Anatomy and Embalming / A Treatise on the Science and Art of Embalming, the Latest and Most Successful Methods of Treatment and the General Anatomy Relating to this Subject

by Albert John Nunnamaker; Charles Otto Dhonau

Aspiration consists in actually pumping the blood from the heart, arteries or veins. In this method, if blood is to be taken from the heart directly, the trocar is used; if the blood is to be taken from the heart indirectly or from the arteries or the veins one of the drainage tubes is used. Either the trocar or the drainage tube is connected by rubber tubing, to the goose neck on the blood bottle, which in turn is connected by rubber tubing to the aspirator side of the aspirator and injector pump. When the air is drawn from the blood bottle, there is a vacuum formed, which will aspirate or draw the blood from the heart directly or indirectly from the arteries or veins. The one great disadvantage of this method is that if the vacuum is made too great, the artery or vein will collapse ahead of the drainage tube and thus prevent the successful aspiration of the blood.

Drainage or gravity consists in opening one of the principle arteries or veins of the body, inserting a blood drainage tube into the artery or vein as far as it seems practical, and then connecting the blood drainage tube to the blood bottle by means of rubber tubing. The blood bottle should be placed considerably lower than the body in order to have the blood drain successfully. If the femoral artery or vein is used, the body ought to be on a considerable incline, the head at least one foot higher than the feet in order to get the maximum amount of blood.

If the axillary, brachial, or carotid, or their corresponding veins are used, the body ought to be on a level or turned to the side of the opening veins.

Simple drainage in itself is not a very successful method of getting the maximum amount of blood from the body.

The process can be modified in three ways which are as follows:

(1) By placing the blood drainage tube in the vein and the arterial tube in the corresponding artery. Inject fluid into the arteries which will tend to push the blood in turn from the capillaries into the veins, and out into the drainage tube into the blood bottle. This modified method has been called by Robbins “Displacement.” This is a good name and one which should be generally adopted.

(2) By placing the blood drainage tube in the artery or vein, preferably the femoral, and connect it by means of rubber tubing to the blood bottle. The operator now stands at the head of the subject, he reaches over, takes hold of each hand of the subject, raises the arms of the subject to right angles with the subject, then crosses the arms and with a steady gentle pressure bears down on the chest of the subject over the heart region.

If the axillary is used the operator is able to manipulate but one arm, the one opposite. Raise this arm to right angles with the body then fold down on the chest, exerting an even steady pressure. By raising the arms the blood will leave the hands, and each time pressure is exerted on the chest blood begins to flow from the artery or the vein, and will continue to flow as long as the even pressure is exerted.

(3) By the combination of number one and two. The operator opens the artery, preferably the femoral, inserts the arterial tube, and injects a pint of fluid to exert a pressure on the venous system. He then opens the vein, inserts the blood drainage tube which is connected with the blood bottle. With the pump in his right hand (granting that he is using the aspirator and injector pump), he stands at the head of the subject and slowly injects the fluid. If at any time the blood ceases to flow, by taking hold of the hands, raising both arms at right angles to the subject, crossing, and while in this position injecting a few ounces of fluid, then bear down gently on the chest with a steady pressure. If the blood will not flow by this method and the operator is using either the axillary or the femoral, there is hardly any use of trying any other method. The operator will be able to draw the maximum amount of blood with this method, if it is at all possible to draw blood.

Often when the blood stops flowing, there is a blood clot formation ahead of the drainage tube. By injecting just a few ounces of fluid or salt water through the tube into the vein, the clot may be pushed to one side, and the blood will continue to flow.