Test 2 Material- 3 Flashcards by Heather Clark

Large volume of arterial chemical
Supplemental chemicals (waterless emblaming)
Increased solution strength (due to increased preservative demand from increased amounts of amonia, which neutralizes HCHO).

Strength, type and quantity of Chemicals- Treatment of bodies presdisposing to decomposition

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Pressure, flow
Use of various distribution and drainage aids

Mechanical and Manual Aids (Decomposition Predisposition)

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Use a constant flow and intermittent drainage
Vascular injection if possible.
Sectional vascular Injection- 6 Point Injection.
Sectional hypodermic injection- all areas not reached by vascular injection.

Controlled Injection and Drainage/ Type of Injection- Decomposition predisposition

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High preservation demand fluid
Large volume
Surface embalming
Hot water recommended for fluid dilution in advanced decomposition.

Strength, type and quantity of chemicals (Where Decomposition is Present)

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Use of various distribution and drainage aids
Hypodermic embalming

Mechanical and Manual Aids (Where Decomposition is Present)

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Do not hesitate to use multipoints. Sometimes as many as 8 or more points. Inject in both directions.

Sectional Vascular Embalming (Where Decomposition is Present)

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Use only as a last resort!

Sectional Hypodermic Embalming (Where Decomposition is Present)

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Excise swollen areas when necessary.
Trocar aspiration and re-aspiration
High index cavity fluid

Operative Corrections (Where Decomposition is Present)

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Gauze bandages
Poast of paris bandages
Manufactured garmends (plastic)
Plastic Sheeting
Cotton

Protective Material (Where Decomposition is Present)

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Hardening compound
preservative powders
Depderants (powder and spray) often re-ordorants if used in historical context.
Sealer
Reducing and bleaching agents
Disinfecting chemicals

Special Chemicals (Where Decomposition is Present)

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Non-finished metal seal emablming case.

Zeigler Box and Heavy Duty Rubber Zipper Pouch

(Where Decomposition is Present)

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Condition resulting from excessive loss of bodily fluid. it is the absorption of moisture into the air from a body.

Dehydration

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The process of drying out.

Dessication

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This may occur internally while dehydration occurs externally.

Imbibition

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Extreme dehydration; is actually a form of preservation. Bodies with severe desiccation turn dark and are not viewable.

Mummification

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To establish or maintain a proper mositure balance in the dead human body. Humectant arterial fluid or co-injection in primary dilution will prevent postmortem dehydration in secondary dilution. Humectant chemicals should be used in the last injection only (due to the fact that it can clog arteries).

Emblaming Objective- Dehydration

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Restricted fluid intake
Excessive moisture loss
Reduction of electrolytes in body fluids

Causes of Antermortem Dehydration

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Examples:

High fever
Coma
Psychosis
Chronic disease
Advanced aging
Lack of drinking water

Restricted Fluid Intake

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Examples:

Vomiting
Prolonged diarrhea
Polyuria
Excessive perspiration

Excessive Moisture Loss

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Example:

Reduction in sodium compounds greatly distrubs moisture balance.

Reduction in Electrolytes in Body Fluids

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Chemical dehydration
Drainage dehydration
Environmental surface evaporation

Three Prinicpal Causes of Post Embalming Tissue Dehydration

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Too strong chemicals

Chemical Dehydration

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Too quick injection/drainage (Slow down injection and drainage)

This occurrs due to the use of angular forceps which limits the control of the flow of drinage.

Drainage Dehydration

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85% - Edamatous cases
75%- Normal Cases
65%- Dehydrated Cases

Mositure Content In the Body

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* Keep head elevated above thoracic cavity during and after gravitation of undiluted cavity fluid. * Use cavity injector instead of embalming machine to gravitate undiluted cavity fluid with minimum pressure (slowly). * Ligating both common carotid arteries and both internal jugular veins prior to cavity treatment. * Gravitate undiluted cavity fluid high to low over viscera in the throacic cavity.

