Embalming III Quiz 2 Flashcards
What is OPTN?
- The National Organ Procurement and Transplantation Network
- A national computer registry for matching donor organs to waiting recipients
What is UNOS?
- United Network for Organ Sharing
- UNOS manages OPTN (the computer system for organ procurement)
What are OPOs?
- Organ Procurement Organizations
- UNOS cooperates with OPOs throughout the county to place organs at the local, regional, and national level
Who regulates tissue donation?
Tissue donation is regulated by the US Food and Drug Administration (FDA)
Procedure for Donation
- Hospital reports to OPO (all hospital deaths) and of the donor and their imminent death/ death within 1 hour of their passing. ME reports those who haven’t died in hospitals
- OPO assesses the potential donors suitability (history and medical examination)
- Donor registry is checked to see if the potential donor is already registered to donate
- If the potential donor has not signed to donate, the next-of-kin must consent
- OPO tell NOK how the donation process works asks what they want donated
- Donor organs/tissues are removed
- Organs/tissues are matched to potential recipients and sent to the institutions for transplantation or preservation
- Donor is released to the funeral home
What law allows one to donate themselves?
- The Revised Uniform Anatomical Gift Act (UAGA)
- Allows those 18 and up to donate their organs/tissues for medical purposes
- A person who signs to have themselves donated signs a “first person consent”. It is legally binding
What can brain-dead, ventilated individuals donate?
- Those brain-dead, on a ventilator with a beating heart can be an organ donor: heart, lungs, liver, kidneys, pancreas and intestines
What can individuals not on a ventilator donate?
- One who was never on a ventilator and does not have any cardiac or respiratory activity can donate tissues only: eyes/corneas, blood vessels, cartilage, skin, bone, pericardium, and soft tissues
How is the preparation of organ donors and trunk autopsy individuals similar?
- The incision for the median sternotomy is a U or V incision
- Incision for an autopsy is a Y incision
- Both the U/V and Y incisions allow for easy access to vessels for embalming
- Hypodermic injection and surface embalming will need to be used
- both require restoration of the trunk cavity
- Leaking may be an issue for both
- delay between death and embalming will require a higher index arterial
- Tracer dye can be used to indicate distribution
- Thorough blood drainage is expected
How is the preparation of organ donors and trunk autopsy individuals different?
- Donors may still have some organs and internal structures intact in the trunk
How are eyes enucleated for donation?
- Facial area is sterilized and draped
- Head of donor is elevated to prevent blood pooling
- specialist uses a speculum to open the eyelids
- specialist removes the eye
- Fills the orbital cavity with cotton and eye cap and closes eye
How will an embalmer treat the orbital cavity of a donor?
- Apply a thin layer of massage cream/lanolin spray
- Remove the packing the specialist put in
- Put in cotton soaked in preservative
- Put in an eye cap for natural form
- Arterially embalm
- Remove eye cap and cotton
- Dry and cauterize the orbit
- Put a trocar botton in the base of the orbit
- Put incision powder over the base of the orbit
- Fill orbit with mastic compound/cotton
- Put in eye cap
- Create natural eye closure
- Secure eye closure with an adhesive cream or glue
- Apply a thin amount of lanolin spray to prevent dehydration
How is skin removed for donation? (parital/split thickness)
- A dermatome instrument is used: removes thin layers of skin
- uses layers 10-20/1000 of an inch thick
- Split thickness skin is removed from the anterior and posterior sides of the body
How is skin removed for donation? (full-thickness)
- Free-hand method is used: dermal and adipose/fat tissue is removed
- Donor is placed in a prone position (flat and face downward)
- Recovery site is sterilized and shaved
- Drapes cover parts not recovered
- Specialist may cut down to the fat or muscle layer
- After the recovery, the donor is bathed, absorbent pad placed under them, and put in a body bag
- Skin removed from abdomen, back and thighs
Who receives full-thickness skin donations?
- for children (better chance of skin living), those with hernias, extensive trauma, cancer
- Full-thickness is used for facial, joint and hand wounds because the outer characteristics of the skin are available
Who receives partial/split thickness skin?
- Split thickness donations are used to create a bandage to decrease fluid loss and infection.
- for burn victims
How will an embalmer treat the skin recovery area of a donor?
- Two people should help get the deceased on the table.
- put an absorbent material under them because much leakage may occur.
- Treat the recovery sites with a phenol-based liquid or gel
- Arterially embalm: Use a high index fluid
- After the embalming is complete, look for untreated areas and use hypodermic injection and/or surface embalm any untreated areas.
- Apply a coating of preservative gel over the areas
- After all the embalming is complete, be sure to prop the deceased up on body boards to allow airflow under them.
- Airate the room and allow tissues to dry over night
- Before dressing, apply an absorbent preservative pad to the deceased, wrap area with plastic and put on a plastic union-all.
- you can add absorbent powder in the union-all if leakage is persistent
What fluid should be used for donor patients?
- higher index fluid and mix in a moderate to strong concentrated solution
- Hypertonic solution of 2% and above
Manual Aids to Help Distribution
- Lowering hands below the table
- Squeezing the sides of the fingers and the nailbeds
- Bending, rotating, and flexing of limbs
- Elevation of a swollen area
Mechanical Aids to Help Distribution
- Drainage instruments
- Injection pressure
- Pulsation
- Rate of flow adjustments
- Diameter of the arterial tube help to control the speed and volume of embalming solution
Operative Aids to Help Distribution
- Invasive treatments such as channeling, wicking, incising
What are special-purpose arterial fluids?
- Fluids specifically formulated for special/distinct embalming cases/situations
- High Preservative demand, jaundice (5 - 9 % & phenol), renal failure, extensive burns or decomposition
Non-hardening Index Arterial Solutions
- under 5-15 index
- Low index
Semi-hardening Index Arterial Solutions
- between 16-25 index.
- Mild Index