EMBALMING Prepared by : Christian RavinaM.Sc.(N),2nd yearM.T.I.N.Changa

DEFINITION •Embalming is the process of sanitizing & preserving human remains to make them as safe as possible for handling while retaining naturalness of tissue for the funeral viewing purposes •An embalmer is one who is trained in the art & science of embalming

4 PARTS OF EMBALMING PROCESS •Arterial embalming •Cavity embalming•Hypodermal embalming•Surface embalming

ARTERIAL EMBALMING •Which involves the injection of embalming chemicals into the blood vessels, usually via the right common carotid artery • Blood is displaced from the right jugular vein. • The embalming solution is injected with a centrifugal pump & the embalmer messages the corpse(dead body) to break up clots as to ensure the proper distribution of the embalming fluid • In case of poor circulation, other injection points are used

CAVITY EMBALMING •The suction of the internal fluids of the corpse & injection of embalming chemicals into body cavities, using an aspirator & trocar•The embalmer makes a small incision just above the navel & pushes the trocar in the chest & stomach cavities to puncture the hollow organs & aspirate their contents

•He then fills the cavities with concentrated chemicals that contains formaldehyde •The incision is either sutured closed or a “trocar button” is screwed into place

HYPODERMAL EMBALMING •The injection of embalming chemicals under the skin as needed

SURFACE EMBALMING •Which supplements the other methods, especially for visible, injured body parts •A typical embalming takes one or two hours. An embalming case that requires more attention could take longer time

EMBALMING CHEMICALS •These are variety of preservation, sanitizers, disinfectants & addictives used in modern embalming •The purpose is to temporarily delay decomposition & restore a natural appearance for viewing a body after death

•A mixture of these chemicals is known as embalming fluid & is used to preserve deceased, sometimes only until the funeral, other times indefinitely •Typical embalming fluid contains a mixture of formaldehyde, gluteraldehyde, methanol, ethanol & other solvents•The formaldehyde content generally ranges from 5 to 35 % & ethanol content may range from 9 to 56 %

MEDICO-LEGAL ISSUES RELATED TO DEATH &

DYING

1. DO NOT RESUSCITATE ORDER (DNR)•Sudden death from cardiac arrest requires cardiopulmonary resuscitation by competent persons •CPR is the life saving measures according to the agency policy unless the primary physician has written a “ do not resuscitate order “ in the client medical order

•Health care agencies are required to have policies for a DNR decision •When the client is either comatose or near death there should be knowledge provided by the physician to the client’s family about the action to prolong the clients life

2. WILLS OF THE PATIENT • Various countries have laws regarding the legal requirements for written & oral wills •Nurses are usually required to notify the physician & nurse supervisor before acting as a witness & signing a will •Nurses should stop herself from assisting the client with the wording of the will as this should be done with legal advice from an advocate

3. PRONOUNCEMENT OF DEATH • The government has formed laws to protect the public when dealing with issues of death. The various definitions of death are as follows : • The absence of awareness of external stimuli , lack of movement of spontaneous breathing, absent reflexes, a flat brain wave or EEG & definition of brain death which requires irreversible cessation of all functioning of the brain. • It is usually within the scope of practice of medicine to pronounce a client dead

4. CARE OF DECEASED •When a client dies, the nurse is responsible to treat the deceased with respect & dignity•The nurse should prepare the body for removal to the morchary according to the agency policy •The nurse is responsible for properly identification the body could result in severe distress for the family as well as have legal effect for both hospital & the nurse

5. AUTOPSY •An autopsy is performed to determine the cause of death. In case of suspicious death or the presence of communicable disease, the cause of death also has to do with payment from insurance policies & the workers compensation • It requires a consent in writing & nurse is responsible for ensuring that all documentation is in place before releasing a body for autopsy

6. ORGAN DONATION •The donation of organs for transplantation is a matter that requires compassion & sensitivity from care giver • It is important that family of deceased to know the importance & process for organ donation• In some countries, any person of age 18 or older may become an organ donor by written consent

• In the absence of proper documentation , a family member or legal guardian may authorize donation of the organs • It requires the collaborative efforts of the nurse, physician, social worker & priest to ensure timely removal of the organs

7. ISSUING THE DEATH CERTIFICATE • A Death Certificate is a document issued by the Government to the nearest relatives of the deceased, stating the date, fact and cause of death.• It is essential to register death to prove the time and date of death, to establish the fact of death for relieving the individual from social, legal and official obligations, to enable settlement of property inheritance, and to authorize the family to collect insurance and other benefits.

8. LABELING OF DECEASED

• It is merci-killing. This means easy or painless death. This word was derived from greek word meaning “ Good death” • It is of 2 types :•Active euthanasia •Passive euthanasia

9. EUTHANASIA

•Active euthanasia : It is to take deliberate action to end the patient’s life. A physician who administers a lethal over dose commits active euthanasia •Passive euthanasia : It is stopping from treatment that would prolong a person’s life such as chemotherapy, surgery, NG feeding, antibiotic therapy nut taking no steps to end his life

10. ADVANCED DIRECTIVES • The concept has to develop as a mechanism for dealing with some of the decisions that arise when caring for temporarily ill •When there is no hope for recovery. Their purpose is to speak for incapacitated patient who cannot speak for himself for his treatment & wishes • Advanced directives incorporate, the concept of living will, the patient’s right to refuse unwanted life support such as CPR, anti-biotics , food & fluids

Thank you…