EMBALMING II

MOR 340
LESSON 1.1
Cavity Embalming
PURPOSES OF CAVITY TREATMENT
(ASPIRATION & PERFUSION W/CAVITY FLUID)

Reach the substances and microbes found in the spaces within the thoracic,
abdomino-pelvic, and sometimes cranial cavities

Treat those materials found within the hollow viscera and portions of the visceral
organs themselves that are not reached by arterial injection
CAVITY EMBALMING
DESIGNED TO TREAT…

Contents of hollow viscera

Walls of visceral organs
Contents of spaces between organs & walls of cavity

 If not done: odors, gas, & purge can easily develop.

 WHEN IS IT NOT DONE?

Donation of body to a medical school

TYPES OF PURGE

Source Orifice Description

Stomach Nose/Mouth Liquids/semisolids; “coffee
ground” appearance; odor
Lungs Nose/Mouth Frothy; occasionally blood
present; little odor
Brain (rare) Nose/Ear/Eyes Creamy white semisolid brain
matter; gas in eye tissues
BODY REGIONS

4-Region Plan
Upper R & L quadrants
Lower R & L quadrants
9-Region Plan R. Hypochondriac L.
Epigastric Hypochondriac

R. Lumbar Umbilical L. Lumbar

R. Inguinal/Iliac Hypogastric L. Inguinal/Iliac

TROCAR GUIDES

To reach:
Right side of heart (Heart tap)
Stomach
Bladder
Cecum (the pouch at the junction of the small & large intestines)
Why?
TROCAR GUIDE: RIGHT SIDE OF
HEART

Entry point: 2 inches to left and 2 inches above the

umbilicus
Deceased’s left

Move the trocar along a line from the left anterior-

superior iliac spine and the right earlobe; depress
the point after you have passed through the
diaphragm
TROCAR GUIDE: STOMACH

Direct trocar toward the intersection of the 5th intercostal

space and the left mid-axillary line
Line from center of medial base of axillary space inferiorly
along rib cage
Continue until trocar enters stomach
TROCAR GUIDE: BLADDER

Direct the trocar along the abdominal wall to the symphysis pubis, pull it back
slightly and depress it while moving it forward.

Should be very noticeable when you hit the bladder...(if the tank was full!)
TROCAR GUIDE: CECUM

Direct trocar toward a point ¼ the distance from

the right anterior-superior iliac spine to the pubic
symphysis

Keep trocar up near the abdominal wall

When within 4 inches of the anterior-superior iliac

spine, dip trocar 2 inches and insert into
cecum/colon
PARTIAL ASPIRATION

Sometimes aspiration is necessary DURING the arterial injection.

Abdominal pressure: Gas or edema
Can act as extravascular resistance
Text suggests using a scalpel to puncture abdomen: a trocar will work as well
SUBCUTANEOUS EMPHYSEMA

Tongue & facial tissues distended

Thoracic walls all the way to scrotum

IF NO ODOR OR SIGNS OF DECOMP

Feel for broken rib
Tracheotomy
Needle punctures
ASPIRATION TECHNIQUE

Standard point of entry:

2 inches to (deceased’s) left & 2 inches superior to navel
Inserting on the right would put you in the liver
Fanning or “Fan & Layer” method
Keep trocar in constant motion
Avoid clogging (small intestine “clingy” tissue)
If you hit a pocket of fluid, gas, etc. – stop moving & let it sit!
CAVITY TREATMENT: WHEN??
TWO SCHOOLS OF THOUGHT…

Immediately following arterial injection

Several hours after arterial injection
ADVANTAGES OF IMMEDIATE
ASPIRATION

Large numbers of microbes removed

Prevents possibility of translocation
Minimizes production of gas
Removes materials that could purge
Eliminates a bacterial medium (visceral contents)
Helps prevent blood discolorations
Decreases swelling.
ADVANTAGES OF DELAYED
ASPIRATION

It allows a maximum time for the arterial solution to penetrate the tissue spaces by
maintaining pressure within the vascular system.
Gives tissue more time to firm
If you’ve used a humectant co-injection to “fill out” the features, IVP makes this more
effective.

Bigger firms don’t have the luxury of time and will generally aspirate immediately.
INJECTION OF CAVITY FLUID

Text suggests 16 oz. for each cavity: (thoracic, abdominal, & pelvic.)
Some FH owners may stroke out at this sight
On a “standard” case, one bottle is usually sufficient...(8 oz. “up” and 8 oz. “down”)
Larger cases (250 lbs.+), delayed embalmings, etc. will require two bottles
Turn body on side
Wash/dry > Distribuite cavity fluid > Bring any gases to surface
INJECTION OF CAVITY FLUID

Vent on side of cavity fluid injector

Control flow of fluid

Chemicals applied to anterior surface of abdomino-thoracic wall

Gravitation through openings made during aspiration
Leave the fluid “high” in the abdomen
Absorbed by or rest upon posterior surface of cavity walls
CRANIAL ASPIRATION
(NOT COMMON)

 Use a small (infant) trocar and insert it into the nostril until you
pierce the Cribriform Plate of the Ethmoid Bone
 Inject a small (few oz.) amount of cavity fluid using a
hypodermic syringe
 Tightly pack the nostrils with cotton
CLOSURE OF ENTRY POINT

 Trocar Button
 Purse string suture
 “N” or Reverse Stitch
 Many embalmers will put an adhesive/sealant over the button
before dressing.
PURSE STRING SUTURE
RE-ASPIRATION & RE-INJECTION

Noticeable amount of gas in the abdomen prior to dressing

Ship-out or ship-in
When decomposition is present
Recent abdominal surgery
Obese cases
Evidence of gas or purge
Blood infection or infection of abdominal cavity (e.g., sepsis)
Drowning case
Bodies with ascites

Trade Calls: You never know who’s been working on the body!
ANY QUESTIONS ON CAVITY
TREATMENT???