Hi,
    I really think that anyone who works with the chemical should be
trained on
proper usage of formalin. I think this crisis might have been averted if
that
happened. There is really no need for the histotechs (exclusively) to be
the
only ones to clean up the spill. There should be someone on the surgical
staff
who is trained on how to deal with this too. Especially when there is
bulk
quantities of the chemical being used.
    I am a strong advocate for IMMEDIATE fixation. Autolysis occurs very
quickly
with many tissues. If the tissue is held with out fixing for long the
first part
to autolyse will be the margins. This is often the most important part
of
removing the specimen in the first place. If the margins of the specimen
are
autolytic the pathologist may miss something which won't do the patient
any good
either.
    Nothing will prevent untrained staff from making mistakes. If it was
not
formalin that was spilled, it would have been a leaking container or a
spilled
catheter bag. We're human it happens, but the more trained the staff is
the less
disastrous something can be. Instead of removing formalin entirely why
not
explore ways to use the formalin safer. A spill tray would help. A
formalin
spill kit with absorbent neutralizing pads would be invaluable. I just
don't
think removing the fixation is the best answer.
Amos Brooks

Susan Owens wrote:

> Amos, I hope you are trying to be funny.....But a formalin spill in or near
> the surgery suites would be no laughing matter....Could very well endanger
> the very patients you are trying to help........Just three weeks ago a
> surgery aid wasn't paying attention to what they were doing and caused  two
> gallons of formalin to spill onto the floor......Fortunately for the
> doctors, nurses and patients the spill was in a closed work room just
> outside the OR doors. It was discovered by a nurse walking by the room who
> first smelled and then saw the liquid running out from under the work room
> door........She told her super. who called Histo. It took two Histo techs
> wearing formalin respirators to clean it up......Even then one tech took
> sick and ended up going to employee health (she hadn't fitted her respirator
> properly.) New respirators arrived this week and another 'in service' will
> happen to instruct on the use and fitting .......In the nine years I've been
> at this hospital, this was the first major spill I can think of.....In our
> hospital we keep formalin respirators and neutralizing supplies where ever
> we keep formalin.....
>
> I hate to think want would of happen if the spill was even larger and/or
> those fumes were to have enter a surgery suite.
>
> Formalin in surgery (any size container) is not a good idea......
>
> In our hospital surgery orders the zip lock plastic bags(all sizes),
> prelabeled with 'formalin warming', puts the specimen in the empty bag and
> takes to either Histo gross room or to a cart in a workroom in day surgery
> where they then full with formalin.......The small bx's are put into hard
> plastic jars/containers.
>
> Susan Owens,HT
>
> >Date: 13 Sep 2000 18:02:45 -0500
> >From: Amos Brooks <atbrooks@snet.net>
> >Subject: Re: Formalin in the O.R.
>
> >    Hey I have an idea ... while you're at it you can remove sharps hazards
> >too
> >by having the surgeons dissect with clubs and spoons ...come on, if you
> really
> >give a darn about the quality of the specimens then put up with the
> formaln!!
>
> >Amos