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Handling dead bodies

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Handling dead bodies

Postby itsadisaster » Sun May 16, 2010 5:00 pm

I wasn't sure where to post this so if it needs to be in a different forum pls let me know. It's a difficult subject for some but there might a few tips here that could help out during a disaster or crisis. j & B

Often First Responders cannot reach a disaster site for hours, days or weeks so citizens should be prepared to deal with death or the handling of dead bodies.

Death in a shelter during a nuclear / radiological event – If a person (or pet) dies while in a shelter, cover body with a sheet or put it in a bag (or tape several large plastic bags together) and move it outside the shelter. Don’t try to bury it if high levels of radiation are still in the area, but do poke several pinholes in bag so gases won’t build up. (Make sure to decontaminate yourself before reentering shelter.)

If in a Disaster Situation with Casualties and No Help

- Dead bodies typically do not cause epidemics after a natural disaster. In fact, it’s survivors who will most likely spread disease.

- Don’t put yourself in danger to recover a body if there is any chemical, biological or radiological contamination in the area or structural damage due to an earthquake, etc.

- People handling bodies should wear gloves and boots and avoid wiping their face or mouth with their hands. (Facemasks are not needed but may be helpful to some handlers.)

- Wash hands with soap and clean water often, and disinfect tools, clothing, equipment and vehicles used to move the bodies.

- Bodies often leak feces after death so avoid contact with it (and body fluids) to limit exposure to any possible diseases.

- If no First Responders are on scene (and it may be a while before any are), write down any known details about where and when a body was found, name (if known), personal belongings on or with the body, take a photo (if possible) to help with identification later, etc.

- Graves should be between 5 ft (1.5m) and 9 ft (3m) deep.

- Burial sites should be at least 218 yards (200m) away from water sources such as streams, lakes, springs, waterfalls, beaches, and the shoreline. (If 4 or less bodies: 650 ft (200m) from water … if 5 to 60 bodies: 820 ft (250m) from drinking water well)

- The Department of Health and Human Services for North Carolina suggests pets and wild animals be buried in holes at least 3 feet (1m) deep where there is no possibility of contaminating surface or ground water. Livestock animals should be disposed of by incineration.


Some FAQs per PANO:

Do dead bodies cause epidemics?
Dead bodies from natural disasters do not cause epidemics. This is because victims of natural disasters die from trauma, drowning or fire. They do not have epidemic causing diseases such as cholera, typhoid, malaria, or plague when they die.

What are the health risks for the public?
There is a small risk of diarrhea from drinking water contaminated by fecal material from dead bodies. Routine disinfection of drinking water is sufficient to prevent water-borne illness.

Is spraying bodies with disinfectant or lime powder useful?
No, it has no effect. It does not hasten decomposition or provide any protection.

Local officials and journalists say there is a risk of disease from dead bodies. Are they correct?
No. The risk from dead bodies after natural disasters is misunderstood by many professionals and the media. Even local or international health workers are often misinformed and contribute to the spread of rumors.

Resources: City of Surprise Crisis Response Team and Management of Dead Bodies in Disaster Situations by The Pan American Health Organization
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Re: Handling dead bodies

Postby ReadyMom » Sun May 16, 2010 6:19 pm

This is a topic that you rarely see and NEEDS to be addressed! I'm glad that you did.

When I was at a Public Health summit a year or so ago, I got up to address this topic, since it was brought up at the time and there was very little response as to what to do! You should have seen the looks on the of the faces of the attendees! And they were in PUBLIC HEALTH! The problem is, when you are looking at a large scale disaster, with large death SOMEBODY has to deal with it and if gov't and health agencies are up to their elbows in emergency response ... that 'somebody' may be YOU! And you may have to wait for a government or public health person to get to your home/location for some time. So, What do you do?? ItsADisaser covered it very well.

Here is a page from the 'Get Pandemic Ready' website where this is also addressed:

Death and Dying
http://66.236.6.194:8888/pdf/TreatingTh ... hDeath.pdf

And more on my EHP Site:

Death and Burial
http://emergencyhomepreparation.org/vie ... 5905979983
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Re: Handling dead bodies

Postby Alaska Rose » Mon May 17, 2010 1:20 am

Thanks, both of you. This is something that each of us should know how to handle.
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Re: Handling dead bodies

Postby Who is John Gall » Mon May 17, 2010 1:34 am

Good topic. Among many other things I used to work in a morgue and in bioarchaeology. It was nice, the customers never complained and the conversations...

