High Risk AutopsyRandal R. Nixon, MD PhD
Oregon Health & Sciences Univ.Dept. of Pathology,
Portland, OR
Cleveland, OH - 6/23/04
Source Material
High Risk Autopsies
• Case Selection
• Permissions– Local– NPDSU (required for genetic testing)
• Precautions– Autopsy - BSL 2– Tissue - BSL 3
• Equipment
• Procedure
• Tissue Handling
• Shipping
High Risk Autopsies - Goals
• Limit Exposure– Respirator
– Vacuum
– Limited personnel
• Limit Contamination– Disposables
– Shroud
– Coverings
– Dissection container
– Dedicated tool set
. Obtain diagnostic tissue
High Risk Autopsies - Equipment
• HEPA Respirator suit (Enviro-Safety Products) http://envirosafetyproducts.com
• HEPA Vacuum (Mar-Med Inc.)1-440-572-5175
• Disposables (Mopec)– Cutting board, large– Brain Knife– Headrest
• Plastic Tub• Biohazard Bags
High Risk Autopsies - Decontamination
• Stainless steel– Autoclavable
• 1M NaOH• 30’
– Non-autoclavable• Immersible
– 1-2M NaOH, 1hr, RT
• Non-Immersible– 1-2M
• Aluminum– Sodium hypochlorite
(2% free chlorine) DO NOT AUTOCLAVE
• Liquid waste– 1M NaOH– Autoclave 132°, 4.5hr
• Dry waste– Incineration– Autoclave 132°, 4.5hr
Tissue Processing
• Post-fixation Formic Acid– >95%, 1hr, RT with post-treatment formalin
48hr.
• Process as usual– Discard waste as biohazardous waste
Shipping
Infectious substance, 6.2 UN 1 fiberboard box 602Affecting humans 2814 X 10g (Prions, PrP-Sc)
Dry Ice 9 UN III 10kg 9041845
OVERPACK USED
Emergency contact: NAME / PHONE NUMBERPrior arrangements as required by the IATA Dangerous Goods Regulations 1.3.3.1 have been made.
Useful Websites
• CDC CJD– http://www.cdc.gov/od/ohs/biosfty/bmbl4/bmbl4s7d.htm
• WHO TSE– http://www.who.int/emc-documents/tse/whocdscsraph2003c.html
• WHO Shipping– www.who.int/emc/pdfs/emc97_3.pdf
• HEPA Respirator– http://envirosafetyproducts.com