Ways the Embalming can Guard Against Feature Dehydration From Cavity Fluid

* Primary injection * Large volume * Dilute solution * Coordinating chemicals * Moisture-retaining chemical- humectant * Cold water for fluid diluting * Massage Cream- Used pre, current, and post emblaming. Plastic wrap can be used as a barrier. Use a liberal amount.

Stength, type and quantity of chemicals- Treatment: Dehydration

* Liberal massage cream- massage towards dependent portions of the body. * Use of various distribution and drainage aids. * Hypodermic tissue fillers only after injection. * Controlled injection pressure and rate of flow- use drain tube.

Mechanical and Manual Aids: Treatment: Dehydration

* Fingertips, * cheekbones, * temples, * submandibular area.

Places the Embalmer May Hypodermically Inject Tissue Builder

* Liquid silicone * Massage Cream

Types of Tissue Builder

* Constant flow and intermittent drainage. * Alternate injection and drinage.

Controlled Injection and Drainage: Treatment: Dehydration

Humectants can be incorpoarted in almost any embalming case except: * This due to the viscosity of the humectant. It can cause leaking or uneven distribution and poor drainage.

Decomposition and Edematous cases

The injection site for dehydrated cases. Inject down first towards the feet and then up into the body cavities. Two drainage sites may be necessary- Right internal jugular and right femoral vein. * Fluid strength- 18-25 index * Fluid volume: 6-8 ounces per gallon

Femoral Artery

Often have humectants and/or active dyes premixed in them.

Modern Index Arterial Fluid (20-25)

Should be used only after blood drainage has ceased- clear arterial fluid solution should dominate drainage (last injection).

Humectants

The abnormal collection of fluid in tissue spaces, serous cavities or both.

Edema

* Within the individual cell * in the intercellular spaces * Within the body cavities

The Embalmer can identify Edema in Three Body Sites:

Severe edema within the body tissues.

Anasarca

Edema within the abdominal and/or peritoneal cavity.

Ascites

Edema within the pleural cavity (around lungs)

Hydrothroax

Edema in the cranial cavity- intravranial edema.

Hydrocephalus

Edema of the pericardial sac surrounding the heart.

Hydropericardium

Testicular edema or edema of the scrotum.

Hydrocele

Edema within body cells.

Cellular or Solid Edema (Intra)

Edema in tissue spaces between cells.

Intercellular or Pitting Edema (Inter)

Edema in the alveoli of the lungs.

Pulmonary Edema

Cavities containing edema are the only place that direct aspiration with a trocar can be successful. * Pulmonary edema * Hydrocele * Hydrothorax * Hydrocephalus * Hydropericardium * Ascites

Which Types of Edema can be Directly Treated with a Trocar?

* Anasarca * Interstitial edema * Solid * Pitting

Which Types of Edema Cannot be Directly Treated with a Trocar?

* Distension of tissue * Increased secondary dilution of fluid * Possible (desquamation) caused by decomposition of the Rete Mucous due to Maceration * Distorion of body contour (wrinklage) * Possible leakage

Emblaming Complications Created by Anasarca

* Elevation of extremities to allow for gravitation of edematous fluid (body positioning devices) * Elastic bandage to force liquid from extremities before, during, and after injection (old fashioned) Turkish towel, cold water packs, water/sand/air collar * Type, strength and quantity of fluid (three separate procedures). * Wicking- Make an incision, insert cotton to draw out fluid.

Mechanical Aids- Edema

Continuous Method Only

Emblaming Treatment of Edema

* A mild injection of a large volume may be used to help displace and wash out edematous fluid. (Not recommended for new embalmers). * Astringent (strong) soution may be used with reliance upon secondary dilution to preclude tissue burning. (draws out moisture). * Effect maximum physical removal of edematous serum and inject normal strength solutions. * Utilization of edematous fluids. * Possible sectional embalming by direct hypodermic injection (astringent solutions)

Treatment of Edemaous Cases

When the ____ is affected by edema, the embalmer must first determine whether solid or pitting edema is involved.

