MZ/T 139-2019Embalming Operational Specification (English PDF)

4.1 Object

This anti-corrosion operation is applicable to Class III remains (see Appendix A). Class I remains shall be in accordance with Relevant regulations for Class A infectious diseases were sanitized and immediately cremated. For short stays, use a chlorinated solution containing 5000 mg/L of available chlorine.

Venom or 5000 mg/L peroxyacetic acid solution was sprayed to disinfect, and prion remains were disinfected with 40 g/L sodium hydroxide solution. Type II remains should be disinfected with a disinfectant with a medium effect or above, the remains should be packed in a sealed corpse bag, cremated nearby or buried as required. Unsure belongs to the second According to the actual situation, the anti-corrosion operation method of the remains should be carefully selected to ensure that the operator's personal hygiene protection is in place.

Strengthen health and epidemic prevention in terms of sources of infection and transmission routes.

4.2 Facilities

4.2.1 Funeral and interment service agencies shall set up anticorrosion rooms suitable for the anticorrosive work of the remains;

4.2.2 The anticorrosive room shall be sanitary, safe and ventilated;

4.2.3 The anticorrosive room should be equipped with the following basic items and equipment. antiseptic liquid, perfusion suction equipment, arterial hooks, surgical tweezers (non-tooth tweezers, Toothed forceps), tissue forceps, hemostats, tissue scissors, scalpel handles, surgical blades, syringes, puncture needles, needle holders, suture needles, sutures Wire, tissue retractor, ultraviolet lamp, instrument disinfection cabinet, body fluid and excrement disinfection device, air purification and disinfection device.

4.3 Personnel

4.3.1 The anti-corrosionist should have a technical secondary school or higher education in funeral,, or other related disciplines, or meet the "8 heritages in GB/T 24441-2009" Technical Requirements for Physical Antiseptics ".

4.3.2 Master basic knowledge in chemistry and anatomy, participate in professional knowledge and skills training, and continuously improve professional quality and professional practice Work skills.

4.4 Disinfection and sanitation protection

4.4.1 The disinfection of the anticorrosive room of the remains shall refer to "9 Disinfection of Moderately Hazardous Materials" and "10 Low-level Hazards" in WS/T 367-2012.

"Disinfection of sexual articles" is required.

4.4.2 Anti-corrosionists should establish self-protection concepts, improve personal protection level, wear protective clothing, protective glasses, masks, rubber hands Sanitary protective articles such as covers, shoe covers; master the performance, role and use of disinfectants and preservatives; master the remains, instruments and equipment and environmental protection Environment disinfection methods and precautions.

5.1 Safety protection principles

Operators should avoid direct contact with corpse organs and body fluids.

5.2 Closed wound principle

All open wounds are closed.

5.3 The principle of operating as small as possible on the basis of convenient and effective operation, the length of the incision in the corpse should be reduced as much as possible.

5.4 Tissue incision and suture principles

The skin incision should be combined with the skin texture and tissue structure, and no extravasation of body fluids should occur after suture, and there should be no obvious wrinkles in the suture mouth.

7.1 Common carotid artery perfusion

The right common carotid artery originates from the innominate artery; the left common carotid artery originates from the middle of the autonomic arch. The common carotid arteries on both sides pass through the sternoclavicular joint, Behind the sternocleidomastoid muscle, enter the carotid triangle, in front of the anterior scalene and cervical longus. It has the esophagus, trachea, and thyroid gland, and the outside Internal jugular vein and vagus nerve.

Common carotid artery exposure and approach are as follows.

a) The corpse lies on his back, his head is turned to the opposite side, and the back of the neck is moderately raised;

b). Make a longitudinal incision from the starting point of the sternoclavicular joint to the junction of the middle and inner 1/3 of the clavicle, and make a longitudinal incision at the two transverse fingers of the clavicle up;

mouth);

c). Cut the skin and platysma;

d) using arterial hooks, tissue scissors and surgical forceps to separate tissue;

e) Using arterial hooks, tissue scissors or surgical tweezers to bluntly separate the common carotid artery or innominate arteries from outside to inside and use arterial hook Out, fixed

f). Exposing common carotid artery or innominate artery.

7.2 Axillary Artery Perfusion

The axillary artery is a direct continuation of the subclavian artery. After passing the lower latissimus dorsi, it continues to the brachial artery. The axillary artery is located deep in the axilla, with a large chest, Behind the small muscles, the axillary veins accompany the anterior medial side, and the brachial plexus stem is first outside the axillary artery and then descends around the axillary artery.

