Preparation of the Infant- Exam 2- 4 Flashcards
(37 cards)
It is recommended that the embalmer not use these for the preparation of the infant. Many of these small bodies do not demand as much preservatives as an adolescant or adult, but require a similar strength of arterial solutions. Use regular arterial fluids and strengths only slightly reduced from those of the adult.
Pre-Injection and Weak Arterial Solutions
- Cranial
- Throacic
- Abdominal
- Spinal autopsy
- Limbs examined
Complete Autopsy- Infants
- Cranial, thoracic or abdominal cavities, spine or limbs.
Partial Autopsy- Infants
Removal of only one organ.
Organ Examination Only- Infants
- Organ donors- removal or eyes and/or any of the visceral organs or skin that may be used for transplantation.
- Infants whose embalming has been delayed but who have been neither refridgerated nor frozen.
- Infants that require restorative Treatments (these bodies may or may not be autopsied)
- Fetuses
Unautopsied Bodies- Infants
- Positioning the infant
- Carefully wash the infant
- Remove any intravenous tubes or any other invasive connections to the arterial or venous system. Also remove tracheotomy tube, adhesive tape, etc. Dry wash and cotton gently applied to blood stains, etc.
- Phenol jelly or topical preservative jelly, low fuming, is preferred for osmotic preservation
- Wrap infant in prep towel and show only the face- infants on their backs at rest.
Special Considerations for Non-Viewable Infants
Assume for identification purposes that the non-viewable infant will be seen by one authorized PRD.
- tradition as well as local customs dictates procedures.
Positioning the Body- Non-Viewable Infants
- Feature setting
- Body Positioning
- Dressing
Pre-Embalming Considerations
Avoid mouth closure methods if possible- in a problem case, a muscular suture will fine suture and small half moon needle can be used.
Feature Setting- Mouth (Viewable Infants)
Avoid glue; instead use petrolatum jelly, stay cream, or even massage cream on the lips. Allow lips to part- suckling instinct- a natural feature that should be preserved.
Lip Closure- Infants
Baby eye caps especially designed for children or “cut down” trimmed adult sized eye caps; clear are preferred over flesh color. Glue or petrolatum jelly can be used as an adhesive (Be careful of eyelashes).
Eye Closure- Infants
Head block cannot be used; instead, use towel or small styrofoam blocks to position baby prior to embalming.
- Arms- optional at sides or across the abdomen
- Head optional- straight or slight tilt to right
- Legs- Immediately after injection, wrap legs with wide strips at knees so they will appear straight in casket.
Body Positioning- Infants
Never cut clothing, often parents will dress baby for the last time.
Dressing- Infants
- Pack nose and throat with cotton and sealer, small forcep will be necessary.
- Autopsy- clear plastic over-all incisions- prep towel- plastic and baby hat will be necessary. All incisions must be hidden.
- Small band aids can be placed on top of any incisions.
- Always assume that the family will dress the baby.
Be sure all Incisions are Packed, Sutured, and Sealed
Embalming considerations- nonautopsied
Because vessels are too small to inject and drain and because of the absence of intestinal bacteria- osmotic preservation with topical preservative jelly or topical including cavity packs and osmotic sprays and plast will temporarily preserve the infant long enough for funeralization- long viewings are discouraged, however.
Stillborn Infants and Those Which Die Soon After Birth
Two Methods:
- Ascending Aorta- No
- Abdominal Aorta- Yes
Babies up to One Year of Age (Non autopsied)
- An incision can be made with a strong surgical shear directly down the midline of the sternum. The sternum is then separated exposing the pericardium around the heart.
- The pericardium around the heart is opened exposing the heart as well as the ascending and arch of the aorta.
- A small curved arterial tube is inserted into the ascending aorta as it arises from the left ventricle of the heart.
- Drainage is established from the right artrium.
Ascending Aorta (NO)- This is never to be done
This method will NEVER be used or supported by CCBC Catonsville Mortuary Science Program for 2 reasons:
- Unnecessary mutilation of the sternum
- Arterial fluid will enter the head by way of the common carotid arteries too quickly.
Ascending Aorta
- A 3 inch incision is made just to the left of the midline (or on the midline) of the abdomen from the xiphoid process of the sternum to the umbilicus.
- Open the greater omentum and remove part of the large and small intestines until the spine is visible.
- Abduct the abdominal aorta just to the left of the spine.
- Insert small arterial tube downward toward the common iliac arteries; avoid going into bifurcation. Inject both legs.
- Inferior vena cava will rapidly expand during injection- pierce vena cava with sharp needle to establish drainage.
- After legs and buttocks are embalmed, reinsert arterial tube upward through same entry point in descending adominal aorta. Emblam the head and torso. Drainage will continue from inferior vena cava.
Abdominal Aorta (YES)
Will involve a small intricate baseball stitch. Apply glue over suture and a new band-aid.
Suturing for Both Methods (1 yr age)
Use infant trocar 8-12 inches in length 1/4 inch in diameter. Either the immediate or deterred cavity treatment method can be used based on the condition of the body.
- Recommend re-aspiration before dressing leaving cavities dry. Do not add additional cavity fluid unless decomposition is present. No more than 8 ounches of cavity fluid, undiluted, 4 above- 4 below diaphragm.
Aspiration after Injection of the Infant
The apiration and cavity injection can be done through 3 inch incision already utilized previously.
Advantage of Abdominal Aorta Method
A Trocar button will have to be utilized using this method.
Disadvantage of the Ascending Aorta Method
- Any acceptable mouth closure method.
- Any acceptable lip closure method
- Eye caps for eye closure- baby caps or trimmed adult caps.
- Injection and drainage site- right femoral artery and vein
- Cavity treatment- immediate or deterred method reaspiration prior to dressin; inject undiluted cavity fluid- total 16 ounces: 8 ounces above and 8 ounces below diaphragm.
Children from One to Five Years of Age
