Mortuary Service Arif Raza

Definition A morgue or mortuary is used for the storage of human corpses awaiting identification, or removal for autopsy or burial, cremation or some other post-death ritual

Introduction Place for safe and secure preservation of the dead bodies Preserved till taken away for final rites In small hospital it may be limited to storage space for a body or two In large hospital like medical college, full fledge department of forensic medicine

Introduction Standard of facilities are generally not of the acceptable level Often treated as place of dumping dead Usually found unhygienic with rodents and foul smells Creates problem for public in vicinity Arrangement in mortuary shall ensure physical safety and integrity of body and prevent its deterioration / decomposition

Objectives Safe storage, preservation and handing over of the correct body to the correct recipient in the correct condition Prevent public nuisance because of foul smell created by decomposing bodies and unhygienic sanitary conditions or improper disposal of the biomedical waste Due respect towards body to uphold the dignity in death

Functions Storage of dead bodies till taken away Safe preservation to prevent deterioration Physical security against theft Conduct of autopsies Embalming of the bodies Handing over of body to authorized Maintenance of record of all bodies

Structure Located on ground floor preferably in the rear part Away from patient / visitors area Away from residential areas Should have direct access to the external traffic route Road should provide accessibility to hearse van

Structure If meant only for storage, body storage room with refrigerated chambers Janitors closet Trolley bay Relative waiting Religious rites room

Structure If meant for autopsies Autopsy room Viewing room Change room Toilet / shower Sluice room Police room

Structure Space allocation and the number of body chambers In accordance with the body load Avg. 1 death per bed per year Depends upon size and type of the hospital Policy of hospital regarding accepting bodies from outside Hospital with 50-100 beds should have capacity for 2 bodies and with 200 beds at-least 3 bodies

Structure Space in teaching and research hospitals may be much higher Large hospitals should have space for safe storage of bodies in mass casualty situation Sign posting

Structure Engineering support Lighting (1500-2000 Lux at mortuary table, 200-300 Lux in the body storage) Ventilation and exhaust system Body chambers must have alternate source of power Proper housekeeping Prevention from pests / rodents

Equipment AC chambers (3 Sq M per body) of stainless steel with rails for sliding the trolleys in/out easily Should have humidity and temperatur control (3.5 – 6.5 deg C) Separate thermostat for every chamber Bigger mortuary may have walk in cold chambers Separate space for decomposed and infected bodies (freezers)

Equipment Autopsy room should have stainless steel tables with slope and sink Autopsy instruments Containers for organs / tissues Portable X-ray machine View box

Equipment Other equipments Stretcher Gloves (Leather / Rubber) Overcoats Boots, caps Soap and disinfectants Cotton cloth

Mortuary cold chambers Chambers used to preserve decomposition of dead body Two types Positive temperature (2 – 4 deg.) keeps body for several weeks Negative temperature (-15 to -20 deg.) used at forensic institutes. Decomposition is totally halted

Staffing No dedicated staff in small hospital where autopsies are not carried out Under pathology department or A & E department For large hospital dedicated staff is required for maintenance, safe storage, record keeping, assisting in autopsies Specialist in forensic medicine may be required

Process Policies and procedures for safe and secure storage and preservation of the bodies Acceptance / non-acceptance of bodies Transportation of body from inpatient area to mortuary Identification of bodies Receiving of bodies including records Safety and security of bodies with medico-legal concern

Process Handing over of body Carrying out of autopsies Maintenance of high level of hygiene and sanitation Disposal of biomedical waste Control of infections Availability of embalming facility Respect due to dead

Monitoring Parameters Incidence of theft of bodies / body parts Incidence of handing over wrong bodies to claimant Incidence of deterioration Level of hygiene and sanitation

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