Surgical Specimens Flashcards
Samples may be removed by several methods: (3)
Needle aspiration: fine gauge needle/syringe used to aspirate an area of abnormal tissue/fluid
Incisional biopsy: small portion of tissue is incised and sent for examination
Excisional biopsy: entire section of tissue is sent for examination
5 Rights to ensure proper handling of surgical specimens
Right patient
Right date/time of collection
Right lab test
Right surgeon
Right specimen
Specimens may be classified as
Routine, frozen, biopsy, culture, slide, cytology, forensic, gross, explanted medical devices, organ donation, amputated digits and limbs
Specimen label should contain
Description
Patient name/unique identifier (MRN)
Date/time of collection
Diagnosis
Surgeon name
Presence of chemical preservatives or biohazardous material
Examples of specimens that require immediate analysis for determination of tissue pathology include
breast biopsy
Biopsy of tumors
Biopsy of lesions
Rectal biopsy for ganglion cells
Needle biopsy removes
a core of tissue for diagnosis
Bone marrow biopsy requires
specialized needles that can puncture, directly or with a twisting motion
Muscle biopsy requires
specialized forceps that are applied to the tissue before it is removed and keeps the tissue stretched during the procedure
Culture is performed to
determine the exact organism and which treatment it will be sensitive to once identified
Slides are used for diagnostics like
pap smears!
Cytology washings can include
Bronchial
Bladder
Pelvic
Examples of gross analysis items
Orthopedic plates and screws
Pacemaker generators and lead wires
Foreign bodies, such as a coin
Fabric and clothing implication
Bacterial/fungal growth increases when evidence is stored in closed plastic
Hair and fibers implication
May be transferred between the victim and suspected perpetrator or victim and the crime scene
Broken fingernails implication
Striations are unique to each person; can determine sex, race and blood type
Debris implication
May connect the victim or suspected perpetrator with the crime scene
Foreign objects implication
excessive handling may alter the specimen
Fluid tests on specimens include (5):
Bacteriology
Virology
Cytology
Genetic studies
Cell count
Tissue tests on specimens include:
Permanent section
Frozen section
Biopsy
Hormonal assay
Donor tissue
Calculi
Ova
Muscle
Nonbiologic specimen tests include:
Foreign body
Projectile from crime scene
Clothing of crime or accident victim
Explanted prosthesis
Surgical tissue implants should include which type of documentation
Serial number of implant
Expiration date
Size, if applicable
Type of implanted tissue
Position of the implant
To ensure proper handling of surgical specimens, the OR nurse must verify
Patient’s medical record number
Spelling of the patient’s name
Surgeon’s name
Guidelines for preserving a bullet collected as forensic evidence
Do not drop bullet into metal basin or bowl
Rinse the bullet with water if requested by local authorities
Handle as little as possible
Biopsies that require specialized methods of preparation and preservation to preserve the cells include:
Bone marrow
Muscle
Nerve
Testicular
Explant removal documentation should include
completing a risk management report
Documentation of the serial number in the MRN and the pathology requisition