True, in most cases dead bodies are not a common source of infection during pandemics. However, they can still be a source of infection. Many microbes will remain infectious in dead hosts. A classic example is hepatitis B, which is so hardy that it can live and remain infectious on a dry surface for up to 2 weeks. Tuberculosis can remain infectious for at least 75 years and can reinfect from disturbed graves. Smallpox may remain infectious for decades or centuries, there are reports that the Soviets recovered small pox virus from graves to use as seed in their bioweapons programs. No one knows for sure how long anthrax will remain infectious in dead bodies, but it seems that the anthrax bacteria have evolved to include the dead of the host into their life cycle. The host, say a cow, drops dead in a field with it's body loaded with bacteria. Once the body cools, the bacteria form spores and end up on the ground as the cow decomposes. The grass in that area will be nice and green for the next cow to eat later... Ebola and Kuru have both been transmitted through mortuary practices and rituals.

I am not trying to contradict what Itsadisaster wrote above. It is most likely that living humans (or other animals) would be the primary vectors in an outbreak, not the dead. During a disaster bodies are as likely to spread disease as raw meat left exposed to rot (sorry for the analogy, not trying to be insensitive, just honest). Nevertheless, common sense and universal precautions should be exercised when handling the dead. Wear gloves and wash your hands and arms afterward. Avoid all contact with body fluids and clean them up with a dilute bleach solution afterward. If you know or suspect the person died of an infectious disease, be extra careful.

Body bags are not really needed. If you are able to bury a body soon (within 12-24 hours after death) then just a sheet alone may suffice. If it takes longer than that then a body bag or plastic sheeting would be a very good idea. Heavy plastic sheeting is probably as good as a body bag for holding the body, but a good body bag will have handles that make them easier to handle (moving bodies is difficult). Even if your beliefs hold that the remains should be interned as soon as possible, you should plan for the worst case scenario, like staying in a shelter for a prolonged period like Itsadisaster mentioned. In many northern areas it is common for bodies to be held during the winter for spring burial: the ground is too frozen for graves to be dug. In such a case you may have to plan on storing the bodies outside and have some sort of protection from scavengers available (a temporary cider block tomb?)

Word of warning about body bags, if you do decide to buy some don't buy cheap. The hospital where I work at now does and the "economy" white body bags that they have are dry rotted just from sitting on the supply room shelf. They look good in the package, but as soon as you unfold them they crumble. Literally. The only thing that we use them from is the toe tag. I used to use the heavy black vinyl body bags, and they are great--but expensive. $75-$150+ each.

In the military we used the standard issue green nylon body bags with 6 handles sewn in and these were wonderful. I got ahold of a bunch and kept them stored on our ambulances for disaster response. They can be used as a ground sheet to lay the casualty on for treatment (more comfortable than the ground and less likely to burn than a hot roadway). They make great soft stretchers. And, if it comes to it, you can use them as a body bag. They are made of nylon, they leak. So, they come issued with a cheap plastic bag that you use as a liner. I just looked on eBay, search "military body bag" and they have them for $30-40 each. They are pretty well constructed, so you could use them to hold lots of gear (winter clothes?). If they don't have the plastic liners, plastic sheeting like itsadisaster mentioned works great.

There will be fluids leaking from a body, and even with the plastic it could be a problem. A lot of commercial body bags come with absorbent pads, like Chux pads or the "blue pads" used in hospitals. You can buy these from a pet store--they sell them as "puppy training pads." These soak up the fluids and all but lock them in, like a diaper. They are placed on the bottom of the bag (or plastic liner) directly under the body. For some reason commercial bags usually only have one smallish pad, to be placed under the body's mid-section/buttocks. I would recommend at least one more to be placed under the head, preferably just line completely line the bottom of the bag with them.

Like Itsadisaster said, identification is important. You will want to make sure that you can identify where the body is buried and who the body is. If there is a less than TEOTWAWKI situation, or if there is a return of order, authorities may well be coming around to ask questions. The military uses dog tags to help facilitate identification: two are issued, one to remain on the body and the other to be turned into graves registration. A similar system could be used if you had some made for your family...if worse came to worse one could remain on the deceased and the other affixed to a grave marker. Leather wallets usually last for years when buried, especially if encased in plastic, and they can protect their contents well, even against fire.

