Mortuary – Function, Documentation, Physical facilities, Managerial issues, Policy and Procedures
Concept of Mortuary
Mortuary Department is a critical division within a hospital or medical facility responsible for the respectful and efficient handling of deceased patients. Its primary objective is to provide proper care, preparation, and transportation of the deceased, while also supporting grieving families during their difficult time.
Function of Mortuary
The various functions of the mortuary services can be enumerated as follows-
- To shift the dead body immediately to mortuary, till other formalities for handling over the dead body to the claimant are completed and also to keep the dead bodies in the mortuary till they are handed over to the authorized persons.
- To receive and store the dead bodies requiring postmortem examination.
- Disposal of the unclaimed bodies as per the existing policy of the hospital and as per the law of the end.
- To impact teaching programs to undergraduates and postgraduates by arranging demonstration of the postmortem examination.
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| Mortuary |
Documentation of Mortuary
Documentation is an important activity of the mortuary services in the hospital. Every mortician must maintain a good quality ledger to enter all the details in respect of the bodies brought into the mortuary, preserved and disposed off the mortuary. These records are to be maintained faithfully. Following details are maintained in respect of the dead bodies. If there are facilities the database can be computerized also. It is easier to maintain and retrieve the data.
- Allot a mortuary number to each body for identification
- Name, age and sex of deceased person
- Date and time of death
- Identification details of deceased including the fingerprints
- Contact person’s detail
- Whether post-mortem was carried out or not?
- If post-mortem was conducted, then date and time of post-mortem examination
- Date and time of sending the body to storage chamber
- Length of the body and breadth across shoulders to determine the size of coffin if required
- List of valuables in the possession of deceased
- Date and time of issuing the body
- Signatures of the mortuary technicians.
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| Documentation of in the mortuary |
Physical facilities of Mortuary
Location:-
It should
be located in a separate building, near to the department of the Pathology,
preferably in the ground floor or basement, having easy access from wards,
emergency department and operation theatres.
Size:-
There
should be mortuary chamber for holding two bodies for a hospital of size of
50-100 beds and at least of holding capacity of three bodies for a hospital of
200 beds.
Layout and numbers of rooms:-
Following physical facilities are desirable for a mortuary of large size of hospital or a hospital associated with medical College:
- Parking area for vehicles.
- Post-mortem room.
- Storage chambers.
- Trolley bay.
- Office room for record keeping and processing.
- Pathologist room.
- Changing room for staff.
- Store room for clean, supplies, equipment, chemicals.
- Visitors and relatives waiting area.
- Room for mortuary technicians and attendance.
- Toilets.
Space
requirements
Space requirement will vary from hospital to hospital depending upon the size and types of hospital and also upon the work load and responsibilities of the mortuary services. Whether it is a part of forensic medicine or is a part of forensic institute the space requirements will vary. Committee On Plan Project (COPP) has recommended an area of 6-8 sq. ft per bed as a general guide.
- Floor:- The floors should be of RCC, hard and durable, it should be easily washable and moisture proof and non-slippery.
- Walls:- The walls should be washable; preferably dedoing should be there; also there should be scope for future expansion.
- Windows:- As far as possible, the natural day light should be used and i most of the situations and post-mortem examination are conducted during the time. If due to unavoidable circumstances, it is to be conducted after sunset.
- Doors:- It should be wide enough to allow for passage of portable X-ray machine. Preferably, it should be sliding door.
- Corridors:- The corridors should be wide to allow passage of trolleys and X-rays machine etc.
- Lighting:- As far as possible there should be adequate day light and it addition to it, there should be provision of the artificial light with stand by generator.
- Ventilation:- The exhaust fans are required and atleast 10 air changes per hour are recommended.
- Heating:- The heating requirement can be met with the help of the heaters and a desirable temperature for work areas is 50 degree F to 65 degree F.
- Supply of hot/cold water:- Adequate arrangement for provision of heated and cold water should be made.
- Drinking water facility:- There should be provision of safe drinking water.
- Wash basin:- Facilities for hand washing with soap separately for the staff and visitors is required.
- Air conditioning:- If resources are available it is desirable to have AC facilities.
- Fire fighting:- Fire detection, fire alarm and fire fighting system must be in place.
Equipments of Mortuary
Following types of equipments are required in the mortuary of the hospital-
- Cold chamber for maintanence of temp at +2/+4 degree C.
- Cold chamber for maintanence of temp at -15/-25 degree C.
- Autopsy table.
- Table, chairs, stool, file cabinet lockers.
- Computer with printer
- Sterilizer.
- Instruments cabinet.
- Portable X-ray machine.
- Spectrophotometer.
- Fume chamber.
- High pressure liquid chromatography.
- Thin layer Chromatography kits.
- Gas liquid Chromatography.
- Weighing machine.
- Large sinks for hot and cold water.
- Cutting saw and other instruments of dissection.
- Embalming machine, it facilitates of embalming are available in the mortuary.
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| List of equipments for 500 bed hospital |
Staffing of Mortuary
The staffing will depend upon the size and type of the hospital. If the hospital is associated with a medical College the staffing requirements would be different. As a general guide two forensic expert for 150 autopsies, one additional expert for every 100 autopsies. In addition to the above, the additional requirement of staff is as follows:
- Two mortuary technicians for one mortuary.
- Five mortuary attendants for round the clock duty.
- Security guards on rotational duty for round the clock guarding of the mortuary.
- Three safai karmachari for cleaning purposes.
- X-rays technicians for performing, X-rays in medico-legal cases as per the requirement.
Managerial
issues, Policy and Procedures of Mortuary
The Mortuary services are very sensitive services of the hospital at one hand the sentimental values of relatives are attached with the deceased and other hand the medico-legal importance of the case. The situation is to be handled with great care. There should be a Standard Operating Procedure (SOP) for the important issue like:
- Receiving of the dead body and maintenance of the database.
- Identification procedures of the dead bodies.
- Disposal of unidentified bodies and unclaimed bodies.
- Embalming procedure.
- Storage procedure.
- Timing for conduction of the postmortem examination, preservation of viscera and sending the viscera for chemical examiner for further examination and expert opinion.
- Issuing of the dead bodies to the authorized persons.
- Universal precautions for staff.
- Conduction of demonstration and teaching programs in the mortuary student.
- Monitoring and evaluation of the mortuary services.
Monitoring and evaluation of the mortuary services
i) Daily check
- Temp in cold chamber.
- Compressor check.
- Check for cleanliness.
- Gas pressures
- Water level.
ii) Monthly check
- Motor.
- Generators.
- Wiring of electricity.
- Embalming machines.
iii) Half yearly check
- Preventive maintenance of equipments.
- Change of compressor’s oils.
- Greasing of motors.
iv) Record maintenance.
v) Workload assessment.
