(11) Decomposition

What are some predisposing factors to decomposition?

-Edema (water speeds up process and allows for putrefactive agents)
-Peritonitis (bacteria in gut escape into vascular system and rest of body)
-Second degree burn victims
-Gangrene
-Trauma
-Advaned pregnancy
-Febrile Diseases
-Septicemia
-Drowning

What is recommended for injecting a decomp case?

-Restricted cervical is the most recommended
-Six/multi point
-Both of these methods allow for greater control over the amount and strength of the fluid entering a particular area

Should you avoid preinjection?

Avoid

What type of arterial fluid should be used for decomp?

Specialty or high index fluid (25 index minimum)
-Minimum 2% solution strength
-Hypoderm or surface pack cavity fluid

How strong should the first gallon be for decomp?

a little weaker to take care of discoloration

What can be used for mild to moderate decomp cases?

Waterless mixture

How can you reduce the risk of swelling when injected a decomp case?

Use pulse

Use a strong solution, but

less volume

What pressure should you use for arms and legs when it comes to injection?

Higher pressure

What are some problems associated with rigor?

-Pre rigor: great absorption of preservative
-Rigor: little absorption of preservative
-After rigor: great preservative demand

What is an early sign of decomp for color?

Greening of RLQ

How can early signs of decomp manifest vascularly?

-Small veins in any area can become brown
-Livor mortis is present and only some discoloration is removed with injection
-PM stain is prevalent

How is odor an early sign of decomp?

-Caused by chemical groups called mercaptans and amines
-Produced by putrefaction
-Hydrogen sulfide and ammonia combine with mercaptans and amine

How can early signs of decomp appear in purge?

-Gas developed in the abdominal cavity
-Ruptured capillaries
-Congested lungs

How can early signs of decomp manifest with gases?

-Can cause purge
-Bacterial activty
-clostridium perfringens

What is desquamation?

-early sign of decomp
-Skin slip
-Resembles a bad sunburn
-Superficial tissues separate from skin

What can you do to treat early signs of decomp?

-Use warm water to mix fluid and STRONG solution
-Surface embalming/cavity packs

What are some pre-embalming treatments for advanced decomp?

-Residence removal, use rubber gloves, masks, rubber pouch or sheeting. Disinfectants and deodarant sprays
-Wrap body in wool blanket to absorb odor and liquid
-Remove as much of soiled clothing as possible and inform family that it will be destroyed

What are the embalming treatments for advanced decomp?

-If possible to inject carotids, inject abot 1 gallon of undiluted (minimum 30 index) arterial and add 32 ounces of coinjection. No drainage taken
-Aspirate and inject at least 48 ounces of cavity fluid
-hypo inject sidewalls and extremities

What are some post embalming treatments for advanced decomp?

-Place in zippered pouch and apply hardening/absorbing compound
-You can wrap in sheets then soak in cavity fluid
-Kitty litter works well for absorbing and controlling odor
-Glue bag with surface glue
-Place in another pouch