrinsic factors governing decomposition
TemperatureHumidity - Bacterial and parasitic activity- not on the body, but attracted to the odor of the decomposed, unembalmed body. Organisms that contain their food from dead organic matterVermin including maggots, lice, and rats.
198
optimum temperature for bacteria growth.
98-100 F
199
minimum temperature for bacteria growth
32 F
200
maximum temperature for bacteria growth
120F
201
Body coolers should be set about (how many degrees). this will retard, but not stop decomposition
32-40 F
202
what happens when the temperature exceeds 120 F
the body is destroyed
203
warm moist air will _________ decomposition.
accelerate
204
Could agonal edema and agonal dehydration occur at approximately the same time in the same body?
Yes, one area may become edematous because of moisture that has left, or dehydrated, another area.
205
loss of tissue just prior to death, could result in thickening of the blood, dehydration of certain tissues
Emaciation
206
The consideration given to the dead body prior to, during, and to prescribe and apply the proper embalming technique, and after the embalming procedure is completed; documentation is required.
Embalming analysis (case analysis) -
207
1. Cause and Manner of death2. Body Condition3. Discoloration – possible to treat?4. Postmortem changes – chemical or physical changes5. Drugs – legal & otherwise
Intrinsic Factors
208
1. Environmental (humidity, MO’s, vermin temperature).2. Postmortem interval – time posses who death occurred & embalming is preferred.3. Embalmer
Extrinsic Factors
209
records all information concerning the case, embalming procedure and other important information concerning the case.
Embalming case report
210
It is important to make certain that permission has been given for _____________.
embalming
211
Initial treatment of the body should INCLUDE the following, but NO SPECIFIC ORDER is required.
1. Spray a disinfectant on the sheets before removing.2.The body should be positioned in the center of the embalming table with the head slightly higher than the rest of the body.3.Remove and record all clothing and personal effects, such as jewelry, (valuables should be securely stored until they can be returned to the family).4.Disinfect the clothing when necessary.5.Remove medical dressing, bandages or wrappings.6.Topical disinfecting (either spray or wash).7.Disinfect the oral and nasal cavities.8. Relieve rigor mortis. 9.Position the head on a head rest so the neck is aligned in such a way that it will not interfere with fluid distribution or drainage.10.The head may be tilted to the right, approximately 15 degrees (slightly), which is the generally preferred casketing position.11.Place the hands in the desired position.12.Use additional impermeable posing devices as needed to position the body correctly
212
The purpose of this is to create feature naturalness (order optional).
Posing the features
213
Posing the features include the following...
1. Shaving2. Closing eyes3. Mouth closure4. Casketing
214
When treating the body we should __________ a __________ on the _______________ before removing.
spray disinfectant
| sheet
215
The body should be _______ in the ________ of embalming table with the head ____________ than the rest of the body.
positioned
center
slightly higher
216
________ and _______ all clothing and personal effects, such as jewelry. Valuables should be securely stored until they can be returned to the family
remove
| record
217
_________ the clothing when necessary
disinfect
218
_________ medical dressing, bandages, or wrappings
remove
219
____________ the oral and nasal cavities
disinfect
220
_____________ rigor mortis
relieve
221
___________ the head on a _____________ so the neck is aligned in such a way that it will not interfere with _________________ or ___________
position
head rest
fluid distribution
drainage
222
The _____ may be ______ to the ________, approximately _______ degrees (slightly), which is the generally preferred casketing position
head
tilted
right
15
223
Place the _________ in the desired positon
hands
224
Use additional _________________________ as needed to position the body correctly
impermeable posing devices
225
(if required) - in many cases, it improves the appearance of the deceased and assists in the application of cosmetics.
shaving
226
Note on shaving:
The embalmer should check with the family with respect to a mustache or beard. Also, check concerning facial hair on females and infants. It is easier to shave a body after embalming than it is to restore the hair.
227
Steps to know when shaving....
