PCL 1 -- Process of embalming bodies

PRE-EMBALMING

An embalming report is filled out, which
1. Logs all jewellery and personal items on the body;
2. Details any discolorations, cuts, bruises, etc. on the body;
3. Documents the procedures and chemicals used during embalming.

All clothing, bandages, IV needles, catheters etc are removed. A strong disinfectant spray is used to clean the skin, eyes, mouth, and other orifices.
If rigor mortis (the stiffening of muscles after death) has set in, it is relieved by moving the limbs and head about and massaging the muscles.
If the decedent is a man, he is normally shaved at this point. Razor burn is less likely before the arterial chemical firms the skin of the face). Even women and children are shaved to remove the fine "peach fuzz" on the faces. This is done to avoid the makeup from collecting on the hair and making the makeup more noticeable.

FEATURE SETTING

The embalmer places the remains straight from head to toe on the embalming table. The arms are held in position, usually with hands folded across the stomach, by a special positioning device. The head is placed on a head block, and many embalmers will tilt the head 15 degrees to the right so mourners can see the face more easily.

The traditional method for closing the eyes involves placing a bit of cotton between the eye and eyelid. The eyes can sink back into their sockets, so in order to prevent this, small plastic "eye caps" are placed on each eye ball. An eye cap is shaped like a large contact lens and has a textured surface that grips and holds the eyelid in place. A small amount of stay cream is placed on the eye cap to avoid dehydration of the eyelids. Contrary to popular myth, the eyelids are never sewn shut, but in some cases, they may be glued together to prevent separation
The mouth is closed either by tying the jaw together with a piece of suture string or by a special injector gun. With the suture method, a curved needle with a piece of suture string is threaded through the jaw below the gums, stuck through the upper jaw into the right nostril, threaded through the septum of the nose into the left nostril, and then passed back down into the mouth. The two ends of suture are tied, being careful not to tie it too tightly, so that a natural appearance of the mouth is created. Some embalmers prefer to close the mouth using the needle injector gun. The gun drives a needle with a piece of wire attached into the jaw. Needles are driven into both the lower and upper jaw and then twisted together.

To finish closing the mouth, usually a mouth former is used. A mouth former is similar to an eye cap as it has a textured side that grips the lips, but it is shaped like the mouth. A small amount of stay cream is also used on the mouth to avoid dehydration and help hold the lips in place. The mortician may also squeeze the inside of the mouth with a little mastic compound, a paste kind of like caulk to give the mouth a better and more pleasing shape.

ARTERIAL EMBALMING

Arterial embalming begins by selecting an artery to inject the fluid into and a vein to drain away blood. The most popular site (although multiple injection and drainage sites may be used) is on the right side of the body near the collarbone, where the right common carotid artery and the right internal jugular vein are located. A small incision is made just deep enough to cut the skin and an aneurysm hook is used to separate the tissue above the vein and artery. The embalmer raises the artery above the skin surface and passes two pieces of suture string beneath it to create a ligature to tie off the vessel once the arterial tube is inserted. The same is done with the vein.

Each vessel will receive a tube to facilitate injection and drainage. The artery is incised (very carefully as to not cut it in half) and an arterial canula (tube) is inserted into the artery towards the heart. The ligature is now tightened so that a seal is made between the tube and the artery. The same is done with the jugular drain tube. A clear hose is attached to the drain tube and the hose from the embalming machine is connected to the arterial tube. Drainage can also be achieved by keeping the vein open using angle forceps. Many embalmers prefer this as it allows clots and blockages to be flushed from the vascular system more easily.

Pre-injection chemicals break up clots and condition vessels. Co-injection chemicals restore dehydrated tissues, fight oedema (too much fluid in the tissues), and correct hard water. Cauterants dry, seal and preserve open wounds. The most important chemical, the arterial fluid, is made up of preservatives, germicides, anticoagulants, dyes, and perfume.
Although the main ingredient of arterial fluids is formaldehyde, there are a few chemical companies who are manufacturing these chemicals with the less toxic (but less effective) glutaraldehyde. Formaldehyde is extremely toxic and a known carcinogen.
The embalmer must inject about 1 gallon of fluid for every 50 pounds of body weight. A typical gallon of fluid might be made up of 1 bottle of arterial fluid, 1 bottle of co-injection fluid, 1 bottle of water corrective, and enough water to complete the gallon. This recipe changes depends on the condition of the body.

