What is the timeline for aspiration and injection?
Immediately after arterial injection or several hours after arterial injection
We aspirate and treat the cavities because:
1. Cavity embalming treats the contents of the hollow viscera 2. The walls of the visceral organs that might not have received sufficient arterial embalming. 3. Proper cavity treatment will help delay decomposition, prevent gas, odor and purge
What equipment is required for aspiration?
A pointed, sharp trocar A device to create suction or a vaccum Flexible tubing or hose to connect the two
What equipment is required for cavity injection?
*gravity cavity injector or other injector device connected with tubing to the trocar *disinfectant/preservative chemicals
What is required to make a hydroaspirator work properly?
1. installation on cold water line with sufficent water pressure. 2. a vacuum breaker is normally part of the plumbing installation to prevent backflow into the water line 3. a piece of plastic or glass tubing. 4. a hydroaspirator itself.
direct the trocar point toward the intersection of the 5th intercostal space and the left mid-axillary line, continue until the trocar enters
anatomical trocar guides (internal guides): cecum
direct trocar toward a point 1/4 the distancefrom the right anterior-superior iliac spine to the symphysis pubis. Keep the point of the trocar up near abdominal wall until within 4 inches of the right anterior-superior iliac spine; then dip the point 2 inches and insert it
2 methods for removing gas or edema from the abdomen:
1. using a scalpel make a puncture at the standard point of trocar entry and insert a blunt trocar or drain tube into the hole. This will allow aspiration of most of the glasses or fluid. 2. using a scalpel make a puncture in the left inguinal area of the body. Fluid will gravitate to this lower location and gas may also be removed.
What time are the time periods for cavity treatment?
immediately following arterial injection or sereral hours after arterial injection
Advantages to immediate aspiration:
Prevents the production of gas that may cause purge. Removes microbes that may accelarate decomposition. Removes blood from heart, liver. and fluid from lungs. Removes semi-solid contents of the hollow viscera that may contribute to bacterial translocation. Allows immediate channeling of the neck that may reduce swelling of the facial tissues.
Advantages to delayed aspiration:
allows sufficient time for arterial fluid to penetrate tissue spaces. Helps pressure the walls of the visceral organs. Most embalmers will delay aspiration for a short period. The length of time it takes to clean the embalming machine and perform terminal disinfection of the body may be long enough. It is best to aspirate prior to suturing incisions made for arterial injection (any surgical drainage opening should be closed before aspiration of the cavities)
Cavity treatment for partial autopsy and organ donations:
treat walls of the autopsied body with hyperdermic injection and autopsy gel or powder. fill the cavity with absorbent material and saturate with cavity fluid. treat the unautopsied areas with normal aspiration and cavity treatment
putrefaction of the brain is indicated by bulging eye balls, with purge from the ears & nose. the text suggests use of only the right nostril. a small trocar is used to puncture the cribiform plate of the ethmoid bone. at this point the trocar enters the anterior portion of the cranial cavity. It is NOT possible to aspirate the posterior portion of the cranial cavity. cavity fluid (only a few ounces) is injected with a hypodermic syringe and long needle. tightly pack nostrils with cotton to prevent leakage.
proper procedures for injection of cavity chemicals?
After complete aspiration of the thoracic, abdominal, and pelvic regions, cavity fluid is injected (usually by gravity) within the hollow organs and over the viscera. It's important to inject fluid near the anterior surface of the viscera and then allow the fluid to gravitate to lower regions. DON'T dilute cavity fluid, ALWAYS use at full strength.
Differences between fuming and non-fuming cavity chemicals:
fuming = high index non-fuming = low index (5 or 10), but with other preservatives
Cavity fluid for the average 150 lb. body?
3 bottles of cavity fluid; 1 bottle (16 oz.) for each region: thoracic, abdominal and pelvic. many embalmers use 1 bottle of cavity fluid above the diaphram & 1 bottle below diaphram A poor practice is to restrict the cavity fluid to 1 bottle; 1/2 above diaphram and 1/2 below diaphram
3 ways to close the trocar entry point:
1. trocar button, easily removed for re-aspriation 2) sutures - "purse string" or "N stitch" sutures should be tied in a bow, to allow for reopening to aspirate. 3) if body has distention from gas then entry may be left open and covered with bandage - (not recommended for bodies that are to be shipped)
obese bodies drowing victums when there is purge bodies that have ascites if decomposition is present all bodies that ship in all bodies that ship out it there is presence of gas or distention blood injection, peritonitis, septicimia, pnemonia any distention or swelling of the neck or facial tissues (or back of the hands)
when should the throat be aspirated?
just before dressing & casketing
At what levels (depths) should cavity fluid be injected?
trocar should never be at a deep level injection, it should be into and over the viscera
Do we begin treatment above or below the diaphram?
pathological conditions of the stomach, intestines, lungs, trachea or esophagus visceral expansion due to high rate of flow or excessive machine pressure. gas in the abdominal cavity due to digestion or decomposition. aneurisms along any part of the aorta. invasive surgical procedures
very dark and resembles pitch or tar liquid or semi-solid odorous (skatole, indole, mercaptan) allow to continue to purge encourage purge with firm pressure to the lower adbomen don't pack till after cavity treatment content may contain fecal matter, arterial solution and blood
fluid purge or false purge:
with cavity fluid any blood will be brown in color purge of arterial fluid will be same color of arterial fluid used purge or arterial fluid may be an indication of a ruptured major artery
procedure for purge with good drainage:
proper distribution is not taking place, sectional embalming is indicated
general remedies of purge:
aspiration and reaspiration of all cavities and of cavity fluid into all areas
obese bodies require additional cavity treatment:
bodies with ascites and hydrothorax require special attention any evidence of abdominal surgery may predispose of purge pack all orfices tightly with cotton re-pack if cotton becomes saturate use AV plugs when necessary stop purge from mouth or nose as a last resort the esophagus may be tied off or severed
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