THE “SEMI-FOWLER POSITION”  

A case swollen and heavy with edema presents a real problem to the embalmer.  How do you return the decedent’s features to some semblance of normal size?  Is it even possible?  

Yes, if you know what to do.  Your best line of defense in this situation is the “Semi-Fowler’s position.”  This position, used frequently in medical settings (hospitals, care facilities, etc.) is an excellent choice for dealing with an edematous case.  Using it allows effective fluid drainage, with results that are often quite dramatic.  

To use the Semi-Fowler’s position, arrange the decedent in a semi-sitting (or, semi-reclined) position, on an angle of approximately 30 degrees.  To support the case at this angle, use, if available, the backboard specially built for the position (it should have a shelf for a head block, or a head positioning device).  When you have no other option, you can use boxes (for example, boxes of embalming fluid) to accomplish the position.  The trick is to elevate the body as much as possible to approximate a sitting position.  Next, embalm the case.  I would like to emphasize here that the proper choice of fluids can make all the difference in the outcome of the case.  My personal choice would be a combination of Champion’s Hi-Form, Xeros, and Tri-San fluids.  Next, aspirate the body on each side of the lower abdominal quadrant.  Afterward, do not suture the trocar openings (you can additionally leave open arterial incisions, etc.) until the next day.  Allow the case to remain in the Semi-Fowler’s position overnight.  Doing this will allow gravity to drain away excess fluids .  Follow up with Champion’s Cavity 48 for abdominal treatment (Champion guarantees almost 90% no-purge).   

I have personally seen some previously grossly swollen cases return to normal size overnight.  If you are interested in further information on this position, or on acquiring a Semi-Fowler’s position board, e-mail me at jon@snydersembalming.com.

Body placed in the semi-fowler position using the backboard, a head block, and adjustable arm positioners.  For best results, the buttocks should actually abut the front edge of the backboard.  Also, the head block should not press into the cervical tissue or against the ears.

The leg positioner, with blocks, if necessary, can be used to prevent the body from slipping down the table.  In certain cases, a towel under the buttocks will also prevent the body from sliding.

Drawings taken from "Embalming Perspectives & Paradigms Challenged" (Published by Arc/Mesa) with permission of the author, John S. "Jay" Rhodes III, C.F.S.P. The term "Semi-Fowler" has been coined by Rhodes to describe a position used by his family for three generations. The term can be found in a medical dictionary for a similar positon. John S. Rhodes, Sr. learned the basic technique in Pennsylvania and brought it to Florida in 1921.

 

Tip originally posted 9/02.

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