Abstract
Embalming is the process of cleaning, preserving and presenting a deceased patient. Embalmers are at a risk of contracting diseases especially when dealing with deceased patients who have died out of contagious diseases such as Anthrax, mad cow, Tuberculosis, HIV/AIDS etc due to the presences of micro-organisms including bacterial and viruses. Effective control of micro-organisms is reflected in the first two aspects i.e. sanitation and preservation. To achieve these two aspects embalmers employ the use of formaldehyde, a soluble gas. This soluble gas is introduced to the body via the arterial system which allows penetration to every tissue. Formaldehyde works by killing bacterial and fixing cellular proteins to ensure that there won’t be any source of food for any remaining bacteria.
Discussion
Besides ensuring that the deceased patient posses no threat of infection, an embalmer must also ensure that he is immunized against infections diseases. These diseases include tetanus, BCG, Typhoid, Polio and Hepatitis A&B. There are other forms of micro-organisms practices that can used in a mortuary. It is important for any embalmer to understand that the first practice that can save him unnecessary contamination is the good housekeeping methods. This is a daily routine for any embalmer and it includes cleaning, tidying up (the less clutter the easier the room to keep and the less mess the less chance of an accident and subsequent infection). Ensuring good ventilation in an embalming room is also protection to an embalmers health as is direct sunlight that does kill tuberculosis virus. (Sague, 1993).
Apart from the above physical control measures, chemical control measures should also be employed to ensure that embalmers are not exposed to any risk of infection. Sterilization and disinfection are the most effective ways that embalmers can employ to reduce risks of infection from the dead bodies. Sterilization is classified as the destruction or complete removal of all living material including spores while disinfection as the destruction of active micro-organisms but necessary spores. Sterilization is effected by dry heat (burning) and moist heat (autoclaving, steam under pressure) obviously burning is not practical in the theatre so we employ clinical waste disposal. There is also the second method of sterilization called dry heat sterilization which takes place when pathogens are destroyed by hot air. All contaminated material is placed in a marked clinical waste bag and these are collected by a licensed company who burn them. Sharps boxes (special boxes that contain used needles, razors and scalpel blades) are also dealt with through clinical waste.
As working embalmers we may sterilize our instruments if we are lucky enough to have such equipment as an autoclave. Autoclaving is sterilization by steam under pressure, usually at 121o for 15 minutes although for some diseases like MAD COW it is recommended that autoclaving should be 6 times to ensure total destructions of the prions.
Disinfection is another method of avoiding contamination and it involves removing of micro-organisms without complete sterilization. Disinfection is effected by moist heat (boiling) and chemicals. Boiling at 100o for 5 minutes kills most pathogenic organisms but can prove to be hazardous to the embalmer. Chemicals (phenols) are a more widely used form of disinfection in funeral homes. There are many proven chemical disinfectants readily available to the embalmer. The main reason for disinfecting is basically to destroy organisms. There are different forms of disinfection. They include thermal disinfection or pasteurization which is suitable for instruments that can withstand the process of heat and moisture. (Sague, 1993).
The efficiency of this method is dependent on the temperature, ph concentration and the organic and inorganic matter present. Selecting disinfectants depend on the instruments to be cleaned and their purposes. Disinfection is categorized in different levels. There is high level disinfection where all micro organisms are destroyed except bacteria spores. Then there is intermediate disinfection which inactivates some bacteria and then there is low level disinfection which can kill most bacteria except the more resistant one such as mycobacterium. (Block 1991).
As an embalmer I need to understand the factors which will influence the activity of such chemicals and these are; Time, how long will it take to totally disinfect, Concentration, what strength should I make my solution, Temperature, do I need to use hot water, Freshness, how long will the solution last, Amount of infestation, would I need to reduce this before disinfecting, Antagonistic substances, will disinfection be enough, and Direct contact, making sure all sides and faces of whatever I disinfect are in direct contact to the cleaning agent. As with anybody using disinfectants always follow the manufactures recommendations to its successful use.
During presentation cadaver bag are recommended for deceased patients that have died of infectious diseases to prevent leakage of fluids, air or any other contagious human remains. Once the dead body has been covered with the necessary cover, it should be transported inside a trolley to mortuary where they it should remain covered until release from the mortuary. Bodies should be kept under cool temperatures to control further growth of bacteria.
Reference
Block S (1991), Disinfection, Sterilization and Preservation: Philadelphia, PA.
Brock T and Madigan M (1991) Biology of Micro organisms, Prentice Hall: New Jersey.
Sague M, (1993) Universal Precautions in Funeral Practice Communication Centres for Disease Control.