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Hi,
<br> You said "<i>our residents do not listen to reason
or follow instructions very well.</i>"
<br> I strongly refer you to a previous statement of
my own concerning this situation involving a good stout kick in the shins
to whom ever does the grossing of these fatty breast specimens.
<br> I think you need to speak with the pathologist about
this the next time he (she) gripes about turn around time. The turn around
time will increase as will specimen quality if the specimen is grossed
properly. The whole scene is theoretically under his supervision and if
those grossing his specimens are taking shortcuts and not grossing properly,
the culpability falls upon the pathologist.
<br> It makes no difference what you do to prepare a
specimen for processing. If the piece of tissue is too large then the middle
is unfixed, and will not yield acceptable results. There are two options:
1) force the residents to gross properly and cut thinner sections, or 2)
let the specimen sit in formalin for a week (yes, an exaggeration) to be
properly fixed and tell the pathologist he has to wait until they are ready.
Either way you need to see to it that the specimens are fixed. Perhaps
you should have a resident try to section one of the blocks they put through.
<br> I am sorry if this seems harsh but our lab has breast
blocks sent to us every day. Some of this tissue is just lousy, while others
are beautiful. So I think the answer to your question is not to look for
a new processing schedule (although it may help some), but to fix the primary
problem of "slacker residents"
<br>Amos Brooks
<p>"Scott, Allison D" wrote:
<blockquote TYPE=CITE>Does anyone have a protocol for processing breast
specimens. We get breast
<br>cases at least 2 to 3 times a week. Our pathologist is not very
happy about
<br>the turnaround time in getting the case out. Our first problem
is that the
<br>tissues were cut in to big and thick. our residents donot listen to
reason
<br>or follow instructions very well. So therefore we have to work
with some
<br>very big fatty pieces of tissue. We are putting the cassettes
into Rapid
<br>Fixx solution(fixative for fatty tisue), for overnight fixation.
The next
<br>day, they are put into methanol for 2 to 3 hours. After the methanol,
we put
<br>them into acetone for the remainder of the day. They are then
loaded on the
<br>VIP for 2 changes of formalin, 2 changes of 95% alcohol, 4 changes
of 100%
<br>alcohol, clear rite 3 and then paraffin. These are for 1 hour
each. In
<br>some instances we still have to run some cassettes back because they
were
<br>still not processed well. If someone has a suggestion please
reply.</blockquote>
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