As a continuation of decomposition, this article will cover the recommended minimal treatment of symptomatic conditions associated with a myriad of diseases. The embalmer/practitioner must blend cognitive knowledge with manipulative skills to meet the challenges of the 21st century.
The previously identified symptomatic conditions may be associated with many diseases individually or in various numbers. The following may be of major concern in the analytical pre-analysis of the dead body prior to embalming.
Dehydration Jaundice Purge Emaciation
Discolorations Skin Slip Edema Decomposition
Dehydration
• Re-hydration using a triple base preservative pre-injection chemical
• Large volume, low-pressure, low rate of flow
• Room temperature solvent (vehicle)
• Diluted preservative of compatible chemicals
• Conditioners, moisture retaining chemical
Aids
• Massage cream
• Drainage chemicals
• Controlled injections (Pressure and Rate of Flow)
• Hypodermic tissue building
Emaciation
• Rehydration using a triple base preservative pre-injection chemical
• Large volume, low pressure, low rate of flow
• Room temperature solvent (vehicle)
• Diluted preservative chemicals containing lanolin after second or third injection
• Add conditioner for molecular retention
• If additional preservation should be required, a low index arterial is recommended for the control of dehydration, skin texture, and embrittlement or even for natural incarnadining effects.
Edema
• Handle with extreme care as not to separate the epidermis from the dermis creating manipulative desquamation.
• Tertiary dilution due to the body’s abnormal liquid content
• Leakage pre and post embalming
• Distortion of features
• Rapid decomposition
Aids
• Elevation of extremities prior to, during and after embalming (gravitation)
• Rubber dam, elastic bandages or digital force
• Wicking visual areas after embalming
• Siphonization
• Channeling wire
• Astringent mixture, high index to draw edematous water from the tissue using continuous injection and drainage, co-injection may be necessary due to cause of death, medications, or medical treatments.
• Use concentrated solution of Epsom Salt as a vehicle for fluid mixture.
• The saturated solution should be strained to remove excess Epsom salt crystals which might damage the pump in the embalming machine.
• The Epsom Salt should be used as a solvent/vehicle and mix the preservative chemical in accordance to the predetermined preservative dilution.
• It is recommended that the injection should be sectional to maintain maximum control.
• Restricted cervical injection may be used if only the head is affected or if the whole body is affected except the head.
• Follow up using experiential determination of modified fluid and/or humectant based preservative chemical to restore natural contours.
• Sectional embalming 1 through 6 points
• Regional embalming the autopsied body
• Restricted cervical right and left carotids
• Hypodermic treatment High Index Arterial
• Topical treatment
• Reinforced Plastics
Discoloration
• Primary pre-injection or capillary washes are commonly used to clear or reduce intravascular discolorations. The type of chemical is an important consideration.
• Capillary washes are formulated non HCHO preservative anticoagulants which restore or build up mixture content and lubricate vascular network.
• Many fragment blood components maintain blood liquidity for easy removal.
• Primary drainage chemical with triple base preservatives and sequestering agents which prepare and clear the vascular system for HCHO based arterial fluids.
• Build up intravascular pressure in accordance to the condition of the body and specific cause of discoloration. (1 quart to 7 gallons)
Common Surface Discolorations:
Adhesive Tape Blood Fingerprint ink
Grease Gentian Violet Hair Dye
Iodine Methiolate Paint
Silver Nitrate Tar Lemon Juice
Acid Alcohol Dry Shampoo Turpentine
Tobacco stains, Nicotine Kerosene
Permatex Hand Cleaner Sodium Thosulfate
Isopropyl Alcohol Soap and cold water
Iodine Wash & Sodium Thosulfate
Note: Wash with suitable solvents and cleansing agents
Aids
• Remember proper positioning of the body to allow for natural gravitational processes to clear discolorations. Begins at time of removal, initial positioning on preparation table.
• Determine type of discoloration or stain (Apply digital pressure if the area blanches the discoloration can be removed, if not, then it’s a stain and can only be lightened)
• Controlled injection formulation after preparation/flushing of the vascular system.
• Strong initial injection will fix discolorations and should not be used.
• Use of proper size arterial tubes and drain tubes, manual massage with drainage tube open
• Arterial and/or venous injection and cosmetic application (internal dyes or external liquid/creams)
Jaundice
• Basically there are six forms of Jaundice on the ecterus index. There is one that is more reactive to oxidation than the others. Jaundice is measured in degrees on a color index. A normal range of intensity of color is on a numeric scale 3 to 5. When excessive amounts of bilirubin are present and jaundice becomes apparent, the index is usually 15 or higher. There are about 20+ causes of jaundice.
• During primary disinfection and scrubbing of the body excess bilirubin washes off. To date there is no way for an embalmer/practitioner to determine the oxidative process and how it will affect any given body. The oxidative process converts bilirubin yellow into biliverdin green and on rare occasions will turn the body black (Black Jaundice). Rule of thumb is to treat any jaundiced body as a potential hazard because it is a symptomatic condition of viral hepatitis. Bilirubin in the vascular system prevents clotting and rarely the embalmer will find clots in the jaundiced body.
• A common post embalming problem is blistering this is due to the practitioners failure of using overly diluted arterial fluids. Extensive edema in the extremities may be associated with some primary causes of symptomatic jaundice.
• A pre-injection fluid may be used with a primary injection solution to flush the vascular network of excessive ammonia and water. Small punctures may be made in the wrist or posterior upper leg, channeled with a straightened wire coat hanger and wicked. Elevate affected areas with topical cauterants and preservatives.
Aids
• Flush the system with a primary fluid
• Use constant injection with intermittent drainage
• Use a specially formulated jaundice fluid.
The three most common embalming complications that are associated with a large variety of pathological conditions are:
1. Discolorations (Jaundice)
2. Dehydration (Emaciation)
3. Edema
This will conclude information on decomposition. ET-20 will deal with the autopsy.