Embalming Theory: Week 8

Drainage
and
Cavity Treatment

​

​Week 8

Drainage

• Postmortem Blood Distribution

  • 85% in capillaries

  • 10% in veins

  • 5% in arteries

  Purpose of Drainage

  • To remove blood, clots, interstitial fluid, lymphatic fluid, and arterial solution during vascular embalming (typically through a vein)

  • embalming while stopping venous drainage for short intervals.

Drainage

• Methods of Drainage

  • Restricted Drainage – Limited vein access for controlled removal.

  • Alternate Drainage – Inject 1–2 quarts of arterial solution, stop injection, then allow venous drainage.

  • Intermittent Drainage – Continue arterial injection throughout embalming while stopping venous drainage for short intervals.

Drainage Techniques

• Concurrent (Continuous) Drainage

  • Arterial injection and venous drainage occur at the same time throughout the embalming process.

  Direct Heart Drainage ("Heart Tap")

  • A closed drainage method

  • Fluid is removed directly from the right atrium using a trocar

• Embalming solution

• Blood and blood clots- can be relived with delayed or intermittent drainage

• Interstitial fluid-substance in the supporting connective tissues surrounding body cells.

• Lymphatic fluid-a clear, watery fluid that helps maintain the body's fluid balance and immune health

​Contents of drainage

Drainage

• No Drainage

  • Drainage in the intestinal tract

  • Ruptured Spleen or other internal organs

  • Traumatic death involving major blood loss

  • Infections that cause extensive blood clotting
    

Drainage complications

Drainage

• Purpose

  • To ensure that the contents of the hollow viscera and body cavities are treated

  • To inhibit the formation of any products of decomposition in the body cavities or hollow organs

  • To inhibit putrefactive changes in tissues within the body cavities

General Considerations

Cavity Treatment

Theories – Immediate Embalming Benefits

• Prevents gas formation that can lead to purge

• Removes microbes that accelerate decomposition

• Drains blood from the heart and liver, and fluid from the lungs

• Clears semi-solid contents of hollow organs that may contribute to bacterial spread

• Opens channels in the neck, helping reduce facial swelling

Cavity Treatment

Theories – Delayed Embalming

• Provides time for arterial fluid to fully penetrate tissue spaces

• Aids in preserving the walls of visceral organs

Cavity Treatment

• Right Hypochondriac

• Epigastric

• Left Hypochondriac

• Right Lumbar

• Umbilical

• Left Lumbar

• Right Iliac (Inguinal)

• Hypogastric (Pubic)

• Left Iliac (Inguinal)

Abdominal Anatomical Regions

Nine-Region Method

• • Right Upper Quadrant(RUQ)

  • Left Upper Quadrant(LUQ)

  • Right Lower Quadrant(RLQ)

  • Left Lower Quadrant(LLQ)

Four Abdominopelvic Quadrant Method

Stomach Injection (Trocar Guide)

• Aim the trocar at the intersection of the 5th intercostal space and the left midaxillary line

  • (Line extends downward from the center of the medial base of the axillary space along the rib cage)

• Advance the trocar until it enters the stomach

Trocar Guides

• Cecum Injection (Trocar Guide)

  • Aim the trocar toward a point ¼ of the distance from the right anterior superior iliac spine (ASIS) to the pubic symphysis

  • Keep the trocar close to the abdominal wall until within 4 inches of the ASIS

  • Then dip the point 2 inches and insert forward into the colon

Trocar Guides

Right Side of Heart (Trocar Guide)

• Aim the trocar along a line from the left anterior superior iliac spine (ASIS) to the right earlobe

• After passing through the diaphragm, depress the point and enter the right side of the heart

Trocar Guides

Urinary Bladder (Trocar Guide)

• Keep the trocar close to the abdominal wall

• Direct it toward the midline of the pubic bone (symphysis pubis) until it touches the bone

• Retract slightly, depress the point, and insert into the urinary bladder

Trocar Guides

• Trocar

• Tubing

• Hydroaspirator

• Electric aspirator

• Autopsy aspirator

Aspiration and injection equipment

Cavity Treatment

• Nasal Tube aspirator

• Gravity injector

• Cavity injector

• Hand pump

Trocar Methods

• Direct Incision Method – The trocar itself is used to make the incision.

• Surgical/Autopsy Method – The body cavity is already open due to an autopsy, partial autopsy, or surgical procedure.

Aspiration and injection methods

Cavity Treatment

Aspiration and injection methods

Cavity Treatment

Cranial Cavity (Trocar Method)

• A small trocar is inserted through the nostril

• Advance it through the cribriform plate of the ethmoid bone

Aspiration and injection methods

Cavity Treatment

• Thoracic and Abdominal Method

  Purpose

  • Remove torso contents to prevent internal organ decomposition

  Method

  • Standard trocar entry: 2 inches left and 2 inches above the umbilicus

  pelvic

Aspiration and injection methods

Cavity Treatment

• Order of Treatment

  1. Thoracic cavity

  2. Abdominal cavity

  3. Pelvic cavity

  When injecting cavity fluid, follow the same order: thoracic → abdominal → pelvic

Re-aspiration

• • Circumstances Requiring Treatment

    • Several hours after embalming, it may be necessary to aspirate the body cavities again

    • This process is called re-aspiration

• Predisposing conditions

  • Intestinal flora

  • Pathological

  • Decomposition

  • Environmental

  • Obesity

Purge

Purge

​Types and Characteristics of Purge – Stomach

• Consistency: Liquid or semi-solid, often resembling coffee grounds

• Odor: Acidic

• Contents: May include stomach contents, blood, or arterial solution text here

Purge

​Types and Characteristics of Purge – Lungs

• Consistency: Frothy with air bubbles

• Color: Clear, off-white, or yellow-white; may be tinged with red blood

• Odor: Minimal

• Contents: Respiratory fluids, possibly mixed with arterial solution

Types and Characteristics of Purge – Brain

• Consistency: Creamy white and semi-solid

• Causes: Swelling, putrefaction of the brain, or head trauma

• Contents: Brain tissue, arterial solution, and blood

Purge

Purge

Types and Characteristics of Purge – Anal

• Consistency: Liquid or semi-solid

• Color: Very dark, resembling pitch or tar

• Odor: Strong, foul

• Relieve abdominal pressure and distention caused by gas

• Remove edema from the abdomen

• Aspirate thoroughly – repeat as necessary

• Pack orifices tightly before dressing and casketing

• Re-aspiration of all cavities and distribution of cavity fluid to all areas

Treatment of Purge