Why might you collect a specimen?
Continuing medical care
Treatment plan based on pathology results
Soft tissue Bone Blood Body fluid Foreign bodies
What id the main thing that prevents specimen errors?
What does poor specimen handling result in?
Injury to pt Extended length of stay Delayed/incomplete dx Delayed treatment Risk of exposure to staff
Communication process of specimens?
Pre op - verify specimens as part of procedure, check consent, appropriate containers, req form, pt labels
Intra op - facility checklist, cover in time out, confirm request with surgeon, confirm identity
Post op - confirmation of specimens name, correct labels and other info, specimen taken to pathology
What do you document for specimens?
Specimen name Body location/side Tissue type Correct spelling Requested pathology exam Date and time of collection
Handling specimen in sterile field?
Handle as little as possible
Keep specimens moist
Cover or place in container and label
Protect in secure location on back table
Steps to transfering specimens off sterile field?
Verify pt name, specimen name and type of test (confirm by surgeon)
Right size container
Instrument used to transfer is contaminated
Why might implants be removed?
Plan of care
Right lid Be leak proof Be puncture resistant Be empty or manufactured prefilled container Best fit specimen to avoid damage
Types of containers for specimens?
Culture tubes with or w/o medium
Labeling containers for specimens?
Pt name, medical record number
Specimen name, side and tissue type
Date and time of collection
If you splash formalin into your eye how long do you rinse?
Transport and temporary storage of specimens?
Protect integrity of specimen
Ensure specimen identification is provided
Protect healthcare personnel
What must specimens have for transport?
Steps for managing highly infectious specimens?
Identify potential for excising highly infecious specimen Communication Review management process Alert pathology Specify required packagin and labels Identify how/when will be transported Call when specimen is sent Give directly to recieving individual Communicate infectious status
Container for highly infectious specimens?
Rigid, leak proof
Wipe outside with disinfectant for transfer
Clean gloves to label
Key elements to forensics?
Use of PPE
Collection as soon as pt care permits
Avoid rinsing, wasning or wiping
Non metal instruments/containers
- protect from scratches
- used for criminal investigations
What type of bags shoukd be used for evidence in foresics?
Paper never plastic
3 elements in chain of custody?
- collection details, who handled evidence, who received it
- follow all local, state and federal regulations
- evidence can be used in court
- based on facility
5 rights of specimrn handling?
RIGHT: Patient Date & time Lab test Surgeon Specimen
Fine gauge needle and syringe to aspirate
Incisional vs excisional biopsy?
Incisional - small portion of tissue
Excisional - entire section of tissue
Routine vs frozen specimens?
Frozen - clarify margins with immediate exam by pathology
Routine - do not require immediate
Biopsy vs culture?
Biopsy - study for histology and cytology
Cultures - examine for infection
How much formalin do you add?
10x more than specimen size
Types of specimens?
Routine Frozen section Biopsy Cultures Slides Cytology washings Forensic Gross examination Explanted medical devices Organ donation Amputation
What do you need for frizen section?
Need to call pathologist for Intra op consult
No fixative in clean container
Similar to frozen section
Intra op consult
Fetus and placenta under 20 weeks
- soobaneous abortion
> 20 weeks = still birth