GOWNS AND TYVEK COVERALLS
Gowns have always offered a significant barrier during any type of preparation or embalming. Now that we are dealing with COVID, it is recommended to have high-density polyethylene Tyvek coveralls in your PPE supplies, as they provide excellent
protection. The benefit of utilizing Tyvek coveralls is they include a shielded zipper, attached booties, elastic cuffs, and a hood. They are impervious to fluids and can be easily cleaned with bleach water.
RISKS TO FUNERAL DIRECTORS AND EMBALMERS
First call transfer It is not wise to learn as you go when it comes to COVID. It is highly recommended that the entire funeral home administration have infection preventative measures before accepting any COVID cases. This will ensure no outbreak within the funeral home or a spread of the disease during a visitation or funeral. Remember, you are dealing directly with COVID, so everyone must be on the same page when it comes to the virus. Anytime a dead body is moved or manipulated, aerosolization of droplets can occur. When you receive the first call from a coroner, medical examiner, nursing home, or hospital, inquire if the patient has or had COVID. This will give the funeral home the opportunity to be prepared for a safe removal. That said, if a family member is the one who makes the initial call on reporting the death, you should not ask them directly if their loved one had COVID. For the sake of this guide, we will say the deceased did have COVID. Immediately inform the funeral home administration that you will be bringing in a COVID positive into the building and that all necessary precautions will be instituted. The funeral home should have a bag or tote in the removal van with all the necessary personal protective equipment just in dealing with this circumstance. The box or tote should contain the following: ● Heavy-duty rubber or nitrile gloves. ● Goggles. Upon entering the residence, you most likely will encounter the immediate family members. Of course, it is quite uncomfortable to meet the family under these circumstances while donning your PPE. However, the family will be aware of the dangers that COVID presents, and they will be understanding. After you have been shown the location of the body and have determined how you will proceed with the removal, depart the home and retrieve the cot. At this point, you should be bringing in the cot with the bedsheet, Dis-Spray or 70% isopropyl alcohol, cotton, and a body bag. The funeral director should now encourage the family to step into a different room while the removal is being made. When approaching the deceased, do as little manipulation to the body as possible to get the job done. Because COVID is an upper respiratory disease, any disturbance to the lungs will cause an exhalation from the nose and mouth. Again, this is an upper respiratory disease, which means it is quickly expelled from the lungs. There are several options to create barriers in the nose and mouth before the removal. First, using the spritz bottle, you may wish to spray Dis-Spray into the deceased's mouth and nose and place a sheet of cotton or a disposable surgical mask ● Minimum N-95 mask or P100 respirator. ● Bedsheet or disposable surgical mask. ● Cotton. ● Body bag. ● Angular or packing forceps. ● Dis-Spray or 70% isopropyl alcohol. ● Minimum full-length gown or Tyvek suit. ● Biohazard bag.
over the entire face. Caution should be used when using the spritz, as there is a potential for backsplash. Another option is to use a needleless syringe filled with Dis- Spray and slowly inject into the nares and mouth and place cotton in the orifices. The preferred method is to take rolled balls of cotton and saturate them with 70% isopropyl alcohol. Take angular or packing forceps, insert the saturated cotton into the nose and mouth, and cover the face with a disposable surgical mask saturated with 70% isopropyl alcohol. Open the body bag, and carefully place the deceased into the bag. Before you zip close the bag all the way, spray Dis-Spray into the pouch (Black et al., 2020). Another precaution that is worth mentioning is when you are zipping the body up, be sure to have the two zipper paddles meet at the head end of the bag. You should not be taking the surrounding bed linen, as this is most certainly contaminated. Place the deceased on the cot along with the cot cover. After informing the family that you have placed their loved one under your care and setting the funeral arrangement time, gently place the cot in the van. When departing the place of death, under no circumstances should the funeral home staff open the removal vehicles windows or have the air conditioning or heater turned on its highest setting as you are returning to the funeral home. Let there be no mistake, this virus is airborne. It has been found to be viable on clothing, skin, bed sheets, and other soft and hard materials for hours and, in many cases, several days. By introducing turbulent air, you could potentially dislodge particles from within the bedding and into your lungs. If the COVID death occurs at a nursing home or hospital, you will continue with the same precautions utilized at a residence. Many nursing homes and hospitals have now developed “COVID wings” in a particular section of the building. This means every single patient has COVID. Before walking into the wing, it would behoove you to have your PPE in place already and ready for the removal. To reduce the spread of the disease, these health care institutions have placed restrictions on family and clergy visits. Most can see their loved ones through glass windows or by FaceTime or other webcasting technologies. Unfortunately, many of these COVID patients are dying alone. When you arrive at the funeral home, immediately take the deceased to the prep room and restrict access to the room. It is not recommended to take off the PPE, as there are cautionary steps that should be taken that we will be discussing below. If you are already suited and booted with the proper PPE, and you have the authorization to do so, there should be no reason to begin the embalming process. Disinfect the entire cot by using Lysol, Dis-Spray, bleach wipes, or the equivalent. Be sure to clean the safety belts, handle levers, stainless steel bars, inside the cot cover, and let air dry. The removal van should also be disinfected. Sterilize the steering wheel, door handles, shifter knob, and anything else that was contaminated. Restock the bag or tote with the necessary PPE that was used for this particular transfer.
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Book Code: FFL1223
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