Saturday, December 1, 2007

How do I embalm?

On June 8th of this year I wrote a post about embalming. Well, I can't count the number of posts that involve embalming but that particular one tried to explain the process. That one was too nice, too refined, too much like a text book. My last post about procedure was regarding cremation and I felt it only just to explain in "real" words how an embalming takes place.
Before I go on, you have to realize like in any profession, the main goal is the final outcome and like everyone else, each embalmer has his own way of doing things. Although there aren't many steps to the process we all have slight variances in how we achieve that outcome. So, if there are any embalmers reading this I really don't want to hear how you do it because this is how "I" do it; and that's what counts to me. Here we go.
First off, every funeral home must by law have access to a preparation room, the "prep room", which is filled with all kinds of goodies used in the process. The basics: An embalming machine, which is simply a pneumatic pump that can be adjusted for rate of flow and the pressure of the fluid being pumped. Scalpels, scissors, aneurysm hooks to assist in finding and raising arteries and veins, needles for the suturing of incisions, drain tubes for insertion into veins to facilitate drainage, a needle injector used to close mouths, forceps, a trocar used for aspiration of the abdominal and thoracic cavities, head block, of course an operating table; these are just the instruments and the majority of them are sized variously, for the variously sized people. You can also find ligature, eye caps, injector needle inserts, mouth formers, rolls of cotton, various arterial fluids, cavity fluid, embalming powder, dyes, shampoos, nail polish, hairspray, plastic clothing, towels, sheets, dry shampoo, glue, razors, shaving cream, gloves, smocks, and the list could go on forever...and these are the basics.
The first thing I do of course is to get into a smock, "glove up" and get the person on the table. I always use "universal precautions". I then remove all of the clothing or hospital wrappings being careful to keep an eye out for any "sharps" that may have been left behind. I then remove any IV's that have been left in, feeding tubes, sometimes colostomy bags, tape, leads, basically everything to the skin all the while taking note of any special treatment that may be needed such as to sores, skin slip...I then cover the persons genitalia with a towel.
Once this is complete I determine the type of fluids I will be using and begin to brew the mixture. While the water which is mixed with the fluid is filling the pump, I wash the person down with a germicidal soap. Once this is done I perform any shaving that is necessary since I find it easier while the person is still un-embalmed. I next "set features" by inserting eye caps which grip the inside of the eyelids and help to keep them closed and also put in any dentures and close the mouth with a needle injector. Very rarely do I use cotton or filler to puff out hollowed features because I feel the person looks more natural if left as is unless there is obvious emaciation.
The next step is to raise an artery and a vein. I usually use the carotid artery and jugular vein to start, however the femoral artery is often used as well as the axillary artery when good fluid flow cannot be achieved; but that will be found out later. Once I've made my incision and located the two vessels I use an aneurysm hook to raise them to the surface. I place a cannula in the artery and the drain tube in the vein and hold them in place with either clamps or ligature.
A tube is attached to the cannula which will supply the mixture of formalin I have prepared and the pump is turned on; I start with very low pressure until I see what the output is like. In theory, the fluid being pumped in forces the blood and fluids out; theory. Sometimes however the blood has clotted and causes dams which do not allow the fluid to flow freely and swelling could result, this is why I start out slow. When this occurs, the vein tube can be pumped manually which helps to break up clots. You can also massage the person in hopes of releasing the clot or clots. If this fails this is when the additional arteries come into play, almost like a bypass.
When the output turns the color of the fluid being pumped in you know that complete circulation has taken place. Before this happens you can tell where the fluid has reached by the pinkish tint that the flesh takes on. Over time you learn to tell just by the feeling of the skin since it feels slightly different where the fluid has circulated. I usually start out with two gallons of fluid and that is often more than enough; if not I prepare more.
Once this is done I remove the cannula and drain tube and tie off the openings so that there is no back flow or drainage of the fluid. I now aspirate. Okay, aspiration consists of a trocar or a long tube with a sharpened point which is attached to a hydro-vacuum. This tube is inserted into the abdomen and pierces the diaphragm to puncture each of the organs and esophagus in the thoracic cavity to remove any remaining fluid. Once this is completed the same process is done to the abdominal cavity. So, in actuality, the trocar punctures the heart, lungs, esophagus and the liver, kidneys, bladder, intestines and spleen. The next step is to replace the fluid you removed with cavity fluid, an extremely strong fluid that is not mixed with water. This is to preserve the mentioned cavities. This abdominal puncture is sealed with a "trocar button".
At this point I suture any incisions I have made after drying them with cotton and adding a sealant powder. The entire person is washed again, the hair is shampooed, and the arms are placed in the fashion I want them to remain since the tissues will begin to firm and remain in the position they are in. All of the instruments are sterilized and all of the non liquid wastes are placed into a bio-hazard bag for disposal with medical waste. Fingernails are then cleaned and trimmed, eyebrows and sideburns trimmed, stray hairs plucked or trimmed. The person is then dried, covered with a sheet and awaits their clothing. The embalming is done and it takes as long as it takes; there is no time limit.
These are abbreviated steps, there are many details which I have left out but for the most part you now know how to embalm someone.


