sterilizing solutions, or its equivalent. Remember, this virus lives for four days on stainless steel. Using your mop bucket with the appropriate amount of bleach and water, sanitize the entire floor. Using your spritz bottle with bleach and water, sanitize the high touch areas: outside of the embalming machines, light switches, faucets, flush handles, and door knobs. It is imperative to know how to remove PPE once you have embalmed a COVID positive case. This virus is airborne and can stay viable for hours in the air and on clothing. As soon as you leave the prep room, do not enter again unless it is absolutely necessary. Give time for the disinfection to work and allow the virus, which is in the air, to settle.
(16 oz.) of cavity fluid, preferably a 30% index at a minimum, into both of the lungs. As you remove the trocar, put digital pressure around the trocar tube with the saturated cloth and close with the trocar button. Let the cavity fluid (16 oz.) treatment work overnight or for two days before you aspirate. When you have completed the operation, cover the body with a plastic casket cover and let it drape over the sides of the table. It is important to note that no bleach should be used for the disinfectant throughout this entire operation. Mixing bleach with formaldehyde results in the creation of hydrochloric acid fumes. When all preparation has been completed, soak and sanitize all instruments with Dis-Spray, Solucide disinfectant, Wavicide
REMOVING PPE
Wash your hands vigorously for a minimum of 20 seconds with hand soap. What you are doing here is allowing the soap to break down the lipid envelope of the virus. If you can, wash up to the forearms. The more skin you can wash and the longer you can do it, the better. Once the handwashing is complete, using two hands, remove your goggles or face-shield, and set them to the side. Remove your respirator with two hands upward and over your head. Know that the respirator and goggles or face-shields are still contaminated, so having a disinfectant solution prepared before the operation is imperative. Remove the cartridges from the respirator, spray down the respirator, goggles, or face-shield and let air-dry. Do not spray the cartridges directly, but you may use a rag with disinfectant and wipe down.
Not much has been discussed related to doffing PPE after an embalming operation, so we want to touch on this subject. Because this is a respiratory disease, we must stress that the respirator should be the last item of PPE removed. After the embalming operation is completed, remove the PPE. Spray bleach water on your Tyvek coveralls, and using your hands with a fresh pair of gloves, rub the entire suit down, including the attached booties and hood. If you are using a non-disposable gown, it should be laundered with lukewarm water and soap. Remove the gloves carefully and use the glove-in-glove method. The acceptable approach to removing your gown or Tyvek coveralls is to roll the gown outward from your body carefully and downward to your legs. Rolling the gown in this manner allows all contaminates to be contained, and moving downward allows contaminates to be far away from your face. At this point, step out of the prep room and close the door.
ASPIRATION
the cavity chemical injector. With the bottle still attached, remove the trocar carefully with a disinfectant-saturated cloth wrapped around the tube, and insert the trocar button. Remove the Dis-Spray or 70% isopropyl alcohol-saturated cotton from the nares and complete a nasal aspiration if necessary. Use the same procedure with the nasal aspirator tube as you did with the trocar tube. Replace new disinfectant-saturated cotton into the nares. Place a second toe tag on the deceased indicating “COVID Positive.” Again, do a thorough cleaning and disinfecting of the entire prep room, and continue to keep access restricted to just one or two embalmers. When you arrive home after work, you should be aware of the additional precautions that you may need to take to keep you and your family safe. If possible, remove all work clothing in the garage before stepping into your home. Immediately take a shower and wash your entire body with soap. This disease has been shown to stay active on inanimate objects for hours, so it is essential to protect yourself and family from any of those risks. You may even want to leave your clothes in a laundry basket in a garage for two to three days and have them washed afterward. When handling the clothing, try not to shake or deviate the clothing material to reduce aerosolization. It is recommended to use color-safe bleach or plenty of detergent with the warmest water that is allowable for that material.
The following day or two, you will aspirate. In fact, the longer you wait to aspirate, the better. As you will recall, you introduced a total of 16 oz. of cavity fluid in each lung. You will now aspirate not only the lungs but the entire thoracic and abdominal cavities. Before you begin, you will be wearing the recommended PPE, and the prep room will now have restricted access. Make sure the plastic or Plexiglas is in place over the top of the sink. Again, if you do not have these items, use a thick bed sheet covering the entire sink and is wrapped around the drainage tube. Have your disinfectant-saturated cloth at hand and remove the trocar button. Insert the trocar and using the hydro-aspirator, thoroughly aspirate the entire body. Pay close attention to the lungs and trachea during this operation. Using linear positioning, use the tip of the trocar to puncture the lungs in several areas. Try not to make a puncture through the trachea, as this will allow direct access from the lungs to the perforated area of the trachea. Introduce a total of 32 oz. of cavity fluid; 16 oz. in the thoracic cavity, and 16 oz. into the abdomen. Once you are completed with the trocar operation and while the trocar is still inserted in the abdominal or thoracic cavity, do not remove the cavity bottle from the cavity chemical injector you are holding high in the air. There is a potential the virus could make its way through the trocar tube, through the rubber tubing, and out
AUTOPSY
seal with multiple zip ties. Clean the mouth and nares with disinfectant-saturated cotton, but there is no need to pack these areas. Upon completing of the embalming operation, wash down the body with soap and water, and place a plastic casket wrapping over the body and let drape over the table. Use the same sterilization techniques for instruments, prep room, and removal of PPE as previously discussed.
There are no more significant dangers from an autopsied body than a regular body as it relates to COVID. It is more beneficial to the embalmer, as the lungs have been removed. That said, you are now more exposed to new dangers such as sharp bones and more bodily fluids. All recommended PPE, proper safety procedures, and restricted access to the prep room should still be instituted. Use caution while opening the viscera bag, as it does contain lung tissue. Create a small opening, and introduce the cavity fluid for disinfection and preservation. Close and
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Book Code: FFL1223
EliteLearning.com/Funeral
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