Safety Regulations and Precautions

Question 1

What do ‘Universal Precautions’ mean as applied to autopsy?

Answer 1

All autopsied patients will be treated as if they are infectious patients, regardless of history!

Question 2

At what point during the autopsy is there the highest risk of cuts, punctures, or abrasions?

Answer 2

During the evisceration

Question 3

How can you limit your risk of cuts, punctures, or abrasions during the evisceration?

Answer 3

Have only ONE scalpel at the table and know its location at all times
Have only two persons at the table, coordinating their movements when cutting
Beware of any wire sutures
Never replaced needle covers on hypodermic needles after use!

Question 4

How can you limit risk of contamination or infection?

Answer 4

Keep all organ blocks wet and continuously submerged or rinsed with running water
Do not close scissors vigorously in a snipping action
Discard as much tissue as possible
Do not drip blood when moving or weighing organs
If personnel leave the room they must remove their gloves and aprons

Question 5

What clean-up procedures can reduce the risk of infection and contamination?

Answer 5

Use of envelope-lysing detergents
Use of 1:10 dilution of household bleach
Placement of all laundry in special bags labeled as contaminated
Placement of all tissue and disposable materials in biohazard boxes

Question 6

What is a ‘potential exposure?’

Answer 6

Inoculation with a blood-contaminated source (needle stick, cut with surgical instrument, etc.)
Blood contamination via open skin areas

Question 7

What should you do if you have been exposed?

Answer 7

Complete the Supervisor’s Report of Occupational Injury or Illness (A-016 form)
Report to the Employee Health Substation ASAP
Do NOT go to the emergency room unless emergency care is required!

Question 8

What special procedures are required in suspected cases of Creutzfeldt-Jakob’s disease (CJD)?

Answer 8

Notify a neuropathology senior staff member in any case with a history of CJD or rapid-onset dementia
Before sawing the skull, place a clear plastic bag over the patient’s head and tie/tape securely
Decontaminate all surfaces, instruments, and the body with 10% bleach
Fix the brain for one week in brain formalin
Fix brain sections for 24 hours in 10% buffered formaldehyde, then treat in concentrated formic acid with constant agitation for 1 hour
Never use gross organs for student labs

Question 9

What solutions are used to clean and disinfect all floors, surfaces, and instruments?

Answer 9

Soap and hot water

1:10 dilution of household bleach

Question 10

How are biological wastes disposed of?

Answer 10

All material for disposal is double-bagged, deposited in the contamination refrigerator, and disposed of by autopsy service personnel

Question 11

What chemicals used in autopsy present a potential hazard?

Answer 11

Formalin
Zenker’s fixative (potassium dichromate and mercuric chloride)
Glacial acetic acid
Alcohol

Question 12

What safety precautions should be observed when handling toxic autopsy chemicals?

Answer 12

Avoid contact with skin and eyes
If contact occurs, flush with copious amounts of water
Pour solutions under the hood to avoid prolonged inhalation of fumes
Alcohol is flammable - do not use around open flame

Question 13

What mechanical equipment used in autopsy present a potential hazard?

Answer 13

Stryker saw - do not assume it cannot cut soft tissue!

Band saw - EXTREMELY dangerous, use extreme caution!

Question 14

How do you know if a patient has received any radioactive material?

Answer 14

A purple-bordered page is added as the last page of the chart

Question 15

Patients with low/safe levels of radiation can still present a danger - why?

Answer 15

The autopsy suite could potentially be contaminated, and radiation could build up from successive cases

Question 16

What types of infectious cases MUST be reported?

Answer 16

Viral hepatitis
Cytomegalovirus
Mycobacterium infection
Meningococcus infection
Creutzfeldt-Jakob disease