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Lesson 1.2 Instructor Notes

This document discusses post-embalming treatments and monitoring the body. It covers supplemental treatments for areas without arterial fluid, closing incisions with sutures or adhesives, removing invasive devices, treating swelling or discoloration, and inspecting the body for issues before it is casketed. Potential post-embalming problems like leakage, separated tissues, or purge are also outlined. The document provides detailed steps and considerations for proper embalming treatment and monitoring of the body.

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Caleb Flax
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31 views

Lesson 1.2 Instructor Notes

This document discusses post-embalming treatments and monitoring the body. It covers supplemental treatments for areas without arterial fluid, closing incisions with sutures or adhesives, removing invasive devices, treating swelling or discoloration, and inspecting the body for issues before it is casketed. Potential post-embalming problems like leakage, separated tissues, or purge are also outlined. The document provides detailed steps and considerations for proper embalming treatment and monitoring of the body.

Uploaded by

Caleb Flax
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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Lesson 1.

Treatment After Arterial Injection


Read the following from Embalming: History, Theory, & Practice by Sharon Gee-Mascarello (6th Ed.):

Chapter 15

Before progressing through the lesson, go to the Terms page and define each term
using the course glossary (or the book/notes if necessary.)

Discussion of Specific Points

I. Post-Embalming Treatments

A. Supplemental Treatments for areas that didn't receive arterial fluid

1. Surface embalming

a. Liquids

b. Gels

c. Powders

*Not as effective as gels or liquids

2. Treatments for facial areas

3. Hypodermic embalming

a. Much more effective than surface embalming

b. Techniques and considerations

B. Closure of Incisions

Two methods of closure: sutures & super adhesives. The text lists several steps
that must be taken before any incisions are closed.

1. Suturing: the text has several photos of the following stitches

a. Individual (Bridge) sutures


b. Baseball (aka Sail) suture: the most secure and most common type of suture.

c. Single Intradermal (Hidden) suture

d. Double Intradermal suture: very similar to single intradermal only TWO needles
are used.

e. Inversion (Worm) suture: same pattern as single intradermal only stitches are
parallel to incision.

f. Interlocking (Lock) suture

g. Continuous suture ("whip stitch") - temporary suture used by autopsy


technicians to close Y incisions; not a secure suture.

2. Direction of Suturing

a. The text lists the suggested direction of suturing common incision sites.

3. Super Adhesives

a. It is the instructor's opinion that the use of adhesives to close an incision is


necessary only where such incisions might become visible, such as an anterior
parallel incision in the cervical region.

b. Can also be used to close the scalp in a cranial autopsy.

C. Removal of Invasive Devices

1. Intravenous (IV) devices should be left in place until embalming is completed.


Swelling can occur if they are removed as arterial solution can enter the
extravascular spaces around the puncture and distend the area.

1. Pacemakers - can cause an explosion in the cremation chamber if incinerated.

a. Here is an interesting read from the Spring 2010 issue of Dodge Magazine about
the hazards of pacemakers and defibrillators.

b. The text cites certain "radioactive" units but this is no longer common.

2. Colostomy bag

a. The text states it can be removed before or after arterial injection

b. Your instructor recommends AFTER the embalming process; it can be unpleasant


to deal with during the entire process if removed at the beginning!
3. Surgical drains

D. Final Washing & Drying of the Body

E. Treatment of Ulcerations, Lesions & Discolorations

F. Treatment of Purge

The text suggests tightly packing the nasal passages, throat and rectum prior to
arterial embalming to reduce any purge. It is the instructor's opinion that these
orifices should be left open and any purge allowed to drain during the embalming.
This will eliminate it from the body during injection and should reduce the chances
of it appearing after embalming or even when the body is "in state." Packing of the
orifices should, in the instructor's opinion, be done after embalming and cavity
treatment is completed as cavity treatment can alleviate any pressure which may
be causing the purge in the first place.

G. Treatment of distension/swelling in visible areas

1. It is important to know the cause of distension before starting any corrective


treatments.

a. Distension from the embalming process (e.g. pressure or rate of flow is too
excessive, poor drainage, excessive massage, etc.)

b. Edema (gravitation, massage, channeling, application of pressure)

*Major problem in removing edema from face/hands is the wrinkling of the skin
that follows.

c. Gas

*Subcutaneous emphysema (e.g. due to CPR)

*Tissue gas - is there noticeable crepitation?

*The only way to remove gas is to lance and channel the area (after embalming!)

H. Inspection of mouth for purge/moisture & resetting features:

1. If cotton was used in the mouth and purge has occurred, it should be replaced
with new, dry cotton.

2. Gluing eyes & lips: Some firms have a policy of waxing the lips of ALL bodies to
prevent dehydration and/or cover wrinkles and imperfections. It is the instructor's
opinion that this is not necessary. Gluing the lips before application of cosmetics
will usually create a much more natural appearance and is MUCH less time-
consuming.

I. Plastic Garments

1. These will not be necessary on every case but do provide excellent (and
inexpensive) "insurance" against any unforeseen accidents (e.g. anal purge) which
might occur at extremely inopportune times (such as a family visitation.)

2. Types of plastic garments

a. Capri garment - a single unit of plastic clothing that combines pants and
stockings

b. Coverall

c. Unionall

J. Terminal disinfection

K. Personal Hygiene: "Wash your hands!"

L. Documentation

1. Embalming report

2. Shipping Information

II. Monitoring the Casketed Body

A. The text gives several examples of potential post-embalming problems

1. Cosmetic Corrections

a. Skin can darken overnight: decomposition or dehydration

2. Separated Tissues

a. Eyelids & lips

3. Leakage

a. The text lists several common areas of potential leakage


b. One not listed in the book (but quite common) is an undetected point where
trocar broke through during aspiration.

*It's important to always check the body before dressing to make sure no such
leaks have occured.

4. Purge

a. If purge develops while body is in state, reaspiration will be necessary.

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