Lesson 1.

1
Cavity Embalming

Read the following from Embalming: History, Theory, & Practice by Sharon Gee-Mascarello (6th Ed.):

Chapter 14

Before progressing through the lesson, go to the Terms page and define each term
using the course glossary (or the book/notes if necessary.)

Discussion of Specific Points

I. Cavity Embalming (or Cavity Treatment)

A. The second major procedure in the preservation & sanitation of the dead human
body.

B. Designed to reach substances/microbes found in spaces with the thoracic,

abdominopelvic, & sometimes cranial cavities; hollow viscera & their contents and
organs that may not have been reached by arterial injection.

1. Cavity treatment increases the surface area of the internal organs which
increases the amount of tissue upon which the cavity fluid can act.

C. Two-step process: aspiration of cavities/contents & injection of preservative

1. Materials to be aspirated: Gases, fluids & semi-solids

D. Occasion when cavity treatment is NOT employed:

1. Donation to medical school - obviously the cadaver would be of no use to

medical students if the viscera have been destroyed by cavity treatment.

2. There are rare occasions when an autopsy will be done AFTER arterial
embalming. In this case, cavity treatment would not be employed as destroying the
viscera would essentially render an autopsy pointless.

E. Purge

1. Types & Characteristics: (see table in text)

a. Stomach

b. Lung
c. Brain

d. Fluid: "false purge" - color/consistency similar to arterial solution

e. Rectal: feces & other material escaping from rectum

II. Instrumentation

A. Trocar - Picture of a trocar

1. Nasal tube aspirator - picture of a nasal tube aspirator

2. Autopsy aspirator - picture of an autopsy aspirator; and a second type.

B. Hydroaspirator - picture of a hydroaspirator

C. Electric aspirator - picture of an electric aspirator

D. Historical Equipment: Hand pump & air pressure machine

E. Cavity fluid injector

1. The book erroneously uses the term "gravity injector" to describe this instrument
used to inject the cavity fluid into the body. As you'll remember from Embalming I,
a gravity injector is an instrument used for arterial injection that relies on gravity to
delivery the solution into the vascular system. A cavity fluid injector (see Ch. 4)
also relies on gravity (the bottle of fluid is inverted and held above the body) but
using the term "gravity injector" is inaccurate in this case (and, in my opinion,
somewhat confusing.)

III. Guides to contents of the abdomen

A. Nine-Region Method: (See Figure in text)

B. Four-Region Method or "Quadrant Method" (See Figure in text)

IV. Trocar Guides: (See Figures in text)

A. Right side of the heart

B. Stomach
C. Cecum

D. Urinary Bladder

V. Aspiration before or during arterial injection

VI. Time Periods for Cavity Treatments

A. Immediately (or shortly) after arterial injection

B. Delayed Cavity Treatment: 8-12 Hours

1. It is usually more desirable to wait for a period of time after arterial injection
before cavity treatment. But at firms doing a high volume of calls, time is a luxury
they do not often have and cavity treatment must be done immediately after
embalming.

2. Delaying aspiration maintains the pressure within the vascular system and allows
a more thorough distribution of the arterial solution into the tissues. It may also
cause portions of the body that didn't receive adequate distribution to become
better embalmed. For example, the legs of the deceased received very good
distribution to the knee; below that is marginal at best. By delaying aspiration, the
embalmer will often see a marked improvement of the distal portions of the legs
due to the intravascular pressure that has been kept in tact (by not aspirating right
away.)

VII. Techniques & Treatments

A. Trocar point of entry: 2 inches to left (of the deceased) and 2 inches superior to
umbilicus

1. "Fan & Layer" method: direct the trocar in a "fanning" direction across the cavity.
The lower the trocar and repeat the process on the next "layer."

2. Generally the trocar is kept in motion to minimize blockages (such as the

intestines which exhibit a "clingy" effect on the trocar.) However, if the trocar is
inserted into an area filled with liquid (or gas), the trocar should kept in that
position until the fluid (or gas) has been thoroughly drained and/or removed.

a. Common on cases exhibiting ascites, hydrothorax, ruptured aorta, etc.

B. Suggested order of treatment: thoracic, abdominal then pelvic cavity

1. Treatment of male genitalia

2. Cranial aspiration

VIII. Injection of Cavity Chemicals

A. Occurs after cavities have been aspirated.

B. How much cavity fluid should one use?

1. The text suggests 16 ounces (one bottle) for each cavity (thoracic, abdominal,
pelvic) of a 150-lbs. body. In practice, three bottles for a 150-lbs. body would be
somewhat excessive and unnecessary. While most fluid manufacturers will suggest
two bottles per body (one for the thoracic cavity and one for the abdominal), many
funeral home owners will prefer one bottle on almost all cases: except larger/obese
or decomposed bodies.

2. Again, do not confuse the term gravity injector with the proper term for the
instrument used to inject cavity fluid: cavity fluid injector.

a. There is a small opening on the side of the cavity fluid injector that allows air to
flow into the bottle. By placing your finger over this hole, you can stop the flow of
fluid from the bottle to the body. This vent can also become blocked with buildup
from the fluid and should be cleaned frequently.

b. Machine injection is mentioned where the cavity fluid is poured into the
embalming machine and injected via a hypovalve trocar. This is not a common
technique as cavity fluid can have harsh effects on the machine.

3. Inject cavity chemicals on anterior surface of the body and allow chemical to
gravitate downwards through the viscera.

4. Some embalmers will roll the body on its side to move the chemical around and
bring trapped gases to the surface.

E. Closure of openings

1. Trocar button

2. Purse-string and "N" suture

F. Reaspiration
1. Text lists several conditions under which reaspiration would be strongly advised.

2. If the viscera do not feel firm during reaspiration, it may be necessary to inject
more cavity fluid.