Once the chemicals are in the reservoir of the embalming machine, it is time to begin injection. The embalming machine has two knobs which regulate pressure (the force of the fluid) and the rate of flow (speed of the fluid). These knobs are adjusted to create the optimum rate of injection for the body, where there is no set rule for. Some machines have a pulse feature that pumps the fluid much like a heart would pump, with alternating pressure. This is very effective in avoiding swelling of tissues. The machine is switched on and the fluids begin to move through the hose, through the arterial tube and into the body.

Once the embalming fluid begins to flow into the arterial system, pressure begins to build up in the entire vascular system. This helps the fluid to reach all parts of the body and penetrate the tissues. The jugular drain tube is opened periodically (it is normally closed) to allow blood to escape and prevent too much pressure in the vascular system, which could cause swelling.

There are several signs the embalmer uses to gauge whether embalming fluid has permeated throughout the entire body. Dyes used in arterial fluids help the embalmer know where fluid has reached and where it has not (these dyes also help to produce a more pleasing cosmetic appearance). Return of the arterial fluid from the jugular drain tube tells the embalmer that fluid has gone throughout the entire vascular system. Also, firm tissues shows that the preservative chemical has reached all the tissues.

Once arterial injection has been completed, the arterial and jugular tubes are removed, the vessels are tied closed, the incision used to access the vessels is sutured closed, and sealed with a special chemical.

CAVITY EMBALMING

Cavity treatment starts with aspirating (suctioning) fluids out of the internal organs in the abdomen and thoracic cavity, with the use of a trocar. A trocar is a long metal tube with sharp blades at one end and a connector for a hose at the other. The hose is connected to a device that creates suction; either an electric aspirator or water powered aspirator (called a hydro-aspirator) and then connected to the trocar. The sharp blades on the trocar are used to pierce through the abdomen near the belly button. From this entry point, the embalmer directs the trocar towards all the internal organs, allow the trocar to remain in each organ long enough to suction off the fluids.

The hose is disconnected from the aspirator and connected to an adapter that screws directly onto the bottle of cavity fluid. The trocar is once again pierced into the organs and the cavity fluid flows into them by simple gravity. Usually two bottles of full strength fluid are used to treat the entire thoracic and abdominal cavities. Cavity fluids are very similar to arterial fluids, containing about the same percentage of formaldehyde. However cavity fluids are slightly more acidic than arterial fluids, thus producing firmer tissues faster.

Once the cavities have been treated, the trocar is removed and a "trocar button" is screwed into the hole in the abdomen that was used to access the organs.

These steps apply only to a body that has not been autopsied. During autopsy, all the internal organs are removed and inspected by the medical examiner and then placed back inside the body or sometimes incinerated. At the funeral home, the mortician removes the viscera and places it in a plastic bag called a "viscera bag" and allows it to soak in cavity chemical. The inside of the body cavity is aspirated with a special instrument and then coated with an embalming gel and/or an embalming powder. The treated organs are then placed back inside the body, or the bag full of organs is placed at the foot of the casket.

If the viscera are not returned, then the empty cavity may be filled with adsorbent pads. In either case the autopsy opening is sutured closed and sealed.

POST EMBALMING

Cosmetising: The body and hair are washed once more to remove any blood or chemicals and then dried thoroughly. Restorations such as rebuilding features, masking sores or abrasions, etc are done. Makeup are applied on the face, neck, and hands. Either a translucent makeup is used in normal cases or an opaque makeup is applied if the skin is discoloured. In either case, the effect should be as subtle as possible. The fingernails are trimmed. The hair is styled, either by the embalmer or by a professional hairdresser or barber.

The remains are dressed in the outfit chosen by the family. This outfit almost always includes underwear, shoes, and socks. In the case of autopsy or other difficulties, plastic undergarments are placed on the body to prevent leakage.

Finally, casketing takes place. The body is placed into the casket and posed in the proper position. The family normally views the body at this point and decides on any changes that need to be made. During the viewing period (which can sometimes last for several days) the embalmer will periodically check the body for signs of decomposition and takes any corrective action.

In the skilled hands of a embalmer, remains that have been disfigured in an accident or started to decompose can be restored almost, if not exactly, to the original looks.

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