BIE International Diploma in Embalming - Final Theory cheat sheet

Systemic circulation passes: right atrium → right ventricle → pulmonary circulation → left atrium → left ventricle → aorta → systemic arteries → capillaries → veins → vena cavae.

Right common carotid arises from the brachiocephalic trunk; left common carotid arises directly from the aortic arch.

Common carotid bifurcates at about C4 into internal carotid (brain and eye) and external carotid (face, scalp, neck).

Femoral artery is the continuation of the external iliac artery below the inguinal ligament; the femoral vein lies medial to it.

Axillary artery becomes the brachial artery at the lower border of teres major; the brachial artery divides into radial and ulnar arteries.

Capillaries are the main exchange vessels; arterial embalming fluid reaches tissue via capillaries and drains through venules and veins.

Normal blood pH is 7.35–7.45; acidosis accelerates protein breakdown and alters tissue firmness.

Livor mortis is gravity-dependent; rigor mortis results from ATP depletion; algor mortis is postmortem cooling.

Cocci are spherical bacteria, bacilli are rod-shaped, and spirilla are curved or spiral bacteria.

Endospores of Bacillus and Clostridium resist heat, drying and many disinfectants; sporicidal action is required for inactivation.

Viruses are obligate intracellular agents; enveloped viruses are generally more susceptible to disinfectants than non-enveloped viruses.

Prions are abnormal infectious proteins resistant to routine autoclaving and disinfection; incineration or validated prion protocols are required.

Mycobacterium tuberculosis is transmitted by airborne droplet nuclei; aerosol-generating procedures increase exposure risk.

Hepatitis B is bloodborne, stable on environmental surfaces and vaccine-preventable; HIV is less environmentally stable.

Autolysis is enzymatic self-digestion; putrefaction is microbial decomposition, usually beginning in the gut.

Embalming reduces but does not guarantee sterilization of all microbial or prion contamination.

Final formaldehyde strength = (index × concentrate volume) ÷ total volume; a 20-index fluid diluted 1:1 gives about 10%.

Common arterial injection sites are common carotid, femoral, axillary, brachial and radial or ulnar arteries.

Drainage is usually via corresponding veins using gravity, massage and occasionally suction; jugular and femoral veins are common routes.

Pre-embalming steps include identity and authorization checks, PPE, disinfection, positioning, feature setting and relief of rigor.

Co-injection fluids may contain anticoagulants, surfactants, humectants, dyes and buffers.

Cavity embalming follows arterial treatment: aspirate thorax and abdomen, then inject concentrated cavity fluid via trocar.

Hypodermic and surface embalming treat areas not reached by arterial injection, such as digits or vascular obstructions.

Formaldehyde cross-links proteins; fixation depends on concentration, penetration and contact time.

Six-point injection uses bilateral carotid, axillary and femoral sites when distribution is inadequate.

Standard precautions apply to every deceased person regardless of known infection status.

PPE selection is risk-based: gloves, gown, eye protection and mask; double gloves where blood exposure is likely.

Hand hygiene is required before and after glove use and after contact with body fluids or contaminated items.

Sharps must go directly into rigid puncture-resistant containers; recapping by hand is avoided.

Blood spills: absorb, clean, then disinfect with about 10,000 ppm available chlorine or a validated equivalent.

Formaldehyde is a carcinogen; typical UK limits are 2 ppm 15-minute STEL and 1 ppm 8-hour TWA.

After a sharps injury: encourage bleeding, wash, cover, report and seek occupational health assessment.

Waste streams for sharps, infectious waste, anatomical waste and offensive or household waste are segregated according to local rules.

Pre-treatment checks include identity, authorization, cause of death, infection risk, implants and cultural or religious requirements.

Documentation includes date and time, personnel, authorization, fluids used, injection and drainage sites, complications and restorative work.

Consent must be obtained from the person with lawful authority before embalming.

Communication with families uses plain language and respects grief, culture and religious practice.

Scope of practice is limited to tasks the practitioner is trained, competent and legally authorized to perform.

Continuing professional development maintains competence through learning, reflection and updating of knowledge.

Personal presentation, punctuality and respectful behaviour support professional trust.

Referral is required when a request exceeds competence, authority or legal scope.

Embalming requires lawful authorization or consent before treatment begins.

Unexpected, violent, suspicious or unattended deaths may require coroner or medicolegal referral before embalming.

Pacemakers and implanted power sources must be removed or disclosed before cremation.

Confidentiality continues after death; information is disclosed only to authorized people or where law requires it.

Formaldehyde-containing waste and fluids require approved disposal routes; drain disposal only if local regulations permit it.

Licensure or registration and adherence to professional codes are legal and ethical requirements.

Financial arrangements should be transparent and agreed before services are provided.

Discrimination on grounds such as religion, culture, disability or sexual orientation is unethical and often unlawful.