Mortuary Service

Mortuary Service Arif Raza

Definition • A morgue or mortuaryis used for the storage of human corpses awaiting identification, or removal for autopsy or burial, cremation or some other post-death ritual

Introduction • Place for safe and secure preservation of the dead bodies • Preserved till taken away for final rites • In small hospital it may be limited to storage space for a body or two • In large hospital like medical college, full fledge department of forensic medicine

Introduction • Standard of facilities are generally not of the acceptable level • Often treated as place of dumping dead • Usually found unhygienic with rodents and foul smells • Creates problem for public in vicinity • Arrangement in mortuary shall ensure physical safety and integrity of body and prevent its deterioration / decomposition

Objectives • Safe storage, preservation and handing over of the correct body to the correct recipient in the correct condition • Prevent public nuisance because of foul smell created by decomposing bodies and unhygienic sanitary conditions or improper disposal of the biomedical waste • Due respect towards body to uphold the dignity in death

Functions • Storage of dead bodies till taken away • Safe preservation to prevent deterioration • Physical security against theft • Conduct of autopsies • Embalming of the bodies • Handing over of body to authorized • Maintenance of record of all bodies

Structure • Located on ground floor preferably in the rear part • Away from patient / visitors area • Away from residential areas • Should have direct access to the external traffic route • Road should provide accessibility to hearse van

Structure • If meant only for storage, • body storage room with refrigerated chambers • Janitors closet • Trolley bay • Relative waiting • Religious rites room

Structure • If meant for autopsies • Autopsy room • Viewing room • Change room • Toilet / shower • Sluice room • Police room

Structure • Space allocation and the number of body chambers • In accordance with the body load • Avg. 1 death per bed per year • Depends upon size and type of the hospital • Policy of hospital regarding accepting bodies from outside • Hospital with 50-100 beds should have capacity for 2 bodies and with 200 beds at-least 3 bodies

Structure • Space in teaching and research hospitals may be much higher • Large hospitals should have space for safe storage of bodies in mass casualty situation • Sign posting

Structure • Engineering support • Lighting (1500-2000 Lux at mortuary table, 200-300 Lux in the body storage) • Ventilation and exhaust system • Body chambers must have alternate source of power • Proper housekeeping • Prevention from pests / rodents

Equipment • AC chambers (3 Sq M per body) of stainless steel with rails for sliding the trolleys in/out easily • Should have humidity and temperatur control (3.5 – 6.5 deg C) • Separate thermostat for every chamber • Bigger mortuary may have walk in cold chambers • Separate space for decomposed and infected bodies (freezers)

Equipment • Autopsy room should have stainless steel tables with slope and sink • Autopsy instruments • Containers for organs / tissues • Portable X-ray machine • View box

Equipment • Other equipments • Stretcher • Gloves (Leather / Rubber) • Overcoats • Boots, caps • Soap and disinfectants • Cotton cloth

Mortuary cold chambers • Chambers used to preserve decomposition of dead body • Two types • Positive temperature (2 – 4 deg.) keeps body for several weeks • Negative temperature (-15 to -20 deg.) used at forensic institutes. Decomposition is totally halted

Staffing • No dedicated staff in small hospital where autopsies are not carried out • Under pathology department or A & E department • For large hospital dedicated staff is required for maintenance, safe storage, record keeping, assisting in autopsies • Specialist in forensic medicine may be required

Process • Policies and procedures for safe and secure storage and preservation of the bodies • Acceptance / non-acceptance of bodies • Transportation of body from inpatient area to mortuary • Identification of bodies • Receiving of bodies including records • Safety and security of bodies with medico-legal concern

Process • Handing over of body • Carrying out of autopsies • Maintenance of high level of hygiene and sanitation • Disposal of biomedical waste • Control of infections • Availability of embalming facility • Respect due to dead

Monitoring Parameters • Incidence of theft of bodies / body parts • Incidence of handing over wrong bodies to claimant • Incidence of deterioration • Level of hygiene and sanitation

Thank you

Mortuary Service