Showing posts with label edema. Show all posts
Showing posts with label edema. Show all posts

Thursday, January 10, 2019

→ What You can Learn from Gravity Injection - Must Read


No this post is not about drinking games or parties, it is actually about embalming. However, it seems within the funeral industry the college kids and hardcore adults might know more about it than some embalmers do today. Can anyone guess what the pressure of the alcohol is in this video, or better yet what about the rate of flow?

If you were conducting yourself within the industry with a license and have not heard someone say, "rate of flow swells the body while embalming" that would surprise me. Sure, turning the rate of flow valve to much or too quickly can lead to swelling rather quickly. Performing this action does in fact increase the measurable flowing pressure, then the internal pressure, and the result is swelling.
In regards to swelling, consider this example. If the rate of flow is equal to the rate of drainage, how can there be swelling? Better question, what is the pressure? No we aren't going to talk shell embalming or that increasing drainage is not possible even though it is- Siphonbalm. Simple answer is there can't be and so it must not be true. After just a little consideration one cannot make the rate of flow swelling claim reasonably or intelligently. The constant in the swelling occurrence is the increase in internal pressure, which can be measured with our Frankembalm machine.

But was there even such a thing as rate of flow while embalmers were putting beer bongs, I mean funnels, in the air using gravity to inject? The answer is yes. There was a rate of flow as fluid would flow due to the force of gravity. This is still true. Without force, which we measure as pressure, you do not have flow. Said another way, pressure creates flow. It is that simple.  Consider how you or anyone would gravity inject. Mild elevation as you get started. With mild elevation you will expect and get a mild rate of flow. Fluid will take the path of least resistance and be unable to pass areas of greater resistance. The elevated height will determine what is a path of great resistance or least resistance. The speed of drainage will begin to remove pooled blood from the body, this will lessen the pressure demand to distribute fluid. As rate of drainage becomes steady, increase the elevation and the job is done. Tubing size is the same as with all embalming machines, cannula size is the same, typical elevation at ten feet high would create approximately five pounds of pressure- has this ever lead to severe swelling? Not that I have seen.

How can we use this knowledge to improve our present skills? Is there a benefit to high flowing embalming? High flow results in de-saturation of tissue. In addition to distribution benefits, Jaundice cases, edema cases or even standard cases can greatly benefit of high flow embalming. Flushing bilirubin out is key for achieving a well preserved "un-green" jaundice case. Drawing moisture into the vascular system for removal will improve preservation of edematous tissue. Finally, drawing any water from any case will delay decomposition.

To make you a bit more comfortable injecting with a 'high rate of flow' with centrifugal embalming machines, here is a quick how to which probably doesn't require you to buy anything.
Make two incisions, one at the right clavicle site other at the left bra strap site.
From the left bra strap site incise and insert forceps in the subclavian vein and left jugular vein. 
From the site at the right clavicle incise and insert forceps into the right jugular vein.
Inject south via the carotid artery with pressure setting below 1 lb.
Remember what we know about gravity feed, as fluid flows and returns drainage turn the 'rate of flow' by 1/5.
As drainage continues to increases, continue opening the valve until it is completely open.
From that point raise the pressure carefully until you have achieved the desired results, you will not be disappointed.  

Whats your pressure number?

Tuesday, November 27, 2018

→ Diffusion- Chemical Science & Embalming

To be up front, do NOT consider this to be the greatest source of information about chemistry.  In fact, failing in a chemistry class among students a couple years older than I was the beginning of my chemistry education.  Let this instead be the most practical explanation of "diffusion" and why it matters to embalmers.

Diffusion, at a basic understanding, can be described as a process where molecules are evenly dispersed over time. This transport will happen from an area of high concentration to low concentration. Gravity and edema is a fitting example any embalmer can understand. Consider gravity and its affect on water retained in the body. In this example we can expect fluid to be retained in the legs.  Logically the greatest volume or concentration of fluid would be at the lowest parts of the legs. If we would elevate the legs into the air, fluid would move from a high concentration area to a lower concentration area.  To be more specific, fluid would move from the legs towards the abdomen. In science we describe this process as diffusion.

There are many factors which can influence diffusion.  Understanding these factors assists the embalmer to apply the most effective techniques.  For instance, temperature is a way to influence diffusion.  It is also a reason many experts suggest using warm water within the fluid solution. On the micro level, molecules when cold move the slowest, while molecules hot move the fastest. The movement or lack there of aides and inhibits the transport of molecules which occurs during the diffusion process. This is part of the challenge which many embalmers face during extreme refrigerated cases.

Several other factors contribute to our complete understanding of diffusion. Permeability of cell walls can be drastically affected by polar ions such as calcium, chloride or salts.  Talking permeability, smaller molecules will have an easier time passing as compared to larger molecules. Also, thicker walls are harder to pass while thinner walls are easier to pass. Considering all of this, we wouldn't be able to pass anything without force.  We measure force as pressure. Pressure is a quantitative measurement of force which can be taken at any site or location. As in our example, legs elevated, we are using gravity to generate negative pressure in the low fluid concentration area ( abdomen ) and generate positive pressure in the high fluid concentration area ( legs ). Similarly under injection we are using the pump motor to force fluid and generate postive pressure against the vascular wall. As the pressure increases, the speed at which fluid ( high concentration ) diffuses into the low concentration areas ( the tissues ) increases.