I have seen many burned bodies and I would not recommend that anyone even consider a backyard cremation. People do not burn well. You have to get the fire hot and burn them for a long time and in the end you will still have a lot, if not all, of them left. When someone is cremated in a professional crematorium they make whatever is left fit into the urn. Think about it. Also, you may latter find yourself having to explain to the authorities why you decided to "burn the evidence." Even if you are faced with the disposal of many bodies a trench grave would be much better than cremation and would represent a much better use of resources such as petroleum products.
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Re: Handling dead bodies

Postby ReadyMom » Mon May 17, 2010 8:01 am

Who is John Gall wrote:-snip-
Heavy plastic sheeting is probably as good as a body bag for holding the body, but a good body bag will have handles that make them easier to handle (moving bodies is difficult). -snip


Recommended: The 55 Gallon Contractor Trash bags are about the biggest you can get in the stores. (You may need to use two because they are not quite long enough, but they are a good thickness.)
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Re: Handling dead bodies

Postby Vina8 » Mon May 17, 2010 8:19 am

You guys continue to amaze me. I am so grateful to have the expertise of people like Itsadisaster, ReadyMom, and Who is John Gall on the forum. Hard subject, but necessary. Thank you all. (y'all for my NC and other southern friends.)
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Re: Handling dead bodies

Postby itsadisaster » Mon May 17, 2010 9:57 am

Thank you both (RM and WIJG) for the added information and links. (RM - I had trouble with EHP link but I'll go direct and find it.) I was hoping others would add their expertise since our stuff just barely scratches the surface. We've struggled with that "dead bodies do not cause epidemics" statement from PANO for the exact reasons you wrote WIJG. If you don't know the person, how do you know what diseases they may harbor? And during a chem/bio situation most people aren't knowledgeable about the different agents so could be placing themselves (or a water / food source) in danger. And don't even get me started on VHFs (Ebola, etc) - those totally creep me out.

And agree re burning (personally, the smell is reason enough not to do it). Also remember if using large plastic trash bags for bodies that might lay around for a while before you bury it .. poke some holes in bag since gas buildup from decomposition could create a mess. Death during a crisis can be a very traumatic, complicated topic so again .. truly appreciate your well thought out posts.
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Re: Handling dead bodies

Postby ReadyMom » Mon May 17, 2010 10:22 am

ITA: Re The EmergencyHomePrep forum--technical difficulties are at hand. Apparently they upgraded a service and I didn't get notice in my email box. I'm waiting confirmation on my submission for the upgrade to get back on line. Ugh! I get so nervous about loosing the material on that site! Rocknrandy is great about helping with the periodic backups etc, since I'm so technically challenged! -k
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Re: Handling dead bodies

Postby jackiep35 » Mon May 17, 2010 10:33 am

great topic. i never thought about dealing with death with no no morge to take car of it.
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Re: Handling dead bodies

Postby Whisper » Mon May 17, 2010 7:54 pm

Good stuff for such a difficult subject. You all did a great job on it.
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Re: Handling dead bodies

Postby ReadyMom » Mon May 17, 2010 9:30 pm

ReadyMom wrote:ITA: Re The EmergencyHomePrep forum--technical difficulties are at hand. Apparently they upgraded a service and I didn't get notice in my email box. I'm waiting confirmation on my submission for the upgrade to get back on line. Ugh! I get so nervous about loosing the material on that site! Rocknrandy is great about helping with the periodic backups etc, since I'm so technically challenged! -k


My EHP site is back up and running! Sorry 'bout that. -k
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Re: Handling dead bodies

Postby Alaska Rose » Tue May 18, 2010 12:33 am

The suggestion to incinerate dead farm animal bodies (large) is okay, except in most situations, there wouldn't be enough fuel to incinerate a small animal, let alone large farm animals. If it is impractical to allow time to take care of the problem, burial is the best method of care, in my opinion.
Some duct tape to keep those plastic trash bags in place would be handy, also, or tarps if that is what is available. After wrapping, punch a few holes, on the side that is up.
Sometimes graves are dug, here in the Winter, in the villages, by building a fire, letting it die down and immediately digging out the soil that is thaws and repeating until the proper depth is reached. In larger towns, they usually predig several holes ahead of winter freezeup.
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Re: Handling dead bodies

Postby ReadyMom » Tue May 18, 2010 9:28 am

Another thing to think about: WHERE will your 'cemetrary' be? It might be your own backyard. Or it might be a vacant lot in your development/neighborhood.
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Re: Handling dead bodies

Postby Tinker » Sun May 23, 2010 6:19 am

Another option is always taxidermy...

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Re: Handling dead bodies

Postby Who is John Gall » Mon May 24, 2010 1:34 am

Something that I did not mention before is handling the dead in an less than TEOTWAWKI. What if a family member should die in the home and calling the coroner is not immediately practical? For example, say you grandmother as a heart attack and dies during a severe winter storm: power/phones out, roads closed, what to do you do? You could probably anticipate a return of services within 72°, but there is no guarantee. You want her preserved as well as you can, in case an open casket funeral might be held.

