Removal of the body from the place of death requires careful handling and sanitary precautions to meet current needs in accordance with ethnic and religious customs. With global migration increasing throughout the world, uniform body care may be required with an integrated code between countries and WHO (World Health Organization). Uniform body care may be required to meet primary regional, ethnic and religious values of the deceased. Removal (handling of a body) requires careful handling with the use of proper equipment.
Primary disinfection begins with the care and maintenance of equipment and sundries. The cot should be equipped with a body lifter, disposable plastic sheets, plastic pouch, towels, ear loop masks, protective gloves and disinfecting/deodorizer spray. For handling the remains sling straps or slide under transfer lifter must be available.
The service person should be equipped with protective disposable garments which include disposable coveralls/gowns, clear plastic poncho, sleeve covers, head cover, face mask/shield, gloves hand or arm length and knee high shoe covers. For additional protection, barrier creams should be used following scrubbing of the hands before gloving.
Removal should be done with precaution and safe guards for self-protection. Every removal site should be treated as an environmental hazard. This includes the body, surgical bandages, catheters, open wounds, bed clothing, refrigerators, morgues and accident sites. Where open lesions exist, handling with double sheeting is required. The use of plastic sheeting or pouch is recommended. An ear loop mask placed over the mouth and nose of the deceased would prevent expulsion of potential hazardous microbes while moving the body. Pre-embalming purge from body orifices (blood, fecal material, and urine) is another source of danger.
Disinfection and decontamination is essential in the preparation room as a part of the primary treatment of the equipment and the body. The body should be brought to the preparation room preferably by trained personnel. The cot cover should be removed and sprayed with a disinfectant and air dried, when possible, outside to allow natural ultraviolet rays to provide extra destruction of the microbes. It would be preferred to use a clean disinfectant cover for each removal.
The sheeting or pouch should be sprayed before exposure of the body. Dressing or clothing should be sprayed, removed and disposed of in a safe manner (red plastic bag). The body should be slid onto the embalming table. If you are alone, short sling straps can be placed around the hips and shoulders of the body and pulled from the cot onto the table. To reach across the table and pull the body onto the table could cause injury to the back of the practitioner. Micro fractures to the spine can, over a period of time, cause serious back problems.
The cot should be sprayed and cleaned with a disinfectant and when possible air dried. Special attention should be given to the wheels. They are contaminated at the place of death; they contaminate the removal vehicle and the floor of the preparation room. Cross contamination may be one of our major unknown concerns that have not been identified.
Primary disinfection continues to the body. The body should be completely sprayed with a disinfectant this includes all orifices and hair. The body should be allowed to sit while preparing instruments, sundries, and equipment to allow the spray to work. Then carefully wash the body with a low lathering disinfectant liquid soap. In order to control odor, special attention to the auxiliary and genital regions is a must.
Careful cleaning and disinfection of the epidermis is to remove dirt, oils, bacteria and mold spores. Mold spores are part of the reproductive process and are common flora in the pores of the skin. Embalming distends the tissue closing pores and the spores are enclosed. After embalming, the tissue dehydrates and the pores open releasing the spores creating active mold growth like that found on bread.
The hair should be cleaned thoroughly with a disinfectant shampoo. Those bodies with dandruff (seborrheic dermatitis) or cradle cap (thick crust) should be treated with three or four ounces of a mineral sequestering agent, massaged into the scalp and allowed to act throughout the embalming process. If the condition warrants additional treatment, dry shampoo is used as a final hair treatment after the embalming to lift the crust (use cotton balls to local and specific areas).
Part 7 will deal with the positioning of the body.