Medical Examiner's COVID-19 Release Procedure & Handling Guidelines
Release of suspected/confirmed COVID-19 cases from the Medical Examiner’s Office
The medical examiner’s office (MEO) has implemented a total containment policy following the completion of postmortem exams of suspected/confirmed COVID-19 cases. The decedent will undergo a two-person identity verification process prior to being shrouded after which the shroud will then be labeled with the MEO case number and name of the decedent. The shrouded remains will then be placed in a blue body bag which will be disinfected and also be labeled with the MEO case number and name of the decedent. Any suspected/confirmed COVID-19 case will have an orange sticker (see example below) placed on the outside of the bag. In the event that COVID-19 test results are available prior to the release of the decedent, the bag will also be tagged with either a "TESTED POSITIVE FOR COVID-19" or "TESTED NEGATIVE FOR COVID-19" sticker (see examples below). Funeral home representatives will not be allowed to open the bag to place an identification band on the decedent during the release process in the body loading area to prevent the need to utilize additional PPE in order to preserve critical PPE resources. Personal belongings will be double-bagged in red bio-hazard bags and placed in the body bag with the decedent.
Suspected/confirmed COVID-19 postmortem handling guidelines:
As always, use universal precautions.
Transportation of Decedents:
Follow standard routine procedures when transporting the decedent at the time of release. Wear disposable nitrile gloves when handling the body bag.
PPE Recommendations for Handling Decedents:
- Double-glove using nonsterile, nitrile gloves when handling decedents.
- If there is a risk of cuts, puncture wounds, or other injuries that break the skin, wear heavy-duty gloves over the nitrile gloves.
- Wear a clean, long-sleeved fluid resistant or impermeable gown to protect skin and clothing.
- Waterproof apron
- Use a plastic face shield or a face mask and goggles to protect the face, eyes, nose, and mouth from splashes of potentially infectious bodily fluids.
- NIOSH-certified disposable N-95 respirator or higher (strategies for optimizing the supply of N95 respirators can be found here).
- Surgical scrubs, shoe covers, and surgical cap should be used per routine protocols. Doff (take off) PPE carefully to avoid contaminating yourself and before leaving the prep room or adjacent anteroom.
- Information on how to safely put on and remove PPE can be found here.
In the Prep Room:
- A logbook including names, dates, and activities of all workers participating in the embalming and cleaning of the prep room should be kept to assist in future follow up, if necessary.
- Limit the number of personnel working in the prep room at any given time to the minimum number of people necessary to safely embalm/prepare the decedent.
- Limit the number of personnel working on the decedent at any given time.
- Use caution when handling needles or other sharps, and dispose of contaminated sharps in puncture-proof, labeled, closable sharps containers.
- The usage of drain tubes are preferable over angular spring forceps for draining.
- Limit the use of aspirators as they increase the risk of aerosolization of infectious material.
- Keep ventilation systems active during embalming and while cleaning is conducted.
- Do not use compressed air and/or water under pressure for cleaning, or any other methods that can cause splashing or might re-aerosolize infectious material.
- Clean and disinfect or autoclave non-disposable instruments using routine procedures, taking appropriate precautions with sharp objects.
- When cleaning is complete and PPE has been removed, wash hands immediately with soap and water for 20 seconds. If hands are not visibly dirty and soap and water are not available, an alcohol-based hand sanitizer that contains 60%-95% alcohol may be used. However, if hands are visibly dirty, always wash hands with soap and water before using alcohol-based hand sanitizer. Avoid touching the face with gloved or unwashed hands. Ensure that hand hygiene facilities are readily available at the point of use (e.g., at or adjacent to the PPE doffing area).
Update: The CDC and FDA have added new recommendations and guidelines for funeral homes during the COVID-19 pandemic. Click on the links below for more information.