Axillary artery exposure and approach are as follows.

a) The body is lying on the back, the upper arm is abducted, and the side shoulders and backs are raised;

b). Make a 3.5 cm ~ 10 cm horizontal incision from 2 cm below the middle 1/3 of the clavicle and cut the skin, subcutaneous tissue and pectoralis major muscle for fascia, bluntly separate the pectoralis major muscles and pull them up and down, and pull the pectoralis minor muscles outward to reveal the deep axillary vascular nerve cord;

c) Exposing the axillary artery;

7.3 Brachial artery perfusion

The brachial artery extends directly from the axillary artery. Along the medial sulcus of the biceps brachii and the median nerve downward, first on the inner side of the nerve and to the middle of the upper arm Slightly below, crossing each other, turning to the outside of the nerve. To the deep of the cubital fossa, the flat radial head is divided into radial and ulnar arteries.

Brachial artery exposure and approach are as follows.

a) The corpse lies on its back, the upper arm of the perfusion side is abducted 90 degrees, and it is rotated outward as much as possible;

b). Make a longitudinal incision in the medial groove of the biceps brachii in the middle of the upper arm, corresponding to the middle 1/3 of the upper arm and 1/2 of the upper and lower medial sides. Cut the skin and skin.

Organization

c) bluntly pull apart the fascia with the arterial hook at the inner edge of the biceps brachii, and separate the biceps brachii and the inner head of the triceps brachii to both sides

d). Separate the medial cutaneous nerve from the forearm and the thicker median nerve, and pull the median nerve apart inward.

Warp, use a hook to separate the thick brachial artery and peel it up and down;

e). Exposing the brachial artery.

7.4 Radial artery perfusion

The radial artery starts parallel to the radius from the cubital fossa, passes between the brachioradialis and pronator round muscles, and descends between the brachioradialis tendon and the radial wrist flexor tendon.

The lower section is only covered by the skin and fascia, which is easier to reveal here.

Radial artery exposure and approach are as follows.

a). Remains in supine position, with forearms forward, palms up;

b). Two horizontal fingers on the transverse wrist line, make an incision of about 1 cm to 1.5 cm along the outside of the radial wrist flexor tendon;

c). After incision of the skin, the subcutaneous tissue is separated with an arterial hook;

d) pulling inward the radial wrist flexor tendon, with fat vessels visible on the outside;

e) Carefully separate blood vessels, including relatively thin radial arteries, which need to be carefully stripped to avoid side leakage;

f). Exposing the radial artery.

7.5 Femoral artery perfusion

The external iliac artery was renamed the femoral artery after entering the femoral space through the inferior margin of the inguinal ligament. In the upper thigh, the femoral artery is located between the sartorius muscle and Between the long adductors, there are femoral veins inside, femoral nerves outside, and lymph nodes around. It is accompanied by a saphenous nerve in the descending direction. After crossing the sartorius muscle, the adductor muscle in the tube, it is the popliteal artery after exiting.

The femoral artery is exposed and the approach is as follows.

a) Take the body in a supine position and raise the hip on the operating side;

b). Cut the skin about 3 cm to 5 cm from the median point of the inguinal ligament down about 2 cm from the medial point of the inguinal ligament, or do it on the two fingers below the inguinal ligament.

Parallel cuts.

c). Cut the skin and fascia, if the fat is too thick, you can cut off part of the fat;

d) using arterial hook to separate subcutaneous tissue to find inguinal ligament, and separate fat and lymph nodes under broad fascia;

e). Below the inguinal ligament, the innermost is the femoral vein, followed by the femoral artery, and the outermost is the femoral nerve;

f). Exposing the femoral artery.

7.6 Dorsal Foot Artery Perfusion

After the anterior tibial artery exits from the calf mesentery, it follows the anterior surface of the mesentery and descends from the lateral edge of the anterior tibialis muscle to the long extensor toes to the small distal end to the back of the foot is called the dorsal foot artery.

The dorsal foot arteries are exposed and approached as follows.

a). Remains in a supine position with the backs of the feet facing up;

b). According to the midpoint of the line from the toe to the heel and the midpoint of the transverse diameter of the instep, make a vertical or horizontal incision at the intersection of the second line, about 1.5 cm in length;

c). Cut the skin and use the hook of the artery to pull the skin and subcutaneous tissue;

d). Fatty cords can be seen between the long extensor tendon and the long toe extensor

e). Carefully separate the cords and find the dorsal foot artery with an outer diameter of about 2.5 mm;

f). Expose the dorsal foot artery.

