Kathy Gorham, writing from an unidentified small hospital facing the Herrn 
JCAHO Inshpektors, asks:

>>We have been fighting with O.R since opening our lab 22 years ago about 
formalin and cutting open the specimens. The R.N's in surgery don't want 
anything to do with the specimens. The inspector says we need to get the 
formalin out of O.R or have [it] monitored like we do in our lab. And of 
course the O.R. crew jumped on the band wagon to get rid of formalin. So our 
question is "Do you use formalin in O.R.?"  We are afraid that if we don't 
continue having O.R fixed the tissues they will forget to do it after
hours or on week ends. <<

I think the short answer here is that most small hospitals handle formalin in 
the O.R., in whatever size containers are necessary - and I've worked in a 
good many such hospitals in the last few years. I'm not convinced this is a 
safe, desirable, or inshpektor-friendly practice, however.

If I ran the zoo, I'd restrict formaldehyde solution in the O.R. to securely 
capped containers of no more than about 100 mL capacity, for biopsy specimens 
and others of similar small size. For anything bigger, the specimen would go 
in a refrigerator that was used for nothing else - not for medications, not 
for food, just for specimens. From there the specimen would be taken to a 
similar dedicated refrigerator in the laboratory.

If management won't pay for the refrigerators, they can put up with the 
formaldehyde. - This is how I would want to handle the situation, but it may 
be too sensible a view ever to be implemented in the crazy world we all work 
in today.

Bob Richmond
Samurai Pathologist
Knoxville TN