CHAPTER 2

1. CHAPTER 2 FUNDAMENTALS OF EMBALMING

2. Terminology • The American Board of Funeral Service Education definition of Embalming is- a process of chemically treating the dead human body to reduce the presence and growth of microorganisms, retard organic decomposition, and restore an acceptable physical appearance.

3. Terminology • Decay- decomposition of proteins by enzymes of aerobic bacteria. decompose is another word for Decay. • Putrefaction- Decomposition of proteins by the action of enzymes from anaerobic bacteria. • What is the difference between aerobic and anaerobic bacteria?

4. Terminology • Aerobic means with air. • Anaerobic means without air. • Therefore, Decay is what happens to the body because of the air around it, such as a body lying unfound in the mountains for several days, and Putrefaction is what happens inside the body where there is no air, like in the case of gangrene.

5. Terminology • Decomposition- the break down of compounds into simpler substances by the action of microbial and/or autolytic enzymes. • Preservation- the science of treating the dead human body chemically so as to temporarily inhibit decomposition.

6. Terminology • Preservative- Chemicals which inactivate saprophytic bacteria, render unsuitable for nutrition the media upon which such bacteria thrive, and which will arrest decomposition by altering enzymes and lysins of the body as well as converting the decomposable tissue to a form less susceptible to decomposition.

7. Terminology • Shannon’s definition of Preservative- a preservative will stop bacteria that live off of dead tissue from thriving and will change the chemical make up of the proteins that destroy blood cells and tissue in response to the dead body; therefore slowing down the decomposition process.

8. Question? • Can preservation happen naturally or does man have to cause preservation to occur?

9. Answer • Depending on climate, temperature, and the surrounding environment, preservation can occur naturally. Can you think of an example? Would a body in The Sahara Desert preserve itself naturally? What about the Rainforest? Why or why not? • However, the type of preservation required for recognizable viewing needs to be accomplished by man.

10. 4 Embalming Treatment Classifications Arterial Cavity Surface and Hypodermic

11. Arterial Embalming • Can be used to prepare general or localized body region • A limb or an entire body can be arterially embalmed. • Is used with both autopsied and un-autopsied remains.

12. Arterial Embalming • Consists of injecting 3 to 4 gallons of preservative solution under pressure, into the circulatory through an artery while concurrently draining blood from a vein. • Arterial fluid flows through the bodies circulatory system but not through the heart. • Arterial embalming is also referred to as capillary embalming.

13. Arterial Embalming • 85% of the bodies blood is contained in the capillaries. The embalming fluid must go through the capillaries to enter the tissue spaces where it makes contact with the cells of the tissue and the bodies protein thus embalming the body.

14. Cavity Embalming • What is the difference between ARTERIALLY EMBALMING and CAVITY EMBALMING? • Can you perform one without doing the other? • Which is more effective?

15. Cavity Embalming • Cavity embalming is performed after arterial embalming. • It is the direct treatment of the bodies cavities. • Those cavities include abdominal, thoracic, and pelvic.

16. Cavity Embalming • The process is carried out by aspirating the cavity and then filling it with concentrated chemicals. • The trocar is the instrument used in the cavity embalming process. • The purpose of cavity embalming is to reach the hollow organs that are not penetrated by the arterial embalming solution.

17. Cavity Embalming • It is important that the organs gases and solids be released through the cavity embalming process. • Approximately 1 to 2 16oz. Bottles of cavity fluid is used to penetrate the organs and preserve them.

18. Cavity Embalming • Cavity Embalming may be performed more than once on a body in the case of purge or odor. • There is an ongoing debate among embalmers as to whether a body should be cavity embalmed immediately following the arterial embalming or after a period of time (2-24 hours). We’ll explore this in Embalming Theory II.

19. Hypodermic Embalming • Hypodermic embalming is the subcuticular injection of suitable preservative chemical directly into the tissues. • It is accomplished by use of a syringe and needle, or an infant or standard trocar. • The treatment area can include finger tips, the cavity walls of an autopsied body, or a limb that won’t accept arterial embalming. • What other areas can be hypodermically embalmed?

20. Surface Embalming • Surface embalming is the application of an embalming chemical directly to the surface of the tissues. • The chemicals are applied with an aerosol spray, or painted on with a brush using a liquid or gel, and can even be applied using cotton as a surface compress.

21. Surface Embalming • Areas that are surfaced embalmed can be under the eyelids, the cavity walls in autopsied bodies, and underneath the cranial scalp when a cranial autopsy has been performed.

22. Chronology for Embalming the UnautopsiedAdult Body • Although these steps vary from one embalmer to another this is a good list to get you started. As you begin to embalm yourself, you will develop your own style. You will learn different steps from different embalmers, and the funeral home you work for may even dictate exactly how the embalming procedure is to be done.