Face

Cannot be indented by pressure from the fingers. The extra fluids are located within the individual cells of the tissues. This type of edema is seen in allergic reactions and as the result of certain drug therapies, such as the extended use of corticosteroid drugs. Cannot be removed by arterial mechanical means. It woud not be wise to attempt to reduce the swelling by surgical removal of subcutaneous tissues after arterial embalming. Leakage would be a major problem.

Solid Edema

The fluid is in the interstitial spaces (between the cells). Can be gravitated. Merely elevating the head helps to drain some of the fluid fro the tissue spaces. Solid edema, especially in the facial tissues, is not as frequently encountered as this. It should also be mentioned the facial tissues are not as frequently affected by edema as are other body tissues, probably because the head is almost always elevated.

Pitting Edema

When general facial edema exists in the ______ body, the trocar, upon arpiration, can be passed into the tissues of the neck to make channels for drainage of the edematous fluids. Pressure can be applied to the face in a downward motion to squeeze the edema from the facial tissues into the neck and finally into the throax. The carotid incisions can be left open for several hours after embalming to drain fluid from the face.

Unautopsied

* Decomposition occurs rapidly. * Acidosis alters the reaction between proteins and the preservative. * The body appears sallow because urochrome is present in the tissues. * Sites of gastrointestinal bleeding may be sites of arterial fluid loss and sources of purge. * Edema dilutes the arterial fluid. * Uremic wastes in the blood and tissues neutralize preservative. * Skin infections may be caused by uremic pruritis.

Embalming Complications Associated with Chronic Renal Failure

The substance which gives urine its characteristic yellow color. it is dervied from urobilin.

Urochrome

* Restricted cervical injection and drainage for non-autopsied bodies. * Continuous injection and drainage not alternate not intermittent. * Co-inject dissolved MgSO₄ Epsom salt crystals- pre-dissolve in separate container. * Co-inject injectable cavity fluid with high index arterial 30-38 index on bottle to a gallon. * Head freeze * Allow incisions to remain open, to drain for extended time, if possible 12-24 hours. * Elevate head and appendages. * Dry, pack incisions and use duct tape to close incision. * Sheet diaper, hardening compound, and unionall prior to dressing. * Topical jelly and rubber gloves for hands. * Duct tape wrist and neck area.

Special Considerations Associated with Edematous Cases

* Severe wrinkling of the face and hands * Leakage into casket interior

2 Major Problems Associated with Casketed Remains Having Edema

Postmortem evacuation of any substance from any external orifice of the body.

Purge

The contents of ths purge is arterial fluid solution and not bodily fluids. Has two causes: * Too high of an injection pressure or rate or flow. (reduce, close drain tube). * Major ruptured vessel

False Purge

* Cream the areas over which the purge matter flows to minimize burning of the lips, cheeks, neck and nose. Particularly with stomach purge (Do stomach first). * Reduce gas pressures in the abdomen by careful insertion with a trocar.

Treatment: Purge Prior to Embalming

Determine that the escaping puge is purge matter (stomach, lung) and not arterial embalming solution (false purge/ short circuit purge) which may be escaping from damaged lung or stomach tissues. * If purge, treat * If arterial fluid, section injection -6 points, inject 12 directions.

Purge During Embalming

Reaspirate and reinject concentrated cavity embalming fluid until purge is controlled. May need to pack the trachea with non-absorbent cotton (batting cotton)

Purge following Arterial and Cavity Embalming

* Direct treatment through an abdominal incision. * Nasal tube aspiration and irrigation of the throat. Always change cotton in mouth if it has purge because it may dehydrate the lips. Reinsert new cotton after old cotton is removed. * Aspiration and injection of brain through the cribiform plate of the ethmoid bone when distended eyes indicate intracranial decomposition. * Ascites and visceral gas formation- aspirate prior to injection- take pressure off aorta and vena cava.