7.7 Great saphenous vein perfusion

It starts from the medial foot to the dorsal venous network, and goes up the calf and the inner thigh in front of the medial malleolus and penetrates the deep fascia to the femoral vein.

The great saphenous vein is exposed and the approach is as follows.

a) The body is lying on his back with his back facing up;

b). A lateral skin incision is made about 3 cm above the ankle above the medial ankle, and the length is about 1 cm to 1.5 cm;

c). Cut the skin to the superficial fascia;

d) Separate the skin and underlying tissue with an arterial hook, and a large saphenous vein can be seen between the deep and shallow fascia;

e). Exposing the large saphenous vein.

8.1 Peritoneal cavity perfusion

The peritoneal cavity is the space between the membrane on the abdominal wall (wall peritoneum) and the membrane on all organs in the abdomen (dirty peritoneum).

Perfusion method. The puncture point can be selected from the midpoint of the lower abdomen, and the position of the needle is 1 cm above the midpoint of the line connecting the upper edge of the umbilical cord and the pubic bone.

1 cm to 2 cm to the left or right. Use a 5 cm to 21 cm long puncture needle to enter the needle at an oblique angle of 45 degrees to the surface of the abdominal wall.

After passing through the anterior layer of rectus abdominis sheath, rectus abdominis, posterior layer of rectus abdominis sheath, and superficial abdomen transverse fascia, it was then pushed at a 90-degree angle into the peritoneal cavity. Needle entry There is a sense of falling, and it can be rotated 180 or 360 degrees without obstruction. When injecting the antiseptic solution, uniformly inject the peritoneal cavity in a fan shape.

The anti-corrosive solution is effectively diffused. If there is a large amount of ascites or gas in the peritoneal cavity causing abdominal distension, the ascites can be pumped and exhausted before perfusion.

After perfusion, the needle inlet was sealed with a biological agent.

8.2 Pleural cavity perfusion

A closed potential cavity formed by the two layers of the visceral wall of the pleura turning at each other at the root of the lungs.

Layer and the pleural wall layer close to the inner wall of the thorax.

The puncture point can be selected from the scapular line, the front axillary line, the middle axillary line, the posterior axillary line, or the intercostal space of the chest.

Prompt access to the pleural cavity when feeling empty. It should be noted that when the needle is inserted close to the lower edge of the bilateral costal arch, the needle should be at an angle of 45 degrees to the chest and abdominal wall and upward.

Enter the needle squarely and the depth of the needle is greater than 5 cm. The amount of conventional antiseptic solution on each side of the pleural cavity is 50 mL to.200 mL. After perfusion, insert the needle Sealed with biologics.

8.3 Throat cavity perfusion

The pharynx is a muscular funnel-shaped tube, which is behind the nose, mouth, and larynx, including the nasopharynx, oropharynx, and laryngo-pharynx, and has a length of 12 cm. Attach from the base of the skull to the lower edge of the 6th cervical vertebra, it moves down to the esophagus. The front of the pharyngeal cavity passes through the posterior nostril.

The mouth and larynx are in communication, and are the common channels for breathing and digestion.

Injection method. The needle is inserted in the space between the thyroid cartilage and the circular cartilage.

mL ~ 50 mL antiseptic solution.

After intrapharyngeal injection, preservative cotton is used to fill from the mouth and nasal cavity to achieve the purpose of sealing from the upper part.

8.4 Cranial cavity perfusion

The bony inner cavity composed of the brain and skull is the cranial cavity. There is brain tissue and abundant blood vessels in the cranial cavity.

Cranial cavity perfusion into the needle point. above the upper turbinate in the nasal cavity, that is, from the sieve on the sieve on the skull base into the cranial cavity.

Perfusion method. Use a 21 cm long puncture needle to enter the turbinate through the nasal cavity, pass through the sieve on the sieve on the skull base and enter the cranial cavity to the skull top, Inject 10 mL to 20 mL of antiseptic solution into the dura mater space, and then withdraw the needle 2 cm to 3 cm.

Into the brain tissue. After the perfusion is completed, the upper nasal cavity is inserted with absorbent cotton, which effectively blocks the direct communication between the bilateral nasal cavity and the outside world. Preservative fluid routine Amount used. 20 mL to 40 mL.