Everything You Didn't Want To Know About Embalming
In one of my first posts, I invited readers to email me with their questions about the embalming process. Not surprisingly, I've had no takers. Apparently a lot of people are uneasy discussing death and death-related issues. So allow me to enlighten you, dear readers. Read on at your own risk.
The first thing to be done when a body comes into the prep {preparation} room is to lay it out on the prep table and remove the clothes. Once this is done, the body is thoroughly washed, including shampooing the hair. Next the body must be properly positioned. The hands are usually folded across the stomach, with the left hand atop the right hand. This is to allow the wedding band {if any} to be seen. The head and shoulders are elevated; the head is placed on a head block, with the head turned slightly to the right {the deceased's right}. This is to allow proper viewing of the deceased as they lay in the casket. Underneath the shoulderblades a positioning board is placed, which raises the upper back slightly off the table. In addition, the oral, nasal and ocular orifices are sprayed with a strong disinfectant. The nostrils are cleaned out and the hairs trimmed. For male bodies, a shave is usually given. It is important to shave the body prior to embalming; doing it afterward can result in razor burn and make cosmetizing difficult.
Next the facial features must be properly positioned. This is referred to as "setting the features." Eyecaps or cotton are inserted underneath the eyelids. This is to promote a roundness to the eye, as the eyes tend to flatten and sink slightly into the socket after death. The lids are closed, but contrary to popular belief, are not stitched shut. Usually nothing special is required to keep the lids closed, but if they persist in gapping open slightly, a slight touch of aron alpha (superglue) is sufficient to keep them closed.
Once the eyes are properly closed, the mouth must be closed. If the deceased wore dentures, it is preferable to have them available to place back in the mouth. They are brushed and cleaned before being reinserted. The mouth of a deceased person will not naturally stay closed; it will want to drop open.
Warning: Graphic Content Ahead. There are two methods for keeping the mouth closed. The most common is with the use of a needle injector. The other method is the mandibular suture. I prefer the needle injector. This is a device that drives a barb with wire attached into the gumline. One is anchored in the upper gums, the other in the lower. The wires are then twisted around each other to draw the mouth closed. The mandibular suture, which in my opinion is even more violent, consists of stitching the mouth closed by inserting the needle through the roof of the mouth and into the nostrils, through the septum, back down into the mouth, and out through the jaw just posterior {toward the backside} of the chin, then back up into the mouth, where it is tied off. The drawback to this method is the suture under the chin leaves a dimple, which must be covered and cosmetized. Once the mouth is closed, cotton is usually inserted behind the lips to raise them up and give the mouth a natural looking contour.
Once the features are set, the vessels are raised. The most common site for arterial embalming is the right common carotid artery, with drainage out of the internal jugular vein. An incision is made through the skin at the collarbone, then the vessels are exposed by a method called blunt dissection. This is a process where the underlying fascia is pulled aside with instruments called aneurysm hooks. Once the fascia is cleared out of the way, the vessels are exposed and scraped clean of the material encasing them. This cleaning allows them to be more flexible. The vessels are then pulled to the surface, and ligature {string} is tied around them. Each vessel gets two pieces; one toward the head, the other toward the torso. Once the ligature is attached, the vessels are then cut halfway through. The reason for this is you don't want them to snap back down into the body; they would be nearly impossible to find and retrieve. Once the vessels are cut, the arterial tube {cannula} is inserted in the artery and tied down with the ligature. The drainage tube is inserted into the vein and similarly secured. Once your instruments are secured, the embalming fluid is pumped through the cannula and into the circulatory system. As the mixture is injected, the blood will begin draining out of the drain tube. It takes about 1 gallon of fluid for every 50 pounds of body weight, so a person that weights 200 pounds would receive roughly 4 gallons {give or take} of fluid. During the injection of the solution, which can take anywhere from 10 minutes to 30 or more, depending on rate of flow, distribution of fluid, adequate drainage, etc., the embalmer periodically massages the extremities to promote good distribution. In addition, he/she checks the coloring of the fingernails. They should turn pinkish if fluid is reaching the fingertips. He/she also checks the elasticity of the skin. If a body is getting good distribution, the skin will lose some of it's "snap." The embalmer pinches a small portion of skin and pulls on it. If it slowly settles back into place, that part of the body is receiving the embalming fluid. If for some reason {blood clots, atherosclerosis, damage to the vessels} fluid is not being adequately distributed, the embalmer may have to raise more vessels to treat the appropriate areas. For example, if the legs are not getting fluid, the femoral arteries and veins may need to be raised and injected.
