Etiology of Disease and the Practitioner Various Different Microorganisms (Continued)

  Embalming is a step method of preparation and preservation. It is an integration of anatomy and related sciences. Following the initial pre-analysis, the avenue of approach is determined by an overview examination of the body. Having accomplished this, initial arterial injection and predetermined cavity treatment may be necessary.

  If peritonitis is suspected, the diaphragm should be used as an anatomical barrier to control cross contamination between the thoracic and abdominopelvic cavities. The established method of cavity treatment is considered the simplest type of temporary preservation. In the average body, the point of insertion of the trocar is two inches above and two inches left of the umbilicus. This provides a central point of insertion and enables the embalmer to reach the contents of all areas within the cavities from this one single point of insertion.

  A major concern during the aspiration process is how much actual material is removed other than liquid and gases from the various areas. Organs, such as the kidneys, pancreas, spleen and liver, need to be channelized to allow for distribution of cavity chemicals. During this process, fragments of these organs are aspirated. Positioning of the entry point of the trocar is determined by the area needing treatment and the length of the trocar. Place the tip (point) of the trocar on the right earlobe with the handle on the left lower abdominal region. This indicates the entry point for the trocar. The length of the trocar determines the specific approach to cavity treatment. Successful treatment of the body’s cavities is a complete understanding of the physical anatomy and their anatomical boundaries.

  Natural separation barriers, such as the diaphragm, should be utilized whenever possible to prevent cross contamination of destructive and disease producing organisms. During primary disinfection when 2-3 ounces of a disinfectant is poured into the throat, it passes into the bronchial tubes to the alveoli. To facilitate gravitational movement, gentle massage of the throat region with the thumb and forefinger should be inferiorly applied.

  When the head is properly positioned on the head block, the stern of the epiglottis provides a barrier. This forms a lid over the glottis and closes off the larynx preventing liquids or food from entering the air passageways. This lid is located anterior to the esophagus.

  The point of insert of the trocar varies according to the specific needs following death. The initial guide for cavity treatment has been two inches above and two inches to the left of the umbilicus. This is not set in stone but is a starting point. Once it is determined what is to be done following arterial injection, specific treatment should be applied. In cases of extreme edema and or adipose, tissue hypodermic treatment may be necessary to obtain preservation. This is done in part through the aspiration entry point with a hypodermic trocar. This allows for channeling the anterior portion of the thoracic region. The abdominal region anteriorly is then treated prior to aspiration of the cavity.

  Excess fluid from the arterial injection may then be injected hypodermically into the cavities prior to final aspiration. Timing for complete cavity aspiration is determined by the embalmer and pre-existing conditions. The time between arterial injection and fixation of the internal organs is essential to the total process. In some cases, it may be necessary to aspirate and inject a second time prior to dressing. In the male, the penis should be packed with cotton and broad band ligature. In the female, the vagina should be packed with a preservative disinfectant. This prevents leakage and odors. Following terminal disinfection all orifices should be packed.

  The final phase is careful manicuring of the finger nails. Remember the hands and fingernails are a focal point of the reposed body. Discolorations of the nailbed in men and women can be removed during the embalming process using massage techniques. Following embalming, discolored nails can be lifted from the nailbed with an elevator instrument. Discoloration can be removed by scraping the underside of the nail and bleaching and cauterizing with phenol. Cosmetics may be applied either under the nail or over the nail.

  Part 21 will address optional treatments for specific conditions.