Mortuary Service

Arif RazaMortuary Service

DefinitionAmorgueormortuaryis used for the storage of humancorpses awaiting identification, or removal forautopsyorburial,cremationor some other post-death ritualIntroductionPlace for safe and secure preservation of the dead bodiesPreserved till taken away for final ritesIn small hospital it may be limited to storage space for a body or twoIn large hospital like medical college, full fledge department of forensic medicineIntroductionStandard of facilities are generally not of the acceptable levelOften treated as place of dumping deadUsually found unhygienic with rodents and foul smellsCreates problem for public in vicinityArrangement in mortuary shall ensure physical safety and integrity of body and prevent its deterioration / decompositionObjectivesSafe storage, preservation and handing over of the correct body to the correct recipient in the correct conditionPrevent public nuisance because of foul smell created by decomposing bodies and unhygienic sanitary conditions or improper disposal of the biomedical wasteDue respect towards body to uphold the dignity in deathFunctionsStorage of dead bodies till taken awaySafe preservation to prevent deteriorationPhysical security against theftConduct of autopsiesEmbalming of the bodiesHanding over of body to authorizedMaintenance of record of all bodiesStructureLocated on ground floor preferably in the rear partAway from patient / visitors areaAway from residential areasShould have direct access to the external traffic routeRoad should provide accessibility to hearse vanStructureIf meant only for storage, body storage room with refrigerated chambersJanitors closetTrolley bayRelative waitingReligious rites room

StructureIf meant for autopsiesAutopsy roomViewing roomChange roomToilet / showerSluice roomPolice room

StructureSpace allocation and the number of body chambersIn accordance with the body loadAvg. 1 death per bed per yearDepends upon size and type of the hospitalPolicy of hospital regarding accepting bodies from outsideHospital with 50-100 beds should have capacity for 2 bodies and with 200 beds at-least 3 bodies

StructureSpace in teaching and research hospitals may be much higherLarge hospitals should have space for safe storage of bodies in mass casualty situationSign posting

StructureEngineering supportLighting (1500-2000 Lux at mortuary table, 200-300 Lux in the body storage)Ventilation and exhaust systemBody chambers must have alternate source of powerProper housekeepingPrevention from pests / rodents

EquipmentAC chambers (3 Sq M per body) of stainless steel with rails for sliding the trolleys in/out easilyShould have humidity and temperatur control (3.5 6.5 deg C)Separate thermostat for every chamberBigger mortuary may have walk in cold chambersSeparate space for decomposed and infected bodies (freezers)EquipmentAutopsy room should have stainless steel tables with slope and sinkAutopsy instrumentsContainers for organs / tissuesPortable X-ray machineView boxEquipmentOther equipmentsStretcherGloves (Leather / Rubber)OvercoatsBoots, capsSoap and disinfectantsCotton clothMortuary cold chambersChambers used to preserve decomposition of dead bodyTwo typesPositive temperature (2 4 deg.) keeps body for several weeksNegative temperature (-15 to -20 deg.) used at forensic institutes. Decomposition is totally haltedStaffingNo dedicated staff in small hospital where autopsies are not carried outUnder pathology department or A & E departmentFor large hospital dedicated staff is required for maintenance, safe storage, record keeping, assisting in autopsiesSpecialist in forensic medicine may be requiredProcessPolicies and procedures for safe and secure storage and preservation of the bodiesAcceptance / non-acceptance of bodiesTransportation of body from inpatient area to mortuaryIdentification of bodiesReceiving of bodies including recordsSafety and security of bodies with medico-legal concernProcessHanding over of bodyCarrying out of autopsiesMaintenance of high level of hygiene and sanitationDisposal of biomedical wasteControl of infectionsAvailability of embalming facilityRespect due to deadMonitoring ParametersIncidence of theft of bodies / body partsIncidence of handing over wrong bodies to claimantIncidence of deteriorationLevel of hygiene and sanitationThank you