A note about drainage: the prep table is usually inclined, with the head of the table higher than the foot end, which is usually positioned above a drainage sink. All of the blood flows down the table and into the sink, which in turn drains {warning!} into the sewer system. That's right, your tap water was once filled with blood and body fluids. However, in cases involving highly contagious diseases (AIDS, Creutzfeld-Jakob, etc) the blood is collected and disposed of as hazardous waste.
Once the body has been embalmed, the incision site(s) are sealed and stitched closed. Now comes the part I was most concerned I would have difficulty with {but didn't}: cavity treatment.
Warning: Graphic Content Ahead. The body is filled with hollow organs and fluid filled organs. These must be treated separately, and differently, from arterial injection. The gasses and fluids must be removed, or decomposition will set in, despite the arterial embalming. A device called a trocar is attached to a vacuum, and then inserted into the torso. The point of insertion is 2 inches above the navel, and two inches to the deceased's left. Once inside, the trocar is maneuvered around in an attempt to puncture all the hollow organs and draw out all the fluids, gasses, and waste material. These organs include the lungs, heart, stomach, spleen, kidneys, intestines, urinary bladder, and cecum. There may be more, it's been over a year since I performed my last embalming, but those are the vital ones. From the lungs you want to collect any liquids, such as from pneumonia. From the heart, blood, from the bladder and kidneys, urine, from the spleen, bile, and from the cecum, fecal matter. Most vacuum tubes attached to the trocar are clear, so you can observe the progress of this process, called aspiration. If you see clear fluid, you're getting fluid from the lungs, yellow=urine, red=blood, brown/black=feces, and so on. Once the cavity has been thoroughly aspirated, a bottle of cavity fluid is attached to the trocar and pumped inside the cavity. Usually one 16 ounce bottle for the thorax {chest area} and one 16 ounce bottle for the abdomen. Once cavity injection is accomplished, the puncture wound made by inserting the trocar is closed up by one of two methods. It can be closed with a cone-shaped button that is inserted into the opening and then twisted shut, or a purse-string stitch can be used, which draws the wound closed like a medieval coin pouch.
Once the cavity treatment is complete, the body is then washed again, dried, dressed, placed in the casket, then cosmetized. Depending on how many vessels need to be raised, this entire process can take anywhere from 90 minutes to several hours.
Any questions?
The first thing to be done when a body comes into the prep {preparation} room is to lay it out on the prep table and remove the clothes. Once this is done, the body is thoroughly washed, including shampooing the hair. Next the body must be properly positioned. The hands are usually folded across the stomach, with the left hand atop the right hand. This is to allow the wedding band {if any} to be seen. The head and shoulders are elevated; the head is placed on a head block, with the head turned slightly to the right {the deceased's right}. This is to allow proper viewing of the deceased as they lay in the casket. Underneath the shoulderblades a positioning board is placed, which raises the upper back slightly off the table. In addition, the oral, nasal and ocular orifices are sprayed with a strong disinfectant. The nostrils are cleaned out and the hairs trimmed. For male bodies, a shave is usually given. It is important to shave the body prior to embalming; doing it afterward can result in razor burn and make cosmetizing difficult.
Next the facial features must be properly positioned. This is referred to as "setting the features." Eyecaps or cotton are inserted underneath the eyelids. This is to promote a roundness to the eye, as the eyes tend to flatten and sink slightly into the socket after death. The lids are closed, but contrary to popular belief, are not stitched shut. Usually nothing special is required to keep the lids closed, but if they persist in gapping open slightly, a slight touch of aron alpha (superglue) is sufficient to keep them closed.
Once the eyes are properly closed, the mouth must be closed. If the deceased wore dentures, it is preferable to have them available to place back in the mouth. They are brushed and cleaned before being reinserted. The mouth of a deceased person will not naturally stay closed; it will want to drop open.
Warning: Graphic Content Ahead. There are two methods for keeping the mouth closed. The most common is with the use of a needle injector. The other method is the mandibular suture. I prefer the needle injector. This is a device that drives a barb with wire attached into the gumline. One is anchored in the upper gums, the other in the lower. The wires are then twisted around each other to draw the mouth closed. The mandibular suture, which in my opinion is even more violent, consists of stitching the mouth closed by inserting the needle through the roof of the mouth and into the nostrils, through the septum, back down into the mouth, and out through the jaw just posterior {toward the backside} of the chin, then back up into the mouth, where it is tied off. The drawback to this method is the suture under the chin leaves a dimple, which must be covered and cosmetized. Once the mouth is closed, cotton is usually inserted behind the lips to raise them up and give the mouth a natural looking contour.
