-----Original Message-----
From: Jim Ball <xryhisto@ovis.net>
To: histonet@pathology.swmed.edu <histonet@pathology.swmed.edu>
Date: Saturday, October 30, 1999 10:35 AM
Subject: labeled and unlabeled slides

sorry this is so long but I need some in put to the questions that appear at
the end of this disclamer

>I was recently asked to try and get an arsenal of different blocks together
>that could be used for controls for both immuno's and special stains. I was
>not given any extra time out of the day or allowed over time to occomplish
>this task, so as every resourcesful tech does I devised a plan   that I
>thought I could use and and still get this job done, while maintaing my end
>of the work flow in the department.
>I cut extra slides on blocks that I knew I had little or no wet tissue to
go
>back to in order produce additional blocks on ( ie. gastric biosies that
>were ordered for H. pylori) our pathologists have allowed us to use part of
>patient blocks as controls when these controls are not other wise easily
>obtained, but they do not want them identified by their surgical number.
We
>cut 3 extra slides on a gastric a biopsy for a Wartin Starr procedure that
>is notrious for not working the first time. Two slides are kept as back ups
>and are left in a slide stand in case they are needed latter, If we are so
>busy that I am unable to check the results of the stain procedure that day
I
>may hold these unstained slides for up to a month in the slide stand or
>staining rack near my microtome until I can check the results or run one of
>the extra slides on another stain run that I would personaly be doing. This
>practice is done for other special stain procedures also such as irons,
>giemsa, trichromes, etc.  Should the tissue prove to be an excellent
control
>I then go back to the block and cut as many additional slides as possible
>and leave them to dry unlabeled in a slide stand until a special stain can
>be done on one of the slides from the beginning middle and end. I do not
>label these slides until they are proven, because I don not want to put
>extra work into labeling slides that may not even end up being used.
>       Trying to prove Immuno controls is some what different in the fact
>that, while grossing if we should happen on a tumor that looks like it
might
>make a good control ,
>extra tissue is obtained at the time of grossing and the surgical number
>placed on the side of the cassett in order that it is not taken to be one
of
>the routine surgical blocks and cut , stained and given to the pathologist
>the next day. These blocks are kept in a box near the microtome for easy
>retival when time permits for cutting and running slides to be checked.
>Slides may be be cut and saved unlabeled in a slide drying rack over night
>if the staining procedure is going to be performed the next day. I feel
this
>does not present a problem because unlabeled slides should never be used as
>diagnostic material, when the slides are proven, extra slides are cut and
>labeled with a coded numbering sequence such as Her99-0001. This could
>designate a her-2nu control block cut in 1999 and the 0001 designating all
>the blocks taken for controls from that case that produce the desired
>staining effect. This numbering system produces a  system that is both safe
>for the patient and the pathologist . The control blocks are cross
>referenced in a seperate book for CAP inspection purposes.
>         I have taken alot of your time in order to give you a background
>and insight for formulating an answer to the following question. Are there
>techs in your hospital that
>keep extra and or unlabeled slides in their work area for later use, and if
>so has it caused any confusion for other techs in the department. Insight
>from my peers on how this system might be made better are welcomed. I have
>found if these slides are filed in a box and put in a drawer they prove an
>old adage "out of sight out of mind"
>
>
>