Embalming theory: Week 13

Ionizing Radiation

Preparation of Stillborns, Infants, and Children

​

​Week 13: Special Cases

Radiation Exposure and Embalming

• Embalmers may occasionally encounter bodies that have received radiation therapy.

• Medical institutions administering these treatments closely monitor radiation levels.

• Bodies are not released until radiation exposure is confirmed to be within safe limits.

• Documentation of the radiation treatment must accompany the body upon release.

Radiation Levels and Embalming

• High-Level Radiation:

  • Generated as a byproduct of reactions inside nuclear reactors.

  • Not typically classified as hospital waste.

Radiation Levels and Embalming

• Low-Level Radiation:

  • The type embalmers are most likely to encounter.

  • Originates from various sources such as hospitals, research facilities, and nuclear power plants.

  • May include contaminated materials such as:

    • Clothing, shoe covers, rags, and other protective gear

    • Medical supplies like tubes, swabs, syringes, and needles

Ionizing Radiation

• Each state is responsible for establishing standards for radioactive Waster disposal.

  • KS Stature 2019, Article 16-Nuclear Energy Development and Radiation Control gives guidance to funeral homes on the topic of Radioactive material disposal.

  • Generally, it must be stored until it is no longer considered radioactive

  • There are waste disposal companies that specialize in the radioactive waste.

  • Medical institutions provide some form of warning indicating exposure to radiation.

  • The institution is not permitted to release the body until the level of radioactivity has dropped below 30 millicuries for unautopsied bodies; 5 millicuries or below for autopsied remains.

Ionizing Radiation

• Protective measures for the embalmer

  • Items to be worn for protection

    • Wear PPE-addition of heavy rubber gloves worn over standard surgical gloves, a heavy rubber apron.

  • Treatment of instruments

    • Sanitize instruments

  • Limit contact with remains

    • Protection, Limit time of exposure, and distance from the body.

Ionizing Radiation

• Treatment during Embalming:

  • Flush all instruments with running water before submerging in cold chemical sterilant.

  • Dispose of soiled paper toweling, cotton, suture material, hospital gowns, and the like, in the approved biohazard waste container.

  • Washable gowns, towels, and clothing are readily laundered in-house or placed in a laundry bag for the service provider.

  • Document the decedent’s exposure to radiation on the Embalming Report

  • Triage all exposure incidents and report for medical attention.

Preparation of the stillborn, infant, and child

• Preterm- Live birth before 37 weeks gestation

• Stillborn Death occurs before or during delivery

• Infant Birth to 18 months

• Legal definition of a fetus varies by state, but essentially this is a preterm infant:

  • Many states require a fetal death certificate before 22 or 24 week gestation

    • In Kansas this is called a Certificate of Stillbirth

    • In Missouri a a report of spontaneous fetal death is filed and a Certificate of Birth Resulting in Stillbirth can be requested

Preparation of the stillborn, infant, and child

• Embalming analysis with documentation

  • ratios of Body fat and water are higher in infants

  • Infants have delicate skin and vessels are much smaller, thus infant bodies are prone to swelling and distention

  • Do not use harsh fluids

  • Use smaller Arterial Tubes and reduce the pressure.

Preparation of the stillborn, infant, and child

• Embalming considerations

  • Arterial injection- Expect most cases to be post -Autopsy.

    • Un-autopsied

      • Deaths to to chronic illnesses

      • May have complications due to medications and medications-edema

      • Common for the hospital to hold the infant until the mother is released from the hospital

    • Autopsied

      • Trauma , prolonged refrigeration, Autopsies are often more extensive than adult autopsies

Preparation of the stillborn, infant, and child

• Consider humectants, co-injections, and fluids that are designed for infants.

• Hypodermic and surface treatments

  • Depending on the size of the infant, it may be more practical to use hypo and surface embalming, especially for fetal remains.

• Feature setting and positioning

  • Needle injector typically not practical

  • The infant mouth tends to close naturally or can be sutured with the musculature suture.

  • Eye caps and mouth formers can be cut and modified