The preparation room should be located in an area that is convenient for employees, yet not accessible to the public. It should be maintained in a clean and sanitary manner. The size is determined by the estimated case number with room for future expansion.
The 21st century preparation rooms should contain only essential equipment. Most equipment should be mobile for proper sanitizing and maintenance. The walls and floors should be nonporous for easy and controlled decontamination. Chemicals and sundries should be secured under lock and key when not being used. Emphasis should be placed on employee safety and the protection of public health. The preparation room should contain a drench shower, emergency eye wash, multiple grounded electrical fixtures and snap-in plumbing fixtures. Vacuum breakers should be a part of all water sources in the prep room.
Asepsis (a-without, sepsis-infection) is a broad term used to describe a series of procedures intended to reduce infection. Asepsis technics cover a wide range of controlled practices which if carried out consciously will reduce the incidence of sepsis for practitioners. A simple task, such as washing your hands, is essential to the health and well-being of everyone.
Every preparation room should have a first aid kit for emergency treatment in the event of an accident. This is the first line of defense in protecting every practitioner. Even a small laceration or puncture can be serious and warrant medical attention.
In the event of an injury, gloves should be removed, the area should be washed thoroughly and encouraged to bleed. Topical antiseptics and a sterile bandage should then be applied. The practitioner should follow-up with medical attention as soon as possible.
In the event of an embalming chemical being splashed in the eyes, remove gloves and flood eyes with water at the sink or eye wash station. Seek medical care to prevent permanent damage.
An accident report should be completed with the employer as a permanent documented record of the injury. The practitioner could possibly need extensive medical attention or be prevented from working.
When working with a hypodermic syringe (embalming chemicals or tissue builders), a face shield or goggles are recommended/required. Improper cleaning or disinfecting can cause clogging of the hypodermic needle and when hand pressure is applied, the syringe may break or needle may come loose. Only luer-lok syringes should be used.
Use of alcohol gels, protective clothing, masks and shields also control potential accidental chemical injury. So many times individuals put gloves on after handling a dead body without properly washing their hands. This creates a potential danger by isolating potentially dangerous organisms in an encapsulated area. Micro pores or a break in the integrity of a protective glove can open the practitioner to infection or death. Quality of the glove is essential. Gloves should only be used once and then disposed of properly. Poor grade gloves contain micro pores of 5 microns and a virus like AIDS is only 1 micron, which could be a potential hazard to those using inferior gloves.
The process of sterilization is distinguished from disinfection which uses liquid chemicals to destroy disease producing microbes on inanimate surfaces such as vehicles, floors, furniture and walls. Antisepsis is when liquid chemicals are used to destroy disease producing microbes and their byproducts on surfaces of the skin. Sanitization represents the overall cleaning process including the three D’s.
Sterilization is achieved with the use of special equipment and a series of controlled practices utilizing heat and moisture/water. There are some basic principles when using steam as a sterilizing agent. Steam under pressure is effective against vegetative and spore forming organisms, and is not used in funeral establishments due to high cost of equipment (autoclave). Boiling sterilizers are most commonly used if they are available.
In the preparation room, when available, cold sterilization (chemical) is utilized. If laws do not state the use of a sterilizer, it opens a loophole which can endanger the practitioner. Surveys over many years conducted in classrooms indicate that only 3 to 5 percent of preparation rooms use sterilizers. In the real world, instruments are rinsed in water after each embalming procedure and laid out on a towel for future use.
Part 5 will continue with the general overview.