1. (a) In order to ensure the maximum inhibition of pathogenic organisms in the dead human body, the following minimum standards of performance shall be required of each licensed embalmer in the State of Texas in each instance in which he or she is authorized or required to embalm a dead human body.

   1. (1) Embalming shall be performed only by embalmers licensed by the commission, in properly equipped and licensed establishments, or in the event of a disaster of major proportions, in facilities designated by a medical examiner, coroner, or state health official. Only three types of people may under certain circumstances assist licensed embalmers in embalming: provisional licensed embalmers under the personal supervision of a licensed embalmer; students who are enrolled in an accredited school of mortuary science working on a case intended toward completion of the student's clinical requirements, under the personal supervision of a licensed embalmer and with written permission to assist the embalmer from the person responsible for making arrangements or next of kin; and, in the event of a disaster of major proportions and with the prior approval of the executive director of the commission, embalmers licensed in another state as long as they are working with or under the general supervision of a person licensed as an embalmer in this state. It is not the intent of this rule to supersede §203.22 of this title (relating to Required Documentation for Embalming) which authorizes embalming using mortuary students.
   2. (2) In order to prevent those involved in the embalming procedure from becoming unwitting carriers of pathogenic organisms into the community, they shall be required to utilize such protective devices as gloves capable of being sterilized, aprons or operating gowns during the embalming procedure. Disposable garments and/or gloves shall be permitted.
   3. (3) Clothing directly exposed to contamination by pathogenic organisms shall either be burned or thoroughly cleaned and disinfected with a solution having phenol coefficient of not less than one before delivery to any person or before any further utilization.
   4. (4) The technique utilized to effect eye, mouth, and lip closure shall be any technique accepted as standard in the profession. Regardless of the technique chosen, the embalmer shall be required to achieve the best results possible under prevailing conditions.
   5. (5) The entire body shall be washed with an antiseptic soap or detergent. Fingernails, hair (including mustache and beard) shall be thoroughly cleaned, either before or immediately after arterial injection.
   6. (6) Body orifices (open lesions and surgical incisions, nostrils, mouth, anus, and vagina) shall be treated with appropriate topical disinfectants either before or immediately after arterial injection. After cavity treatment has been completed, body orifices shall be packed in cotton saturated with a suitable disinfectant of a phenol coefficient not less than one.
   7. (7) The arterial fluid to be injected shall be one commercially prepared and marketed with its percent of formaldehyde, or other approved substance, by volume (index) clearly marked on the label or in printed material supplied by the manufacturer.
   8. (8) The fluids selected shall be injected into all bodies in such dilutions and at such pressures as the professional experience of the embalmer shall indicate, except that in no instance shall dilute solution contain less than 1.0% formaldehyde, or an approved substance that acts the same as formaldehyde, and as the professional experience of the embalmer indicates, one gallon of dilute solution may be used for each 50 pounds of body weight. Computation of solution strength is as follows: C x V = C' x V' C = strength of concentrated fluid V = volume of ounces of concentrated fluid C' = strength of dilute fluid V' = volume of ounces of dilute fluid

   9. (9) Abdominal and thoracic cavities shall be treated in the following manner.

      1. (A) Liquid, semi-solid, and gaseous contents which can be withdrawn through a trocar shall be aspirated by the use of at least 18 inches (mercury) vacuum.
      2. (B) Concentrated, commercially prepared cavity fluid which is acidic in nature (6.5pH or lower) and contains at least two preservative chemicals shall be injected and evenly distributed throughout the aspirated cavities. A minimum of 16 ounces of concentrated cavity fluid shall be used for each adult body.
      3. (C) Should distension and/or purge occur after treatment, aspiration and injection as required shall be repeated as necessary.
   10. (10) The embalmer shall be required to check each body thoroughly after treatment has been completed. Any area not adequately disinfected by arterial and/or cavity treatment shall be injected using a hypodermic needle with disinfectant fluid for maximum disinfecting results.
   11. (11) On bodies in which the arterial circulation is incomplete or impaired by advance decomposition, burns, trauma, autopsy, or any other cause, the embalmer shall be required to use the hypodermic method to inject all areas which cannot be properly treated through whatever arterial circulation remains intact (in any).
   12. (12) In the event that the procedures in paragraphs (1)-(11) of this subsection leave a dead human body in condition to constitute a high risk of infection to anyone handling the body, the embalmer shall be required to apply to the exterior of the body a standard embalming powder and to enclose the body in a zippered plastic or rubber pouch prior to burial or other disposal.
   13. (13) Dead human bodies donated to the State Anatomical Board shall be embalmed as required by the State Anatomical Board and where conflicting requirements exist, those requirements of the State Anatomical Board shall prevail.
   14. (14) Nothing in this section shall be interpreted to require embalming if the next-of kin does not authorize embalming.
   15. (15) All bodies should be treated in such manner and maintained in such an atmosphere as to avoid infestation by vermin, maggots, ants, and other insects; however, should these conditions occur, the body should be treated with an effective vermicide and/or insecticide to eliminate these conditions.
   16. (16) No licensed establishment or licensed embalmer shall take into its or the embalmer's care any dead human body for embalming without exerting every professional effort, and employing every possible technique or chemical, to achieve the highest level of disinfecting.
   17. (17) Nothing in this section shall be interpreted to prohibit the use of supplemental or additional procedures or chemicals which are known to and accepted in the funeral service profession and which are not specifically mentioned in this subsection.
2. (b) Minor variations in these procedures shall be permitted as long as they do not compromise the purpose of this rule as stated in subsection (a) of this section.
3. (c) A report form, approved by the Texas Funeral Service Commission, shall be completed on each case of embalming. The completed form shall be retained for a two-year period and be made available to the Texas Funeral Service Commission, upon request, for inspection.

Source Note:The provisions of this §203.16 adopted to be effective February 27, 1996, 21 TexReg 1271; amended to be effective June 25, 1997, 22 TexReg 5825; amended to be effective December 23, 2001, 26 TexReg 10293.