Module 5

Describe the circumstances around dilution and Arterial Chemicals

They are designed to be diluted, and if used in a undiluted form can present the body in patches, which is irreversible.

Describe two factors of Impurities in water

Turbidity and Hardness. Turbidity is where the particles are suspended may effect blocking small capillaries.
Hardness is the presence of soluble calcium and magnesium compounds.

Describe a synergen

A chemical which when added to another chemical, increases its effect. Allows smaller quantities of formaldehyde to be used as it increases its effect.

Describe Cavity Fluids

Contain both a preservative and a disinfecting agent, this assists to wet the areas treated. There will be a natural dilution of the cavity fluid in the cavity.

Describe some additional chemicals you might find in fluids

• pre wash/co injection

• Jaundice

• Tissue gas

• Cauterant substances for surface application

• Wound/incision sealants

• Low formaldehyde chemicals

• Humectants

• Firming fluids

• Water correction

• Skin colour variants

• Tissue building

Describe the use of pressure and flow rate when injecting, what are the ideal PSI’s

Pressure and flow are interdependent. Fluid needs to be injected at a rate where the tissues will absorb without becoming distorted. When injecting towards the head, a 1.5-3 PSI should be used, and otherwise psi should not exceed 5.

What are the 7 pre embalming considerations to consider?

• Cause of death

• Infection

• Skin colour

• Dressing

• Age

• Climatic conditions

• Time between death and embalming

Describe the pre embalming considerations regarding; cause of death, infections, skin colour, dressing, age, climatic conditions, time between death and embalming

• Cause of death; Embalmers have no automatic right to know, but if the information can be found, then its an advantage

• Infections; The HOWIE report recommends that a FD should be informed when a person died of a infection, as with some infections, embalming should not be carried out, and extra precautions can be put in place.

• Skin colour; deaths from carbon monoxide poisioning, asphyxia, jaundice may bcause skin colourations, and people with darker skin will require some oil as their skin tends to be dehydrated

• Dressing; The clothes selected may influence the arteries used for injection/drainage.

• Age; Infants/small children need special care due to their size and delicate nature of their tissues. Younger people have Rigor Mortis set in earlier and stronger.

• Climatic Conditions; warmth and moisture usually accelerates decomp, cool and dry accelerates dehydration.

• Time; this effects the condition of the deceased, with a shorter length of time veinous drainage is easier to do, and more beneficial.

Describe the factors effecting the choice of vessels used for injection and drainage

• Children; dependant on the age and size of the child

• Weight; Some vessels may be impractical due to emaciated or obese people

• Disfiguration; Congenital deformity, arthritis, limb loss

• Disease; e.g dry gangrene may inhibit some choices

Name the 5 pre embalming actions that need to take place before embalming occurs, describe them.

• Check documentation; Registration must be complete, appropriate legal/medical documentation must be acquired if cremation, clients written permission, and a ID must be checked against any and all paperwork regarding the deceased/jewellery/personal effects.

• PPE; Scrubs, over gown, waterproof apron, formaldehyde resistant gloves, waterproof arm sleeves, rubber chemical resistant and anti slip boots, hair covering, face mask/visor, spectacles/goggles.

• Risk Assessment; carry out one regarding the environment you are in. monitor this throughout the operation

• Positioning of the Deceased; Identity must be checked, deceased must be in a supine position, head should be supported on a head block, modesty cloths must be used to protect the deceased modesty.

• Tests for Death; these need to be carried out in all cases. Three systems must be tested to make sure life is extinct.

Name the steps that need to be carried out in preparation of deceased for embalming.

• Jewellery should be checked and actioned in accordance to the families wishes

• If desired, jewellery should be removed

• Deceased should be undressed and modesty cloths put into place, assessment of deceased should be carried out

• Clothing needs to be placed in a bag and returned if needed

• Whole skin surface needs to be disinfected, looking at possible complications

• Rigor mortis needs to be reduced

• Clean and disinfect orifices

• Clean teeth/remove dentures

• Observations for best site of incision

• Note condition of hair and style

Describe the process of preparing the embalming equipment

• Equipment needs to be prepared and checked

• A disinfectant solution needs to be prepared and positioned near to the embalming table for easy use

• All instruments should be neatly set out

• Needles may be loaded and ligatures prepared

• Scalpel needs to be loaded with a new blade

• All sharps are kept away from other instruments in a seperate container

• Heating and ventilation needs to be set up for comfortable and safe levels

Describe the process of setting features

• Dentures if available can now be placed in position, or a mouth former may be used. Mouth should be closed in a natural position, a mouth suture can be placed and tied off loosely

• Ensure eyes of deceased are closed at this point, not wise to use eye caps yet, as this means you can monitor pressure in the eyes during injection

• Shaving may be carried out, later is fine

• Suitable massage cream may be applied to face and hands and any other area needed prior to injection commencing

• All handling of tissues need to be done gently

• Care must be taken to avoid damage to the capillary bed

• If the interval between death and embalming is short it is wise to consider setting features prior as there will be very rapid firming

Describe the types of mouth sutures

• Septal; a curved needle is threaded through the muscle tissue at the base of the lower teeth, close to the bone as possible level with the first pre molar, then the needle is directed upward and exits on the same side of the face, immediately lateral to the frenulum, the needle enters the lower jaw on the other side immediately, lateral, to the frenulum and exits at the level of the first pre molar. The needle is then passed from the inside of the mouth to exit into the nostril on the same side using the natural curve of the needle. Its then passed through the nasal septum, in he floor of the nose, following the same pattern on the first side. The needle is passed from the floor of the nose to emerge in the gum above the first pre molar tooth. Loose ends are tied with one finger on the chin to stabilise the mouth, ligature must not be visible, it can be tied in a loose bow and readjusted later if needed.

• Mandibular;