High Risk Autopsy Randal R Nixon MD Ph

High Risk Autopsy Randal R. Nixon, MD Ph. D 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 Obtain diagnostic tissue • Limit Exposure – Respirator – Vacuum – Limited personnel • Limit Contamination – – – Disposables Shroud Coverings Dissection container Dedicated tool set

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 • 1 M Na. OH • 30’ – Non-autoclavable • Immersible – 1 -2 M Na. OH, 1 hr, RT • Non-Immersible – 1 -2 M • Aluminum – Sodium hypochlorite (2% free chlorine) DO NOT AUTOCLAVE • Liquid waste – 1 M Na. OH – Autoclave 132°, 4. 5 hr • Dry waste – Incineration – Autoclave 132°, 4. 5 hr

Tissue Processing • Post-fixation Formic Acid – >95%, 1 hr, RT with post-treatment formalin 48 hr. • Process as usual – Discard waste as biohazardous waste

Shipping Infectious substance, Affecting humans (Prions, Pr. P-Sc) Dry Ice 6. 2 9 UN 2814 1 fiberboard box X 10 g 602 UN III 1845 10 kg 904 OVERPACK USED Emergency contact: NAME / PHONE NUMBER Prior 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/bmbl 4 s 7 d. htm • WHO TSE – http: //www. who. int/emc-documents/tse/whocdscsraph 2003 c. html • WHO Shipping – www. who. int/emc/pdfs/emc 97_3. pdf • HEPA Respirator – http: //envirosafetyproducts. com