Special Treatments: Purge

* Mechanical and manual aids to correct deformities (written authorization) * Operative aids to correct deformities (written authorization) Tendons may be cut and splint of Plaster of Paris bandage should be used to hold the limb in the correct position for proper casketing. * Sectional vascular emblaming * Strength, type and quantity of fluids- may vary as to the type of deformity

Treatment for Deformities and Malformations

If a patient comes to emergency surgery, or dies shortly after having recieved a large internal therapeutic dose of a radioactive isotope, the handling of the body may pose problems of radiation exposure for the surgeon, the pathologist or the embalmer. It is important for members of these groups to realize the existence and magnitude of this problem and it know how to meet it. It is equally important not to exaggerate the danger and not be unreasonably fearful when the hazard is minimal or nonexistent. Inquire about site of needle implants, if any.

General Consideration- Radiation

These kinds of rays are stopped much more easily than Gamma Rays (ionizing), which are similar to X-rays and require lead shielding.

Beta Rays (non-ionizing)

Radon needles are implanted in tissues to treat _____ tumors in the abdomen, breasts, and lungs. These bodies if declared safe may be embalmed as any other cancer case.

Metastatic

Gamma rays and radon needle implants.

Danger- Radiation

For every ___ feeet of distance from the body, exposure to radiation is substantially reduced. The precautions can be summarized: * Protection for the embalmer * Time of exposure to the body * Distance from the body.

Three

Cab occur during treatment of malignant diseases and through occupational exposure.

High Levels of Radiation

Patients receiving large doses of radioactive isotopes must be ______ until the isotope content is not more than 30mc.

Hospitalized

That amount of radioactive material in which 37 million atoms disintegrate each second.

Millicure

In bodies that die outside the hospital, the funeral director should not encounter more than ____ of radioactive isotope.

30mc

If the body's radioactivity is about the level of 30mc and there has not been an autopsy, the body should be embalmed in the hospital morgue under the direction of a _____ \_\_\_\_\_ \_\_\_\_\_. * No! Wait, Time disintegrates the radiation

Radiation Protection Offiicer

If the body contains appreciably mor ethan 5mc of any radioactive isotope and there is to be an atopsy and embalming following the autopsy, it should be done only under the advice of a radiation protection officier.

No, Wait, Time Disintegrates the Radiaton

If the body is to be interred or cremated without embalming, there will be ___ \_\_\_\_ ____ from external handling.

No Radiation Hazard

* PPE worn throughout the entire operation * Utilize large quantities of running water at all times during the embalming to flush drainage matter. (All cases) * Minimize the time of close contact with the body, wait. * Special care should be taken to prevent the floor from being contaminated. Care should be taken that all body fluids are properly discharged down the drain. In case of overflow or spillage, fluid should be taken up immediately using disposable goods. * Instruments should be soaked in a good soap or detergent, then rinsed well with running water. * Gowns, towels, clothing, etc, should be monitored and stored for suitable decay before being sent to the laundry. * Disposable waste matter should be collected in a suitable garbage bag and disposed of by incineration. * Gloves should be thoroughly washed before being removed from the hands, then placed in a container of soap and water and allowed to soak and then stored in a suitable place until the radioactivity has decayed to a safe level. * If the embalmer suffers an introduction of material from the body into lesions, he should wash the injured area copiously with running water and thereafter consult with his physician or a radiation safety officer.

Personal Hygiene for the Embalmer (Radiation)

A chemical element that is similar in chemical properties to another element, but differs in atomic weight and electric charge and emits radiation.

Radioactive Isotope

A chemical element that is similar in chemical properties to another element, but differs in atomic weight and electric charge and emits radiation. An atom that disintegrates by emission of electromagnetic radiation.

Radionuclide

The application of chemical reagents in the treatment of disease in humans, causing an elevated preservation demand.

Chemotherapy

Test 2 Material- 3 Flashcards

(82 cards)