TECHNIQUES AND CHEMICALS
It is important to note that some customs or family wishes, do not allow for the infant’s mouth to be closed for viewing, be sure to receive proper instruction before beginning the embalming procedure. Vessel Selection: Un-autopsied Infants - Carotid Artery (Common) The common carotid artery is the largest, and most accessible of the non-aortic arteries. It is located in an area that will allow for a shallow incision and that can be easily concealable. The internal jugular vein can be used for proper drainage in conjunction with the common carotid artery. A shoulder block or folded towel may be placed under the infant’s shoulders allowing the head to tip back- this will enable the vessels to reach closer to the surface. If proper drainage cannot be completed through the use of the right jugular vein, drainage may be taken from the left jugular or via the right atrium of the heart by inserting an infant trocar through the abdomen. The point of insertion should be made by directing the trocar in the direction of the right ear lobe. Femoral Artery or External Iliac The second-largest accessible non-aortic vessel is the Femoral Artery of the External Iliac Artery, which is slightly larger. The same incision can be made as it would be on a child or adult. Be sure first to inject distal to observe the effects of the solution before injecting it into the remainder of the body. The accompanying veins are relatively large and can be used as a drainage point. Drainage can be performed by inserting a drainage tube or a small pair of forceps to open the vein- a groove director may also be used in conjunction with these instruments. Abdominal Aorta The abdominal aorta is the largest aortic vessel in the human body and is accompanied by the largest vein, the vena cava. Both the artery and the vein lie deep within the body cavity resting on the anterior surface of the spine. The anatomy of an infant shows larger proportions in areas of the body than that of an adult or a child. Careful measures must be practiced when dissecting these vessels to avoid damage to internal organs such as the liver or stomach. A 2 to 3-inch incision must be made in the center of the abdomen just left of the midline and inferior enough to avoid major organs. Once the incision has been made the greater omentum must be opened and portions of the small and large intestines removed or positioned away from the body so that the abdominal aorta can be accessed. After, the incision is made into the aorta a tube is placed in the direction of the feet to allow proper embalming in the inferior part of the body- the lower portion of the body should always be injected first-this allows the embalming practitioner to make sure the fluid indexes, and coloring are correct before injecting into an area that will be viewed. Another tube will be placed in the aorta in the direction of the head to supply arterial fluid toward the superior portion of the body. The vena cava can be dissected for drainage, but it is unnecessary to place a drainage instrument. An imaginary guideline for the Abdominal Aorta is from a point 1/2 inch below (posterior) and 1/2-inch to the left of the umbilicus in an upward direction for 5 or 6 inches, gradually sloping toward the median line (vertebrae). The Abdominal Aorta terminates at the 3rd and 4th vertebrae, where it bifurcates into the right and left common Iliac. Ascending Aorta The ascending aorta is the first section of the aorta that begins at the left ventricle of the heart and extends to the aortic arch. The coronary arteries that supply blood to the heart arise from the ascending aorta. Using a sharp scalpel or surgical shears, an incision is made down the midline of the sternum. An infant’s breast bone is not ossified; therefore, the sternum, which is still cartilage and can be separated easily. Forceps or a block may be used to keep, the chest open and expanded to work beneath the surface.
Several factors are to be identified before beginning the embalmment of an infant child. Firstly, the skin of an infant is extremely delicate and will be easily affected by arterial solutions, topical and hypodermic treatments, as well as the handling of the body. Most common –incorrect solutions can cause dehydration, wrinkling, and distention, which is almost impossible to reverse. Second, around 75% of birth weight is water until the age of one year, when the infant’s percentage of body water will drop to approximately 60% like that of an adult person. Similarly, the percentage of body fat in an infant at birth is significantly low at about 12 %. The body fat % will double by the time the infant reaches six months of age, and by one year of age should be approximately 30-35%. Because there is such a high level of moisture and a high potential of toxins in the body, it is not recommended that pre- injection fluids be used, instead of regular, smaller amounts of arterial and supplemental fluids similar to an adolescent or adult should be applied. Post embalming treatment of an infant is no different than treating an adult. Proper topical disinfection of the entire body and cleaning of nasal, oral, and orbital areas is still essential. Gentle manipulation of the head and extremities may also necessary to remove any rigor mortis that has set in. The manufacturer provides chemicals and guidelines for injection. Most manufacturers have a line of products specific to infants and children. There have been many suggested methods that chemical combinations for embalming infants should be done with a weakened or diluted index, and a high percentage of water. Such theories are false, and each case should be treated independently based on the state of the body, just as would be done in an adult case. Additionally, the intravascular injection should be determined based on the guideline, similar to an adult. Discolorations should be cleared first by pre-injection fluids to prepare for arterial and dye injection. Supplemental fluids may be required depending on how the infant died and the number of toxins, drugs, or moisture that lies within the organs or under the tissue surface. Careful massage of the body to allow for even distribution is strongly urged. If swelling or distending begins to occur, the strength of the arterial solution can be increased, and only a minimum amount injected. The remaining embalming can be completed by surface or hypodermic treatments. Eye Closure Eye caps are available in only a few predetermined sizes and are often too large for infants. Eye caps may be trimmed down so that they fit under the eyelid. Cotton pads may also be used in place of the eye caps. It is recommended that eye closures be completed before arterial injection, though some embalmers choose to do after. There is no wrong way; however best results generally are found if it is done first. Massage cream may be used to help hold the cap or cotton in place also, the use of a rubber-based or super glue may be used to make sure that the eyes remain closed- this is especially important for infants as it is common for parents to remove the infant from the casket to hold them one last time. Mouth Closure The mouth closure on an infant is much more delicate than that of an adult, which limits the practice that can be used. The use of a needle injector is not possible. The most common method is placing a suture in the mandible and guiding the thread through the septum using a sharp curved needle (3/8 inch is best) and finally into the maxillae where it can then be tied off. In some cases where closure is impossible by this mechanism, rubber- based or super glue may be used post arterial injection. Gluing of the mouth, whether, on an infant, child or adult, should never be done before to embalming as there must be an avenue for any residual air to escape from the lungs during the process.
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Book Code: FFL1223
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