Once the features are set, the vessels are raised. The most common site for arterial embalming is the right common carotid artery, with drainage out of the internal jugular vein. An incision is made through the skin at the collarbone, then the vessels are exposed by a method called blunt dissection. This is a process where the underlying fascia is pulled aside with instruments called aneurysm hooks. Once the fascia is cleared out of the way, the vessels are exposed and scraped clean of the material encasing them. This cleaning allows them to be more flexible. The vessels are then pulled to the surface, and ligature {string} is tied around them. Each vessel gets two pieces; one toward the head, the other toward the torso. Once the ligature is attached, the vessels are then cut halfway through. The reason for this is you don't want them to snap back down into the body; they would be nearly impossible to find and retrieve. Once the vessels are cut, the arterial tube {cannula} is inserted in the artery and tied down with the ligature. The drainage tube is inserted into the vein and similarly secured. Once your instruments are secured, the embalming fluid is pumped through the cannula and into the circulatory system. As the mixture is injected, the blood will begin draining out of the drain tube. It takes about 1 gallon of fluid for every 50 pounds of body weight, so a person that weights 200 pounds would receive roughly 4 gallons {give or take} of fluid. During the injection of the solution, which can take anywhere from 10 minutes to 30 or more, depending on rate of flow, distribution of fluid, adequate drainage, etc., the embalmer periodically massages the extremities to promote good distribution. In addition, he/she checks the coloring of the fingernails. They should turn pinkish if fluid is reaching the fingertips. He/she also checks the elasticity of the skin. If a body is getting good distribution, the skin will lose some of it's "snap." The embalmer pinches a small portion of skin and pulls on it. If it slowly settles back into place, that part of the body is receiving the embalming fluid. If for some reason {blood clots, atherosclerosis, damage to the vessels} fluid is not being adequately distributed, the embalmer may have to raise more vessels to treat the appropriate areas. For example, if the legs are not getting fluid, the femoral arteries and veins may need to be raised and injected.
A note about drainage: the prep table is usually inclined, with the head of the table higher than the foot end, which is usually positioned above a drainage sink. All of the blood flows down the table and into the sink, which in turn drains {warning!} into the sewer system. That's right, your tap water was once filled with blood and body fluids. However, in cases involving highly contagious diseases (AIDS, Creutzfeld-Jakob, etc) the blood is collected and disposed of as hazardous waste.
Once the body has been embalmed, the incision site(s) are sealed and stitched closed. Now comes the part I was most concerned I would have difficulty with {but didn't}: cavity treatment.
Warning: Graphic Content Ahead. The body is filled with hollow organs and fluid filled organs. These must be treated separately, and differently, from arterial injection. The gasses and fluids must be removed, or decomposition will set in, despite the arterial embalming. A device called a trocar is attached to a vacuum, and then inserted into the torso. The point of insertion is 2 inches above the navel, and two inches to the deceased's left. Once inside, the trocar is maneuvered around in an attempt to puncture all the hollow organs and draw out all the fluids, gasses, and waste material. These organs include the lungs, heart, stomach, spleen, kidneys, intestines, urinary bladder, and cecum. There may be more, it's been over a year since I performed my last embalming, but those are the vital ones. From the lungs you want to collect any liquids, such as from pneumonia. From the heart, blood, from the bladder and kidneys, urine, from the spleen, bile, and from the cecum, fecal matter. Most vacuum tubes attached to the trocar are clear, so you can observe the progress of this process, called aspiration. If you see clear fluid, you're getting fluid from the lungs, yellow=urine, red=blood, brown/black=feces, and so on. Once the cavity has been thoroughly aspirated, a bottle of cavity fluid is attached to the trocar and pumped inside the cavity. Usually one 16 ounce bottle for the thorax {chest area} and one 16 ounce bottle for the abdomen. Once cavity injection is accomplished, the puncture wound made by inserting the trocar is closed up by one of two methods. It can be closed with a cone-shaped button that is inserted into the opening and then twisted shut, or a purse-string stitch can be used, which draws the wound closed like a medieval coin pouch.
Once the cavity treatment is complete, the body is then washed again, dried, dressed, placed in the casket, then cosmetized. Depending on how many vessels need to be raised, this entire process can take anywhere from 90 minutes to several hours.
Any questions?
posted by Granimore | 7:08 PM
5 Comments:
That is very interesting, Granimore. Are there different techniques needed when the body has suffered multiple trauma or already beginning decomp or drownings?
Yes, there are many variations and treatments depending upon the condition of the body. The process of deciding what strength solution to use, which vessels to raise and inject and how best to treat the body is called "case analysis."
will males get erections from embalming as its run through ?
More of a "semi", actually. But this doesn't happen every time. Only once in a while.
thanks so much so nothing needs doing about it .
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