I hate to say it but over the years I have traveled all over the country and
been in many labs for technical demos and the main feature I see is no one
wants to do anything by hand anymore.  The books are there however, it is
easier to order.  The supervisors don't have the time to teach and we are
still doing OJT for histology.  The requirements and shortages are killing
us for good training as the schools close.  105 NBF is just easier to order
and the safety issues are not really a reason only an excuse not to make it
in many labs.  However, a lot of Histology Labs still don't have good
ventilation or hoods.  Pam

-----Original Message-----
From: Don Hammer [mailto:donh7@earthlink.net]
Sent: Sunday, February 20, 2000 12:20 AM
To: RSRICHMOND@aol.com
Cc: Histonet
Subject: Re: 10% NBF. How to check the concentration.


Hi Bob,

Might be a valid point but I still have to disagree.  Someone, please feel
free to tell me  to just go retire, give it up, and shut up.   NEVER!!
*Evil Grin*

It's been awhile ago, but somewhere in training myself in Histology
techniques, I learned to use Anhydrous.  Guess I'd like to think most have
learned that as well, but perhaps the hospitals you cover are different. Are
the Histotechs in these hospitals on Histonet?  Do they attend NSH
meetings?, State meetings?  Are they Certified?  Do they partake in CAP
required Continuing Education sessions?  If so, perhaps making Formalin
would be a good monthly CE session.

In every lab I have worked in, as a solo or having several employees, the
supply catalogs for the lab were in immediate reach and I think this is true
for most labs.  If they are not, then perhaps the Pathologist Director
should make sure they are.  He/She is, by CLIA regulations, ultimately
responsible, altho able to delegate almost any authority, short of diagnosis
to the techs and hold them responsible. Histotechs do not exist in the eyes
of CLIA, only Pathologists.  So being the sole person responsible in CLIA's
eyes, I submit it is his/her responsibility to either hire trained
Histotechs, or train them well and keep them trained.   I have met very few
not willing to be responsible.  Most take on more responsibility then they
should based on limited direction and communication from and with their
leader, partner and guide(s).

Oh, never forgot to add the Formaldehyde,  but one time a  30 gal. tank I
had designed to fit under the cabinet overflowed.  It was complete with a
mixing stirrer and was water fed.  I forgot the damn facet was on when I
went to do an Autopsy.  :(    Now there was a case of the fumes, albeit
clean floors :(  Open  to the entire Clinical Lab too.....paid  back the
lady who spilled a 24 hour urine specimen next to my work area.  :)

I think teaching those that don't know is a much better use of healthcare
dollars than buying 90% water and paying to have it shipped.   Man, there
goes any free drinks from distributors at the NSH meeting in Milwaukee.  :)
Oh well, always did buy most of my own so as not to feel obligated.

Don Hammer, Retired Guy (opinionated too)  *warm smile*

----- Original Message -----
From: <RSRICHMOND@aol.com>
To: <histonet@pathology.swmed.edu>
Sent: Saturday, February 19, 2000 5:50 AM
Subject: Re: 10% NBF. How to check the concentration.


> Don Hammer
>
> >>I would suggest they toss it out and make their own 10% Formalin. (take
> control)  It's the simplest "recipe" in the books. <<
>
> Actually it's not, to judge my the Samurai Pathologist's experience. Small
> labs commonly prepared their own phosphate buffered formalin until well
into
> the 1980's. In my experience most of them did it wrong, with significant
> adverse consequences in the slides.
>
> The major problem was the dibasic sodium phosphate (Na2HPO4). This
material
> is available both in the anhydrous form, and as a heptahydrate salt which
is
> nearly half water. Older books do not specify which form is to be used,
> though they mean to specify the anhydrous form. But since the heptahydrate
> salt, being nearly half water, is the cheapest, that's what the lab
manager
> (the only person with access to the catalog) orders. Obviously in this
> circumstance you can recalculate the formula, but that requires a high
school
> chemistry course, which the pathologist has forgotten and the histotech
never
> took.
>
> Another common and disastrous error - I've seen it several times, and
confess
> to having made it myself once - is to go to all the trouble of weighing
out
> the buffer salts and getting them to dissolve - and then forget to add the
> formaldehyde at all!
>
> Buying ready-made neutral buffered formalin is a significant expense and
an
> environmental absurdity, but in my experience it's the best way to go.
>
> Bob Richmond
> Samurai Pathologist
> Knoxville TN
>
>