Procedures Hope this helps

From:Jeff Silverman

Linda- Don't know what you mean about "protection of non-gyne slides".
Separate staining of high risk malignant body fluid slides "protects"
against floaters during staining. Labelling of  slides with patient name and
specimen type as well as accession number was one suggestion that came up in
CAP inspection recently. As for disposal of glass slides-  same as glass
blood tubes, biohazard sharps.
Disposal of paraffin blocks - red bag and incinerate as pathological waste

Radiation safety:

Lab Section:  Histopathology
Subject: Radiation Safety
Procedure: Sentinel Node and other Radioguided surgical specimens

PRINCIPLE: The sentinel node biopsy procedure is currently being evaluated
for its utility in sparing patients more mutilating lymphadenectomy surgery
utilizing radioactive labeling to guide sampling of the primary lymph node
drainage areas of primary breast carcinomas and malignant melanomas. This is
done by injecting a chromogenic radionuclide into the primary tumor site and
measuring the lymphatic drainage area with imaging procedures designed to
locate the first lymph node draining the area. These specimens may pose a
risk to Operating Room and Laboratory personnel due to their radioactivity.
Though the level is low, unnecessary exposure is to be avoided.

SPECIMEN: Surgically excised mammary tissue or somatic skin and soft tissue.
Surgically excised lymph nodes. Any specimen containing radioactive
therapeutic agents.

	Patient Preparation: Patient is injected in Nuclear Medicine or in the
operating room 2 hours before surgery.

1.	Upon excision, specimens are placed in labeled containers and fixed by
immersion in Histochoice Fixative.  OR personnel will label specimens as
2.	Nuclear medicine technologist must be called immediately by OR personnel.
The Nuclear Medicine technologist shall survey the specimens with a Geiger
counter. Any item reading greater than 0.2 mR/hour shall be taken by Nuclear
Medicine technologist to that departmentís secure area and allowed to decay
for 60 hours (10 half lives) and until they read less than 0.2mR/hour.
a.	Operating room work areas and refuse reading more than 0.2 mr/hour are
decontaminated or removed to Nuclear Medicine for decay if readings exceed
0.2mR/hour. Radioactive seeds or devices must be removed in the OR or
Nuclear Medicine during or after consultation with the clinician.
3.	The specimen will be logged in Nuclear Medicine. The specimen is brought
to pathology by Nuclear Medicine after decay has been accomplished. The
specimen is then signed for by Pathology.
4.	Intraoperative examination of radioactive specimens is discouraged. If
this is necessary, use remote handling techniques and call  Nuclear Medicine
to test the specimen and advise Pathology as to the level of radiation. A
ring dosimeter is useful to emasure exposure during examination.
5.	Examine the specimen in a plastic tray to contain all spillage. After
completion of the examination, all work surfaces and absorbent materials are
to be tested by Nuclear Medicine in the Pathology Department.  If readings
are greater than 0.2mR/hour,  all refuse is red bagged and taken to Nuclear
Medicine to decay for 10 half lives (60 hours).  The grossing work area is
tested and if necessary decontaminated according to Nuclear Medicine
protocols. The specimen is taken to Nuclear Medicine for decay, logged in,
and returned to Pathology as above.

REFERENCES:  Radiation Safety Officer

  ANNUAL REVIEW:     DATE: ___/___/02  ___/___/03___/___04 ___/___05

               REVIEWED BY:  __________   __________     __________
___________  _________

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