concept meaning and management

1. Dead body management in a
covid patient
Dr Selam Tebeje
Anesthesiologist

2. Outlines:
• General principles
• Steps of dead body management

3. General Principles
• preparing the dead body should always follow
Standard IPC practice.
• All the necessary hand hygiene and PPE supplies :-
– water resistant Gown & Gloves
– Google/Face Shield and Surgical Masks
– cloth to cover the dead body (cotton)
– chlorine solution and sprayer

4. • The dignity of the dead person
• Dead Body Management involves appropriate
consultations and engagement

5. • The major steps are:
1. Preparing of the body at patient room/Isolation
Room
2. Handling of dead body at morgue
3. Transportation
4. Conducting Burial
5. Before return to home after burial

6. 1. Preparing of the body at patient
room/Isolation room
• After the physician declares death,
– Keep practicing standard precautions
– Notify the family
• Prevent exposure to blood and body fluid during
transportation
– Remove all disposable tubes and lines
– Dress all wounds and plug all openings/ prevent oozing of
body fluids or bleeding

7. Preparing of the body Cont’d…
• Minimize movement/physical handling of the body
• Wrap body in cloth and transfer to the morgue as
soon as we can
– Don’t try to disinfect
– Body bags not necessary, unless special circumstances

8. Cleaning and Disinfection
• used linen - wrap-up from out to inside
• Used equipment (re-usable) - autoclaved or
decontaminated
• All medical waste must be handled and disposed
in accordance with IPC waste management
rules.

9. Cleaning and Disinfection Cont’d…
• Disinfect hospital bed, rooms, bed linens and
mattress properly
• All surfaces of the room area : first with
soap/detergent and water then wiped with 0.5%
Sodium Hypochlorite solution; for 5 to 10
minutes,...then air dry.
• Remove PPE and perform hand hygiene.

10. 2. In the Morgue
• Morgue staff must be provided training and practice
on Proper IPC practices
• Hand Hygiene
• Mode of disease transmission
• PPE utilization
• must always be kept clean and properly ventilated
• Adequate Lighting

11. In the Morgue Cont’d…
• Avoid direct contact with blood and body
fluids.
• Use PPE and Remove and discard immediately
• Avoid Autopsy examination unless for medico-
legal
• If done, under strict IPC procedure with a
minimum number of staff involved

12. In the Morgue Cont’d…
• Do standard body preparation, put the body in
coffin, seal and disinfect the coffin
• Hand over to the burial team using stretcher or
metallic bed
• Delay? stored in cold chambers (~4°C).
• If no cold chamber, burial as fast as possible

13. Cleaning and Disinfection
• Environmental surfaces, instruments and transport
bed should be cleaned and disinfected immediately
• Minimum concentration of the disinfectants 0.5%
sodium hypochlorite (bleach), or 70% ethanol
• NOTE: Preserving/conserving of dead body should
not be allowed.

14. 3. Transportation
• Make sure that the exterior of coffin or metallic
bed is decontaminated.
• The personnel handling the body ,,,(use gloves,
face mask and hand hygiene).
• Afterwards, the vehicle, should be
decontaminated with Bleach.

15. 4. Burial Process
• All burial team should wear glove and face mask,
hand hygiene
• Religious ceremony may be conducted with
minimal attendees with strict physical distancing
but coffin should not be opened.

16. Burial Process Cont’d…
• The one that places the body in the grave, wear
gloves and hand hygiene afterwards
• Law enforcement officers
• Regular burial sites can be used

17. 5. Before Return to home after Burial
• reusable equipments should be cleaned and
disinfected
• All disposable PPE should buried or burnt
• rubber boots if used, disinfected with bleach
• people at the ceremony should conduct hand
hygiene before returning home

18. Handling Dead Bodies of Unknown Cause
• Avoid transport of Dead bodies: If obligatory,
strict IPC procedures and trained personnel
• No autopsy, If confirmed COVID-19
• If suspect only, the extent of post mortem
examinations decided by the investigating police
officer and other relevant parties

19. THANK YOU!