RA II Discolorations, Bleaching, and Stain Removers

Define discoloration

Any abnormal color in or on the body.

Define stain

To discolor with foreign matter; an area so discolored.

Define disease

Any deviation from, or interruption of, the normal structure or function of a body part, organ, or system.

Define trauma

Physical injury or wound caused by external force or violence.

Define decomposition

Separation of compounds into simpler substances by the action of microbes and/or autolytic enzymes.

Define lividity (livor mortis)

Postmortem intravascular red-blue discoloration resulting from hypostasis of blood

Define hypostasis

Settling of the blood and/or other fluids to dependent portions of the body.

Define bleaching agent

Chemicals that lighten or blanch skin discolorations.

Define bleaching

The act of lightening a discoloration

Define hemolysis

The destruction of red blood cells that liberates hemoglobin

Define blanch

To whiten by removing color; to make pale.

Define phenol (carbolic acid)

Antiseptic/disinfectant employed to dry moist tissues and to bleach discolored tissues.

What CAN be removed with embalming techniques?

discolorations

What CANNOT be removed with embalming techniques

stains

How can someone determine a discoloration from a stain pre-embalming?

• If blanching occurs via digital pressure it is a discoloration

• If blanching does not occur, the blood has hemolyzed, released hematin into the tissues, causing a post-mortem stain.

What are some pre-embalming causes of discolorations and stains?

• Disease

• Decomposition

• Medical Treatment

• Trauma

• Lividity

• Postmortem Stain

What are some embalming causes of discolorations and stains?

• Too strong an arterial injection

• Inadequate drainage

• Formaldehyde/jaundice reactions

What are some post embalming causes of discolorations and stains?

• Razor burn

• Graying

• Post-embalming decomposition

• Dehydration

What are the treatments available for discolorations and stains?

• Bleaching

• Cosmetics

• Both Bleaching and Cosmetics

List some common bleaching agents in the prep room

• Cavity fluid

• Phenol and/or alcohol

• Preservative gel

• Special-bleaching fluid

What are the effects of bleaching agents?

• Lightening of the stained area

• Lightening of the non-stained area

• Possible dehydration

• Fixation of tissue

What are the bleaching techniques that we as embalmers use?

• Surface Compress/Pack

• Hypodermic Injection

Describe the Surface Compress/Pack bleaching technique

A cotton pack soaked in bleaching agent is applied to the discolored area (topical)

• Apply massage cream to surrounding tissues

• Cover the compress with plastic

• Check at intervals to monitor effectiveness

• Remove once stain is adequately lessened or removed

Describe the Hypodermic Injection bleaching technique

A syringe and needle are used to inject bleaching agent under the skin

• Apply massage cream

• Inject bleaching agent to entire stained area, superficially

• Seal the injection site with adhesive or sealer to prevent leakage

What should you always be cautious of when using phenol as a bleaching agent?

It can over-bleach and dehydrate an area of discoloration.

• Alcohol should be available to “neutralize” the phenol.

• If over-bleaching begins to occur, brush the area with alcohol to stop the process

What are surface stains?

Non tissue stains that include dirt, grease, and grime

What is used to remove adhesive tape on the body?

rubbing alcohol, ether

What is used to remove blood on the body?

cold water, ammonia (peroxide if fresh blood)

What is used to remove paint on the body?

turpentine, paint thinner

What is used to remove nicotine on the body?

lemon juice, household bleach

What is used to remove tar; varnish on the body?

acetone, commercial remover, liquid shampoo

What is used to remove iodine on the body?

alcohol

What is used to remove grease on the body?

ether, acetone, gasoline, liquid shampoo

What is used to remove oil on the body?

ether, gasoline

What is used to remove wax on the body?

ether

What is used to remove urine on the body?

ammonia

What is used to remove ink on the body?

lemon juice, petroleum jelly

What is used to remove glue on the body?

white vinegar, glue solvent

What is used to remove lipstick on the body?

Dry cleaning solvent

Define aspiration

To draw out liquids or gases by means of suction

Define cauterize

To dry tissue through the use of heat or chemical

Define electric spatula

An electrically heated blade, which may be used to dry moist tissue, reduce swollen tissue, or restore contour. (Also called a Heat Spatula)

What is swelling and distention?

Excessive accumulation of liquid or gas in the tissues or abnormal tissue growth.

What are the causes for swelling and distention pre embalming?

• Pathological (disease)

• Trauma

• Decomposition

• Improper handling or positioning of the body

• Medical procedures

What are the causes for swelling and distention during embalming?

• Excessive fluid injection and/or

• Insufficient drainage

• Improper embalming machine usage

What are the types of treatment for swelling and distention?

• Concentrated Arterial Fluid

• External Pressure

• Aspiration

• Channeling

• Incisions

• Surgical Reduction

How is concentrated arterial fluid used to treat swelling and distention in a decedent?

Inject a strong, dehydrating solution

• May mean doubling or tripling the arterial solution strength.

• This helps remove excess moisture

How is external pressure used to treat swelling and distention in a decedent?

• Manually Digital

  • manipulation with the fingers and hands

• Wet Cotton Compress Cold

  • water on cotton placed on swollen feature

• Collar

  • Pneumatic (compressed air, sand or water) collar around the neck

• Electric Spatula

  • Cover area with massage cream and then reduce with heat and a continuous, quick motion

All of these methods help remove/move excess moisture

How is aspiration used to treat swelling and distention in a decedent?

Removal of tissue or gas with a small trocar or a needle and syringe.

• Helps alleviate distention and swelling

How is channeling used to treat swelling and distention in a decedent?

Inserting a needle or trocar into a swollen area to make multiple “channels or canals” for the release of fluid or gas.

• Multiple channels are typically made from a single entry point.

• After channeling massage and/or gravity treatment enhance the removal of fluid or gas.

How are incisions used to treat swelling and distention in a decedent?

• Concealed

  • The first and preferred method

  • Under eyelid, inside cheek, behind lips

  • Make an incision and then apply manual pressure to squeeze out excess fluid

• Exposed

  • Least preferred method as incision is exposed

  • Combine with manual pressure and wicking

  • Requires suturing, waxing/cosmetic, possible surface leakage

• Wicking

  • Cotton is placed against the incision area to “draw out or wick” fluid away from the incision site.

How is surgical reduction used to treat swelling and distention in a decedent?

Usually the last option for swelling, with the exception of tumors or other hard masses.

• Remove tissue

• Dry and cauterize

• Seal the area and suture

• Wax and cosmetize as needed

What is desquamation?

The sloughing off of the epidermis wherein there is a separation of epidermis from the underlying dermis

Define epidermis

Outermost layer of skin

Define dermis (derma)

Corium or true skin; containing blood capillaries, nerve endings, sweat glands, hair follicles, and other structures

What can cause desquamation before death?

excessive exposure to:

• excessive heat or cold

• radioactive agents

• caustic chemicals

What can cause desquamation after death?

• Decomposition

• Inadequate embalming

  • inadequate volume of arterial solution

  • inadequate strength of arterial solution

  • inadequate distribution of arterial solution

How should desquamation be treated?

• Puncture and drain blisters that have developed

• Remove loose skin

• Surface compress of cavity fluid or phenol

  • Can be applied during or after embalming

• It may be necessary to hypodermically inject arterial fluid into the deeper area below the skin slip

• If the skin becomes dark and dry, wax and cosmetics can be applied.