Purges 2022 PDF

11/17/22 Purges 1 Definition Post mortem evacuation of any substance from any orifice of the dead body as a result of pressure Usually refers to nose and mouth 2 Usually contents of the stomach and lungs May a...

11/17/22 Purges 1 Definition Post mortem evacuation of any substance from any orifice of the dead body as a result of pressure Usually refers to nose and mouth 2 Usually contents of the stomach and lungs May also indicate the arterial injection has ruptured a major vessel and that arterial solution is now pushing against hollow organs as it fills the ventral cavity BUT, it does happen 3 1  11/17/22 Biggest problem is when it occurs during or following embalming - could lead to dehydration, discolouration of lips and cheeks 4 Classification: Time 5 Pre-Embalming Purge Cream lips after cleaning Use nasal aspirator Disinfect Set features (consider suture mouth closure method) 6 2  11/17/22 Embalming Purge If minor and not disrupting circulation or causing abnormal amounts of abdominal distention cream face and continue injection (minor means output is much less than input) You still need to be observing positive signs of distribution 7 Embalming Purge cont’d If significant amounts of arterial solution are being wasted, time to go to a multipoint injection Torso will likely need to be hypo- injected since now you are only treating the limbs and head once complete, re-clean and re-set the mouth 8 Post-Embalming Purge Considered embalming failure sign of putrefaction somewhere in body (pressure created by untreated tissues and bacteria) Worst time if body in casket 9 3  11/17/22 Remove body from casket re-evaluate the state of the remains, is hypo-injection of torso needed? Re-aspirate thoroughly, re-inject cavity fluid May be necessary to clean/change clothing or casket interior Emotional suffering increased 10 Classification: Origin 11 Stomach Usually gastro-intestinal Hydrochloric acid from stomach (pH 2-5) makes this purge most dehydrating and distorting May even burn facial skin to point of permanent staining 12 4  11/17/22 Lung From respiratory tract Common with pneumonia, drowning, asphyxia, CO poisoning, accidents which crush chest Tx depends on volume of liquid and time of purge 13 If volume slight and occurs well into procedure, elevate head If volume great, possibly due to pressure building within abdomen. Relieve by making trocar incision to allow escape of gas/fluid Now consider if a multipoint is required 14 Brain Cranial purge. Delayed embalming may mean decomposition beginning in the brain, infection or trauma to head Look for slightly distended eyes for a sign of intra cranial pressure 15 5  11/17/22 Brain cont’d Creamy white consistency The cranial vault is sealed so for this to exit means the skull has been compromised by trauma or disease 16 Classification: Consistency 17 Frothy Purge From lungs air from alveoli mixed with fluid Slightly yellowish with bubbles 18 6  11/17/22 Clear or False Purge Arterial solution coming from nose or mouth Not from putrefaction Vascular rupture (short circuit) May also be caused by needle holes created during mouth closure (false) 19 Bloody Purge Vascular rupture - most likely a vein pre-embalming will probably become arterial solution at some point in injection you must decide if this is impacting your preservation effort 20 Coffee Grounds Purge Gastro-intestinal tract Result of blood mixing with stomach acid Up the esophagus to the oral cavity 21 7  11/17/22 Creamy Purge Cranial purge Attempt to treat source of all purges, not just result 22 Conditions That Promote A Purge 23 Accelerated Decomposition Gases produced in intestines may push on stomach and lungs Weakened vessels may rupture during arterial injection 24 8  11/17/22 Delay Between Death and Embalming Forces of decomposition are only slowed by refrigeration Autolytic changes will weaken vessels 25 Drowning or Asphyxia Fluid accumulation in lungs – Pulmonary Edema With any lung death caused by disease, the body responds to the infection or irritation by bringing more WBC’s to the area – this increases the moisture level 26 Recent Abdominal, Thoracic or Cranial Surgery Weakened blood vessels may rupture or leak during injection 27 9  11/17/22 Tissue Gas Very aggressive path of decomposition Gas bubble blocks arterial solution inside vessels just like a clot Gas pressure displacing contents of hollow organs 28 Esophageal Varices, Ulcerations of G.I. Tract or Internal Hemorrhage Leak via anus or collect and exit via mouth Ulcers are a site that will bleed Esophageal Varices are common with liver ailments 29 10 Ways to Prevent a Purge Avoid excessive massage of abdomen Avoid delaying drainage too long Avoid excessive pressure Avoid excessive rate of flow 30 10  11/17/22 Avoid poor injection Avoid poor drainage Avoid poor aspiration Avoid poor placement of cavity fluid Don’t tighten belt too much Keep head up, hips down, especially when casketing 31 11