32 ounces of cavity fluid to treat the viscera—one bottle for the thoracic cavity and one bottle for the abdominal cavity. Because the vascular system may be compromised or interrupted by the opioids, the embalmer should use pulse instead of continuous flow so as not to force the fluid into the vessels. After the embalming operation, all PPE should be carefully removed and discarded in the medical waste container. A thorough cleaning of the instruments, floor, and other contaminated areas in the prep room is highly recommended. As opioid powders may have fallen on the floor, staff should not dry sweep with a broom, as this can cause aerosolization. A preferred method is to soak some paper towels with water and then sweep the towels around the room, which will cause any opioid residue to stick to the wet paper rather than become airborne.
Throughout the procedure, fluid may reach the tissues of the face through collateral circulation. This is why it is important to leave the cannula stopcocks open, as these will be the drainage sites. Once the body is thoroughly embalmed with the appropriate index solution, the embalmer can move to the head and inject the right side and left side of the head with a slow and steady rate of flow and pressure, which will give satisfactory results. It is highly recommended to use a delayed aspiration, preferably 6 to 12 hours later. This will allow the vascular pressure from the embalming fluid in the vessels to perforate the interstitial tissues for maximum preservation. As mentioned earlier, because of the onset of hypostasis, it is imperative to postpone the early stages of decomposition from opioid use. It is recommended to use
FUNERAL CONTINUING EDUCATION
directors. They found that individuals from all walks of life and socioeconomic backgrounds were dying. Funeral directors had all faced the same circumstances. For instance, many people who died were young and left behind small children (Allen, 2017). More significant was the fact that the opioid issues were not being addressed anywhere in the mortuary field. Some people in the field thought these issues were significant enough but did not see them being addressed anywhere, so they set up a webinar to give members a heads-up about how the opioid epidemic might affect them (Allen, 2017). Additionally, an expert panel spoke at the National Funeral Directors Association International Convention and Expo in Boston on October 31, 2017, to address the escalating epidemic. The discussions were about the consequential issues relating to substance abuse deaths and the opioid issues facing the U.S., which are becoming a serious global problem (a pandemic). may be prepared to save a life when the time comes. Each kit comes with an intranasal spray or a syringe with a vial of naloxone (Illinois Department of Public Health, 2019). If someone is uncomfortable using a syringe, then an intranasal spray is provided. Many county health departments have information about naloxone training. Once trained, a person can administer naloxone and will receive the kit to take back to the funeral home so that it is readily available when it is needed.
It is important to educate all funeral directors and personnel about the dangers and risks of handling the remains of an overdose victim and how the funeral home staff can become more aware of what they are dealing with. From national to state conventions to web-based continuing education courses, it is all about raising awareness. Being proactive in its approach, the International Order of the Golden Rule (OGR), an association for independently owned funeral homes across the United States, has stepped up to the plate. It has created two webinars and published two booklets: Opioid Epidemic: How Funeral Directors Can Respond and Opioid Epidemic: How Communities Can Respond . At first, OGR printed 1,000 copies of the booklets, but because of the remarkable number of requests, there was another mass distribution of 23,000 copies. It all started through study groups with OGR members and the considerable impact opioids has on families and funeral Naloxone training There is a great need to raise opioid awareness in all funeral directors and coroners across the United States and see that every prep room in funeral homes and morgues at coroners’ offices has a naloxone kit on standby. Illinois county health departments have established a two-hour PowerPoint presentation on the history and dangers of opioids, what to look for in an overdose, opioid exposure, and how to administer naloxone. Upon completion of the course, participants are certified to administer naloxone and receive a kit so that they Conclusion The opioid crisis is not going away. On the contrary, it is found in every suburb and small town, affecting people of all ages. Opioid use is growing and rapidly expanding its deadly reach. If a funeral director has not had a death call regarding someone who was using opioids for pain or a death from an opioid overdose, it is just a matter of time. Knowing the precautions References Alabama Funeral Directors Association. (2017). The undertakings . http://alabamafda.org/ Portals/0/PDF/afdaDec2017 Allen, M., & Smith, J. (2017). Opioid Epidemic: How Funeral Directors Can Respond . International Order of the Golden Rule. American Medical Association. (2018). Reversing the opioid epidemic . https://www.ama- assn.org/delivering-care/opioids/reversing-opioid-epidemic Conley-Keck, E. (2019). Iowa sees successes in opioid crisis while Illinois lays out plans . https://wqad.com/2019/02/10/iowa-sees-successes-in-opioid-crisis-while-illinois-lays-out- plans Illinois Department of Public Health. (2019). Opioid overdose response . http://www.dph. illinois.gov/opioids/overdose Mallappallil, M., Sabu, J., Friedman, E., & Salifu, M. (2017). What do we know about opioids and the kidney? International Journal of Molecular Sciences , 18 (1), 223. https://doi. org/10.3390/ijms18010223 National Institute on Drug Abuse. (2018a). Heroin . https://www.drugabuse.gov/publications/ research-reports/heroin National Institute on Drug Abuse. (2018b). Prescription opioids . https://www.drugabuse. gov/publications/drugfacts/prescription-opioids National Institute on Drug Abuse. (2018c). Prescription opioids and heroin . https://www. drugabuse.gov/publications/research-reports/prescription-opioids-heroin National Institute on Drug Abuse. (2019, January). Opioid overdose crisis . https://www. drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis
and steps to take beforehand is important. Most important, it would benefit funeral directors and funeral home staff to get trained to administer naloxone to assist not only the mourner overdosing in the parking lot but also the embalmer in the prep room.
Pearl, R. (2018). Who’s responsible for the 42,000 opioid deaths last year? https:// robertpearlmd.com/opioids Occupational Safety and Health Administration (OSHA). (2019). 1910.132 (D) https://www. osha.gov/laws-regs/regulations/standardnumber/1910/1910.132 Ray, R., & Hoffman, K. (2018). Opioid stigma is keeping many cancer patients from getting the pain control they need. https://www.statnews.com/2018/07/06/cancer-patients-pain- opioids-stigma Renzoni, C. (2019). Are opiates bad for the kidneys? How does heroin affect the kidneys? https://www.therecoveryvillage.com/opiate-addiction/are-opiates-bad-for-your- kidneys/#gref Rowland, B. (2019). As overdose deaths mount, Illinois gets additional money to fight opioid epidemic. https://www.ilnews.org/news/statewide/as-overdose-deaths-mount- illinois-gets-additional-money-to-fight Sullum, J. (2018). Opioids: An overdose is not murder . https://reason.com/2018/05/30/an- overdose-is-not-a-murder Troilo, M. (2019). Prison policy initiative . https://www.prisonpolicy.org/blog/2018/12/07/ opioids Wesco. (2019). The need for nitrile gloves in the fight against fentanyl . https://blog.wesco. com/nitrile-gloves-and-fight-against-fentanyl
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