Embalming the "Severe EDEMA" Case: PART 1
Quite possibly the most challenging case you will ever encounter is the Severe Edema Case. There are many hospitals taking a much more aggressive approach to end of life health care for those suffering disease, infection or trauma. Because medical advancements are keeping people alive "longer" we as embalmers typically see the results of these practices.
We can better prepare our selves and staff simply by knowing how to calculate and execute. The above equation (in green) is a useful formula for successfully embalming these type of cases.
Disclaimer: Secure permission from NOK before performing any procedure considered "above and beyond".
First, perform case analysis:
(There are many factors an embalmer must consider when making a final decision after a thorough case analysis but for the sake of topic I will only discuss the issue concerning edema).
Determine how much "water weight" has been added to the body. (This will come with experience or perhaps a call to the hospital or family discussion. Anything other than an official weigh-in will be considered approximate).
This will be your first indicator and chance to calculate secondary dilution. This is the dilution that takes place when the primary dilution
(your solution in the tank)
mixes with the bodily fluid via arterial system.
Determining Secondary Dilution
Determine how much the person gained by way of water. Water weighs 8.3 lb. per gal.
If the body was carrying an additional 100 lb. of water weight it is easy to extrapolate how many gallons of water are in the body.
100
? 8.3 = 12.05 gal. of water.
Now we can plug this into the formula above.
we know that we need approx. 1 bottle of 33 index arterial fluid per gal of water to crate a 4% concentration. Therefore we pour 12 bottles of 33 index fluid into the tank at the onset. Once we add water to the tank remember to account for that water by adding the proper amount of arterial fluid.
Next, take 2 qt. of HOT water and pour as much epsom salts in as will dissolve. Water can only hold so-much salt before it no longer dissolves. Once you've reached this point of "Supersaturation" you can now use your skimmer to filter out any salt crystals from entering the tank.
In part 2 of this we will discuss injection points, pressure and arterial fluid of choice. Part 3 will discuss how Time and Gravity will assist us and how we handle the wrinkling of tissue.
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