Do you agree having covered temperature, pressure and permeability as it relates to diffusion benefits embalmers? In my opinion, the preservation of not only the deceased but also the art and science of embalming depends on it. Diffusion is what embalmers today count on to saturate and restore tissue for viewing purposes.

Wednesday, November 14, 2018

→ Waterless Embalming- Theory & Practical Application

Theory

Practical Applications Include: Decomposition / Edema / Trauma or Restoration Cases
Within the bounds of our topic, I must share the words of a great mentor who often said-
“ An embalmers ability is not well demonstrated or established with cases with little difficulty- it can be quantifiably measured by the progress made in times of trial and failure. ”
When or how might an embalmer make the determination to go waterless? The first step would be to judge not simply the case at hand, but also yourself. To be true and honest with the skills you possess is necessary to understand the limitations of your own capabilities. Second, how compromised is the case you are called to serve? A very clear indicator for me, as an embalmer, is the signs of marbling. Marbling is the apparent darkened discoloration of the superficial venous system. With this condition, one can reasonably expect the venous system in its decomposed state to have changed. Expect the expected- weaker vessel strength and decreased ability, or complete loss of the ability, to return blood or fluid (drainage).
Signs of decomposition should not be the only qualifier. For our purposes, we might also add cases of edema or restoration-that require rapid firmness. If we compare our most straightforward embalming cases with our more difficult cases, what can we learn? Would we agree that most straightforward cases required a lower chemical concentration and had significantly greater distribution to vessels as compared to the difficult cases. Having developed a case intuition or case analysis skill, the embalmer is provided the opportunity to adjust their method. Based upon the results presented- is it not reasonable to believe there might be a correlation between distribution and chemical concentration? If we accept these results and are honest with our limitations, we can grow. For as Jake Huard said, “To achieve we must believe”. If we continue to develop this belief, we might suggest that an increased chemical concentration can do well to compensate for poor distribution. When employed properly, results will show that this is true. Mastery of this skill requires a broad knowledge of the various difficult cases.
Edema is known to challenge even skilled embalmers. It is well known by expert embalmers, to adjust their fluid concentration to account for the added water. By estimating the volume of retained fluid- embalmers deduct this value from the water added to their fluid mixture. While the higher concentration of fluid enters the tissue- chemical concentration decreases. Though the concept is fairly straightforward, this is truly an art as much as a science.
In closing, trauma may be one of the greatest challenges an embalmer can face. Repairing tissue without first preservation could fail even the most skilled restorative artists. By experiencing the challenge of restoring poorly preserved tissue, restorative artists can learn to advantage their work with greater preservation.
-The Mortuary Scientist

Tuesday, July 3, 2018

→ High Speed Low Drag - Physical Science & Embalming

As an embalmer, you may be a fan of good drainage. Good drainage has long been linked with great distribution. If you have been reading, you now better understand why.
Great drainage requires high flow. Flow in and out at high speed will yield many positive effects. Distribution, blood or staining removal, and “whip,” to name a few. We might agree “whip” is not something we often hear discussed among embalmers. To be put simply, “whip” is the desaturation of tissue. It is an effect that happens when flowing fluid travels fast enough to pull from surrounding tissue. Take the time to concentrate on how this works. Visualize a car traveling under 5 MPH in a straight line. Air in front of the car will be pushed around the car and air will replace the space behind that car as the car moves forward. Now picture this same car traveling above 190 MPH, also in a straight line. The car will cut through the air, leaving a trail in the vehicle’s wake empty. Air will rush to fill this space rapidly from the surrounding area. This is much like what happens as fluid travels fast through the vascular system. The vessels will draw fluid from the surrounding tissue. This is a physical means that can be used to reduce edematous tissue. The embalmer must consider and account for drainage being near equal to the displacement of fluid via injection. To utilize this method to its full potential, the embalmer must also consider the injection point and drainage point.
As an example, consider the injection site at the right common carotid artery with injection south towards the heart, with drainage via the jugular vein. Generalized edema is observed within the legs. This method is going to promote fluid remaining within the body, and be only partially effective to desaturate the legs. Compare the above method to an injection site at the right common carotid artery with a cannula deep within the abdominal aorta and drainage via the femoral arteries. With delivery of the fluid closer to the target location, fluid has less of an ability to travel via other vessels, therefore increasing the volume of fluid being delivered to the area. Subsequently, the drainage from this area can now be greater. By being closer to the target location, the embalmer can affect or influence the drainage with more control, using drainage instruments designed to pull fluid. These instruments which pull fluid will only increase the speed of drainage and therefore increase the desaturation of tissue.
It is wise of the embalmer to consider their approach to be certain that they have spent the proper amount of time desaturating tissues, as well as saturating tissues, to achieve proper preservation. From injection to drainage, where, why and how. Furthermore, the particular case circumstances of as example edema location is necessary to maximize the results of the embalming process.
-The Mortuary Scientist