23. Unautopsied Adult Body • 1. Remove all clothing and record any personal effects such as a ring, watch, or dentures. • Remember that if a family wants the clothing back OSHA requires you must first wash it before returning it. Always ask if the family wants the sheet back if the transfer occurred from the home.

24. Unautopsied Adult Body • 2. Disinfect the body with a droplet spray or disinfectant solution. Disinfect and clean all of the body orifices with the solution and swab them clean. • 3. Position the body. Relieve any rigor mortis simply by manipulating the area with the rigor. Tilt the head slightly to the right and elevate above the chest.

25. Unautopsied Adult Body • 4. Wash the body with a germicidal soap. This is the time to clean underneath the nails. Cleaning the nails after the arterial injection can cause the skin to tear. • 5. Shave facial hair, only if permission has been given. DON’T SHAVE A WOMAN OR CHILD WITHOUT PERMISSION as the book suggests. A family sued a funeral home once because the embalmer plucked a hair from Aunt Ida’s mole!

26. Unautopsied Adult Body • 6. Close the mouth. We will learn the different methods of closure later on in the course. If the dentures are available and you use them, don’t forget to clean them before you put them in the mouth (also remember the GROOVE). Close the eyes using an eye cap. Place massage cream on the entire face and neck at this time to prevent drying of the tissue during the arterial injection.

27. Unautopsied Adult Body • Number 6 is also referred to as “setting the features”. • 7. Select the artery and vein that will be used in the process. • 8. Select and prepare the fluids that will be used.

28. Unautopsied Adult Body • 9. Inject the embalming solution and ask these questions: • How much solution is needed? • What should the solution strength be? • Which areas are and which are not receiving embalming fluid? • When has the body received the right amount of solution? • We will answer these questions in detail later.

29. Unautopsied Adult Body • 10. After the arterial injection, determine if surface of hypodermic embalming is required. • 11. Remove the arterial tubes and drain devices. Dry and tightly suture incisions. • 12. Aspirate the body. • 13. Inject the cavity the cavity fluid.

30. Unautopsied Adult Body • 14. Remove any surgical drains, colostomy bags, or other such medical devices that were on the body from the hospital. Open, drain, disinfect, and suture these areas. • Why not remove the drains and lines from the body “prior” to this point? • 15. Rewash the hair and body. Dry the body. Pack all of the orifices with cotton. Contrary to the book, you do not need to glue the eyes and mouth shut on every person.

31. Unautopsied Adult Body • 16. Reaspirate if necessary. • 17. Clean and fill the embalming machine with water. Clean all instruments used during the procedure and properly dispose of all waste. • 18. Dress the body in plastic garments if necessary. These should not automatically be used.

32. 19. Restorative Art treatment can now begin.

33. Chronology for the Autopsied Body • 1. Spray the body down with a disinfectant and then wash the body with a liquid soap. • 2. Open the temporary autopsy sutures and if present remove the bag containing the viscera, place it in a bucket and pour a bottle of cavity fluid over it. • 3. Relieve the rigor mortis. • 4. Shave the facial hair,with PERMISSION

34. Chronology for the Autopsied Body • 5. Clean the oral cavity and close the mouth. • 6. Clean the eyes and close them with eye caps. • 7. Prepare the arterial solution. • 8. Raise the arteries to be used. This will be much more difficult because each limb has to be embalmed separately.

35. Chronology for the Autopsied Body • 9. Inject the legs. • 10. Select the subclavian or axillary arteries. • 11. Inject the arms. • 12. Inject the head using the carotids. Inject the left side first. • 13. From within the cavity using a small trocar inject the buttocks, trunk walls, shoulders, and back of the neck.

36. Chronology for the Autopsied Body • 14. Aspirate and dry out all of the cavities. • 15. Replace the viscera into the cavities. • 16. Use the baseball stitch to suture the incision. • 17. Anchor the calavarium in place and suture the scalp closed from the right to the left. • 18. Wash and dry the body.

37. Chronology for the Autopsied Body • 19. Apply a surface sealer to the autopsy sutures. • 20. Glue the mouth and eyes, ONLY IF NEEDED. • 21. Place the body in plastic garments, ONLY IF NEEDED. • 22. Restorative Art can now begin.

38. Chronology for the Autopsied Body • We will go into much greater detail on all of these autopsied and unautopsied steps before the end of the school year. • Don’t panic if you’re not understanding all of this, we’ll keep putting it together as we go.

39. Refrigeration and Identification • Most bodies using the refrigeration don’t need any type of handling. • Those that do are usually prepared for identification purposes only. Each funeral home has their protocol for such an event. Many simply set the features and place the remains in a hospital gown, cover the body with a blanket, and lay them on a gurney.

40. Refrigeration and Identification • The book is very detailed about preparing remains for an identification. I don’t know of any funeral home that goes to this extreme. And if they are, they need to be charging the family a fee because what is outlined in the book can take almost as long as an embalming.

41. Refrigeration and Identification • If you work for a funeral home check into the procedure for an identification and storage of the remains.