1. Apply warm water to the face with a washcloth.2. Use shaving cream or soap to lather the face.3. Shave in the direction of hair growth.4. Use small short repeated strokes.5. Clean the razor frequently with warm water.6. Use a small piece of cotton, washcloth, or gauze to pull the skin taut and make an even surface for shaving.7. After shaving, wash the face and apply massage cream.
228
Massage cream will:
1. Help retard dehydration.2. Provide a base for massage.3. Help to cleanse tissue pores.4. Provide a base for cosmetics.
229
Steps when Closing the eyes...
**Important note: do not manipulate the eyelids any more than necessary.1.If not already done so, disinfect the ocular cavity.2.Hint -a small amount of massage cream under the lid may help with closure and protection against dehydration. Place cream on eye caps.3. Eye caps may be used to help provide proper contour of the eyes.4. When closing the eye, the lids should meet in a gentle downward arc with the line of closure with the upper lid covering two-thirds of the eye; lower lidcovering one-third.5. Eyelids abut, not overlap.
230
Sunken eyes
1. Place non-absorbent cotton and eye caps over the cotton.2. Inject massage cream or tissue builder behind the eyeball.3. Inject massage cream or tissue builder directly into the eyeball.
231
Enucleated eyes
1. Remove any packing.2. Cauterize (to burn with a caustic material) the socket - this will close the small vessels to prevent leakage.3. Apply filler a. Mortuary putty and eyecap. b. Cotton and eyecap. c.Prosthesis
232
Excessive manipulation of the lip tissue may cause
distention.
233
Sharp teeth may cause injury to the
operator (embalmer).
234
Steps for Mouth closure
a. Relieve rigor mortis b. Disinfect and cleanse oral cavity.c. Remove, cleanse and disinfect dentures. d. Observe normal bite. I. Dentures II. Mouth formers III. Natural teeth
235
Mouth can be secured with one of these 4
I. Needle injectorII. Masculature sutureIII. Mandibular sutureIV. Wire through the bone (only in certain situations)
236
If the lips will not stay closed try one of these 6 things
I. Use creams to assist with closure.II. Use wet cotton strips.III. Use adhesives.IV. Hypodermic of masseter muscle.V. Subcutaneous sutureVI Wax
237
Observe the following points of natural expression
I. Slight protrusion of the upper lip.II. Corners of the mouth slightly raised.III. Five arcs in the line of the upper lip.
238
Things to do with Extreme prognathism (Buck Teeth)
I. Obtain written authorizationII. Realign teethIII. Extract teethIV Let teeth show
239
Casketing
1. Bring casket as close to the table as possible.2. Prepare the casket prior to placing remains in it. Raise bed to highest point.3. Place head of the remains as close to the head of the casket as possible(except when the remains are short).4.Depress the right shoulder slightly - which turns the body slightly to the right.5 the head should be slightly higher than the hands.6. Adjust hands, clothing and any other item.
240
this was not adjustable and was very impractical. Was placed between the sternoclavicular articulation and the chin.
The Bone Separator
241
this form of mouth closure is used by many practicing embalmers. Operates on a principal of a trip hammer.
injector needle
242
This mouth closure is a suture made through the frenulum of the lower lip (close to the bony structure). MUSCULATURE
Frenulum to Septum Suture
243
The ultimate development of sutures. Threaded needle using long strong linen thread. Placed in center of the mouth directly behind the teeth and pointed downward.
Septum- Mandible Suture
244
Suture that may be used ONLY on those whose teeth are firm. Secure two fine linen threads...one passed around the upper right incisor tooth and tied at the gum line, and second is passed around the corresponding lower tooth and tied at the gum line.
Dental tie
245
Due to disease or injury it may not be possible to use sutures or injector. Then pass a wire through small holes drilled into the mandible and maxilla.
wire through bone
246
commonly used on body whose lips have a tendency to part in spite the fact the jaw has been raised to its normal position. IS NOT A TRUE METHOD OF MOUTH CLOSURE. wet cotton strips
The cotton fold
247
hypodermic needle with concentrated fluid. insert into the masseter muscle with the entry through skin beneath lobe of the ear.
masseter hypodermic