Matty said...

Now that you've explained embalming and cremating...I realize it's not as easy as most people think it is to be a funeral director.
I wonder if you found it very difficult at first? Were you able to look at the body without emotion or is that something that takes time? After awhile can you look at a body as an object...and not a person that once lived, loved, laughed? Does it ever get easier?

Anonymous said...

You read my mind. After I read the, "How to cremate," post, I wondered how the embalming was done.

I'm baffled. Where does the Y incision come to and do you not have to pack the sternum w/ newspaper and where did I get THIS INFO?

Thank you. Good job, as usual!

Catherine said...

Thank you so much for this post. It was so very informative and awesome! I love, love your blog.

After knowing all of this it actually helps me in knowing more about what I want after I die. I'm curious, how do you want your funeral to be? Do you want to be embalmed (do you have to be embalmed)?.

Anonymous said...

Wow. This is very informative. I had no idea it was such a detailed process. I'm wondering, like Catherine, what you would want? I'm leaning toward cremation after reading these two posts.

deathsweep said...

matty - yes I found it difficult at first to look at a dead body. But I think I have become more in tune with the fact that the "body" I'm working with was once a person not less.

empath - the Y incision you're speaking of is the result of an autopsy. Over all, very few bodies are autopsied in relation to the number of deaths. As far as newspaper filling the thoracic cavity of an autopsied body...don't know where you picked that up...but it sounds similar to us hanging the bodies upside down to drain blood!

Catherine & Karen - aside from the knowledge of how the processes take place, I have opted to be cremated. Simpler I think.

Thank you all!

MedStudentWife said...

Another mind-expanding blog, DS. I've always wondered what embalming entailed.

How easy is it to do the "make-up" ?

Hungry Ghost said...

Wow - This is heavy stuff. I've never been to an open casket funeral and hopefully never will, but if I do, I'll be thinking of you draining the blood.

ICE_Molly said...

Of all the thoughts that ran through my head whilst reading this post, the thought of my mother on that cold table vividly enthralls my mind. Having passed away nearly 9 years ago, I think of her now - and how her funeral director would have done that of which you wrote.

I have a lot of respect for what you do - your blog removes the morbidness of your profession. =)

I had an aunt and uncle who owned a funeral home and until your blog, didn't think much of what they do. Thanks to you and your blog - I feel differently!

LadyBanana said...

Very very interesting and informative post... something I knew absolutely nothing about!

Shimmerrings said...

Deathsweep, even though it is not mentioned, here, I have to ask you if the internal organs are ever liquified with some sort of whirling blade, and sucked clean out, during the embalming process, or more precisely, if this is a known technique that some morticians employ? I would certainly hope not, but recently my significant other took a trip, with his elderly mother, to a natural burial site. I realize the owners of the burial site would like to promote their own methods (and once they have x-amount of plots sold, the land becomes protected, a double whammy) ... but, they told my significant other that this liquification and sucking out of all the internal organs is what actually happens during the embalming process, but people just don't know about it. This was disheartening to hear, at the very least, as no one wants to think of their loved one's body as being violated in such a horrific way. I've googled for information about this and have found nothing, so far. I can't help but wonder if this was some sort of tactic these folks use to horrify people, in an attempt to encourage natural burials. Could you please enlighten me on that one? I am not against the natural burial sites, they are quite unique and peaceful settings, and sounds very inviting. On the other hand, I do not want misinformation scattered about, either, to further someone else's cause. Truth never hurts, either, even if it's not what we want to hear. What do you say?

Anonymous said...

I would be interested in knowing what was the most difficult case you have had in terms of repairing severe injuries for viewing. All the technical and clinical info was fantastic, but to me the true magic is the talent to bring the dead back to a form comforting and acceptable to loved ones. If everyone could see what a dead person truly looks like before that magical transformation they would understand what I mean. It is easier to let someone go when they appear to be at peace and look as attractive as possible.

Also, what is the youngest victim you have prepared.

I hope for cases such as these you take yourself home or to a nice quiet bar for a good stiff drink. You deserve one.

Anonymous said...

Embalming is NOT required in almost every state! Also, burial vaults are NOT required in most states. These things only put more money in the pockets of the funeral directors. I suggest the reading of The Funeral Rule that ALL funeral directors must abide. Here is a link that tells the truth about the funeral industry if you have the stomach for it. It will save you thousands of $$$$s. These people are not your friends and money is what matters to them. The US is the only nation that pushes embalming and burial vaults and both are useless! Wake the hell up and use that money for your family!

Poor misunderstood undertaker! How many digits are in your annual income? How many times do you tell unsuspecting victims they have to embalm or have a burial vault just to pad your pockets? Do you post your almost humanlike blog to relieve your guilt for cheating people in their most vunerable state? How sad for you.

deathsweep said...

Sad indeed, sad that your ravings are not anything that I have stated on this blog or in person, yet I really need not explain myself to you. Obviously you have either been burnt by someone or perhaps you are plain, how should I say this nicely, well just plain nuts. I hope you enjoy your own tirades. By the way - it would be nice if you had some balls and didn't hide behind "anonymous".