10 Important Aspects of the Safety of Dead Bodies in Hospitals

1. The body storage room should have proper AC chambers (4/100 beds) (3 sq m per body) of stainless steel with rails for sliding the trolleys in/out easily.

It should have humidity control and temperature control (3.5-6.5°C) with a separate thermostat for every chamber. Bigger mortuaries may have walk in cold chambers. There should be separate space for decomposed and infected bodies (preferably freezers).

2. Mortuary should have adequate ventilation/exhaust system. The body chambers must have alternate source of power so as to ensure continuous temperature control.

3. There should be a quality manual for mortuary services including all the policies and procedures to ensure safe, secure and dignified storage and preservation of the bodies.

4. There should be a procedure for maintenance of high level of hygiene and sanitation, pest/rodent control and control of infections (especially in case of infected bodies).

5. Essential Documentation:

Maintenance of a full and accurate record of the bodies brought to the mortuary and their personal effects (as per the hospital records) is one of the most important tasks of the technician in-charge mortuary.

Every mortuary should have a Mortuary Register containing the following details about every dead body brought into the mortuary.

i. A unique serial number allocated to each body running serially from 1st January to 31 December each year

ii. Name, sex, age, address of the deceased person

iii. Two Identification marks of the deceased and finger prints, especially in case of unidentified bodies

iv. Date, time and cause of death, especially if it was a contagious disease

v. MLC/NON-MLC;

vi. Date/time of receipt of body in the mortuary and signature of the technician receiving the body

vii. Condition of the body at the time of receipt

viii.List of valuables remaining on and received with the body, such as rings /bangles / wrist watch/mobile phone/purse

ix. Name, address, contact number and relationship of the next of kin

x. Date /time of autopsy, if done, and the name of autopsy surgeon

xi. Date/time of release of body from mortuary

xii. Name/address, relationship, signature of the person/police official receiving the body from mortuary.

6. Identification of Dead Body in the Mortuary:

i. To prevent any mix up between the bodies, a proper system of identification of bodies by means of labels/wrist bands must be ensured in the mortuary

ii. The label (water proof) should be tied around the wrist or the neck

iii. It should carry the following information on it: Hospital registration number, mortuary serial number, name, age, sex

iv. In MLC cases, the label should be marked “M.L.C.” in bold letters;

v. The body is to be identified by recipient (police/NOK) at the time of handing taking over.

7. Preservation of the Body:

i. Since decomposition progresses fast, it is essential that the body is preserved in the AC chambers of the mortuary or with ice if mortuary does not have AC chambers

ii. The temperature of the cold storage room must be kept at + 4°C

iii. Temperature should not be allowed to fall below 0° C (freezing point) before the autopsy is done, because this will cause ice to form in the body tissues, the cells will be destroyed and any subsequent microscopic examination of tissues, that may be required after the autopsy, will then be of little value

iv. To preserve the body for long periods, it should be kept in the deep freezer after the autopsy

v. In case of deaths due to highly infectious diseases, the body may be kept separate from other bodies

vi. Embalming of body, in case requested by the NOK and the facility is available.

8. Safety and Security of the Body:

i. Safety and security of the body, until handed over to police, is the responsibility of hospital

ii. Often the police may request the hospital to keep the body in their mortuary overnight for preservation. The hospital may cooperate and do so on behalf of police.

9. Handing/Taking over of the Dead Body in Medicolegal Cases:

i. On arrival of the police, the body is formally handed over to them along with the Death Summary and personal effects of the deceased

ii. The police hands over the body to the NOK after postmortem

iii. The body cannot be handed over to relatives without written clearance from the police

iv. Proper handing/taking over is to be carried out as per the prescribed procedure.

10. Respect and Dignity in Death:

i. It should be the endeavor of all staff involved in handling, storage or transportation of the dead bodies that the bodies are treated with due respect.

Mortuary or Morgue is often the last halt before the final rites of a person who has ceased to be. It is also a place for carrying out the autopsies in some hospitals.

Since mortuary is a place for keeping the dead bodies, it generally does not get the attention due. Often the facility is ill equipped and foul smelling due to poor or no arrangement for refrigeration.

Although the bodies kept in the mortuary are no more alive to the conditions they are kept in, the basic human values demand that the deceased should be accorded dignity in death.

Submitted by : Professor Kamakshi, Category : Knowledge