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