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Postmortem Emphysema

Postmortem Emphysema, often called Tissue Gas
By Michael Bjerum CFSP, 
Certified Crematory Operator Senior Technical Adviser KELCO Supply


Panic over how tissue gas took hold of the body you are caring for is useless.  It is there, and you must deal with it quickly and decisively!  The two best ways to avoid tissue gas are complete cleaning and sterilization of instruments and equipment following each procedure, and recognizing the potential in advance.  Red flags wave when the cause of death was from any illness or injury affecting the digestive tract.  Other concerns come from where the person died.  Beware of drowning, vehicle accidents, deaths that occur out of doors.

The organisms that cause tissue gas are extremely potent, and extreme care must be taken to avoid contamination of other bodies.  Following the care of a body with tissue gas, the prep room and all instruments and equipment must be completely cleaned and disinfected.  EmPower and Medica 28, as well as basic bleach are all products that should be used on every surface in the prep room, and on the instruments.  Just as it is in the embalming process, extreme overkill is the goal in this cleaning procedure.



Treatment of tissue gas:


Unembalmed body with no symptoms, but manor of death may lead to tissue gas

  1. Bathe the body with disinfectant soaps – Deo-San or Kel-Septic;
  2. Topically treat the entire body with a disinfectant – RTU or Medica 28);
  3. Place body on blocks and bridges to lessen pressure spots caused by the body resting on the table – Reposition the body multiple times during the process;
  4. Embalm the body using co-injection products (Kelpresol, Kelquestrol and Kelneutral) to assure absolute distribution, diffusion and osmosis of embalming chemicals.  Kel-Edema also contains chemicals beneficial to preventing and combating tissue gas;
  5. Use a strong dilute solution – 5% dilute solution;
  6. During the injection process bathe and massage the body to assure complete distribution and diffusion of the solution within the tissues;
  7. If there is any question or concern  about an area of the body receiving treatment, raise more vessels to assure complete treatment;
  8. Delay aspiration 12 to 18 hours if possible to allow maximum treatment of the tissues.
  9. Monitor the body closely for any changes.

Unembalmed body with signs of tissue gas

  1. Follow all procedures from part I;
  2. The dilute solution in this case should be increased once complete distribution and diffusion has been accomplished – I recommend a minimum of 10% to 15%, but some textbooks will advise as high as straight fluid (in the case of our Kel-Caut that would be a 50 index);
  3. Hypodermic treatment of affected areas with undiluted Kel-Caut following the arterial injection is advised;
  4. All areas where gas is evident should be treated with surface packs – I prefer Webril Prep Towels saturated with Kel-Gel and covered tightly with plastic.

 
Embalmed body that develops tissue gas

  1. This is a case where the body will need to be re-embalmed;
  2. Raise as many vessels as needed and inject a very high index dilute solution, and assure complete distribution and diffusion of this solution;
  3. Hypodermic treatment of the affected areas with undiluted Kelcaut is a must;
  4. All areas where gas is evident should be treated with surface packs – I prefer Webril Prep Towels saturated with Kel-Gel and covered tightly with plastic.



When preparing a body for casketing plastic undergarments must be used.  These undergarments should contain absorbent material – I recommend the liner sheets for body bags and pouches.  The embalmer should also use Kelex Embalming Powder on the affected areas.
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