So, first of all take her clothes off, the pants will just get in the way of cleaning her. If you have an out fit that you want her buried in, you could put the shirt and shoes on her for now, but be aware that it can get pretty badly stained. Position her arms an legs as you see best. Normally, the legs out stretched and the arms along the sides. Some cultures want the arms crossed over the chest with the forearms forming a crucifix. If you do anything like that, make sure that you have the shirt on first...once rigor mortis sets in it can be very difficult to reposition the arms and legs. If you need to, a bit of string (preferably a broad string or ribbon, and tied loosely so there will be less indentation into the skin) tied around the wrists and ankles can help to hold the limbs in place. Prop the upper body up about 15° (you can use a board under the back with a pillow stuffed under the board at the head), so that the head will be elevated some. Be careful to not elevate the head alone and cause it to be hyperflexed ("chin to chest") as this could result in poor cosmetic results once rigor arrives. The reason for elevating the upper body and head is to avoid edema/swelling. As cells die, they burst and release their contents. This causes pronounced swelling. By keeping the head elevated you will promote the excess swelling/fluid to drain to the lower part of the body. Do not attempt to over do elevating the upper body, keeping the head and shoulders up at a 15° should would be good for the undertaker, having her sitting up when rigor mortis sets in would not be ideal for the undertaker intending to prepare her for a coffin funeral. In addition to elevating the head and upper body, place ice wrapped in a wash cloth or paper towel over her closed eyes and the bridge of her nose. This will further reduce edema to these areas.

Of course, make sure that you have a bed sheet and heavy plastic sheeting under her and several absorbent pads under her rectum/perineum. The bed sheet can be used as a draw sheet to move her and the plastic sheeting could be drawn as a shroud should she need to be buried in the back yard if the aurthorities cannot be contacted in a reasonable time. Practice universal precautions at all times: wear gloves and wash your hands after you handle her. Treat everyone like they could be carrying a deadly disease, even your grandmother.

After you have the body positioned, keep her as cool as you can. Without cooling measures a body will start to noticeably decompose in 12-24 hours (sooner in hotter temperatures). If you can keep the body well chilled you can slow decomposition by 3-7 days. Cover with a light sheet only. Consider packing bags of ice or snow around her, if available. Just be careful where you put it. A bag of ice can be heavy, if you place it over her face it can permanently flatten her lips, cheeks, and nose. A fan alone can do wonders. I attended a lecture once on changes after death and the lecturer presented the case of a boy who shot his mother and her boyfriend while they were on the couch watching TV (in Arizona, in the summer, if I remember the story correctly). Afterwards he felt bad about it, and it was kind hot, so he brought in a fan and directed it at his mother, but not at the boyfriend. The photo taken by the police responding to the scene 3 days latter was amazing. The mother looked like she was still watching TV, no gross decomposition noted. Her boyfriend sitting next to her, however, was significantly decomposed.

Lastly, don't forget that until the coroner releases the body, this is a crime scene. Legally, you are just to leave her were she fell. Everything that I have described above could constitute disturbing a corpse and a crime scene. If you feel that preparing her body as I have described above (or in some other fashion) is indicated, do so aware of the consequences and attempt to mitigate them as best you can. Have help and witnesses available at all times. Take a picture of her before you move her. Take pictures as you undress her, both of her front and of her back. I know that this will sound bad and harsh, but make sure that you cover nothing up. If you cover up her private area the lawyers will say you were trying to hide something. Take several pictures of any point of potential interest (bruises, cuts, etc). For these, take one picture of the body with the area of interest centered in the frame. Then zoom in and take one of the limb or region with the area of interest in the center of the frame. Then take a close up of the area of interest. Finally, repeat the close up with a scale placed near the area of interest. For the scale you can use a ruler with easily read numbers, or even a common object such as a dollar bill or a quarter. Save all of her clothes, that you remove from her, and place them in a paper bag (plastic bags promote mold growth which could contaminate "evidence." Do not wash the body (except to clean up leaking body fluids) and do not mess with the nails or the hair. Leave any dressing or bandages and tubes in place. Leave her dentures in, and make sure that they have not fallen out of place. Consider making a toe tag. Use an index card. On one side write her name, DOB, SSN, address, next of kin and contact info. On the other side write the date and time of death, the circumstances of the death, and who was present (names and contact information). Punch a hole in a corner of the index card, run a rubber band through it and fasten this to one of her big toes.
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