[Histonet] Formalin vs. Saline Specimen Submission

Fri May 12 11:46:14 CDT 2006

Our frozen section room is located in the OR so we receive all of our
specimens fresh.  The Histotech assigned to the FS room is the one
responsible for placing specimens in formalin (or other appropriate
fixative for special testing) except after hours.  The OR staff then
places the specimens in formalin if FS room staff has gone for the day. 
Any question on tissue for special studies the OR staff pages the tech
on call or pathologist on call for direction.
We do have a grossing station that has ventilation in case we need it
.
For specimens submitted in saline....if during the day, the resident
assigned to the service for which that specimen was intended is paged
immediately for triaging of the case.  If after hours, the specimen
would most likely be placed in the refrigerator overnight and picked up
first thing in the morning.  Generally, if the specimen is to be handled
right away they generally put enough saline on the tissue to keep it
wet.  If it is going to sit longer than that, more saline would be
used.
Specimens that need to be refrigerated for any reason are stored in the
grossing room refrigerator or Morgue cooler (if too large for the
fridge) and after hours,in the fridge in our lab receiving area.
 After hours, I mentioned how the OR handles their specimens for
us...if there are frozen sections involved, the pathologist on call
would be paged to come in and handle the case.  If the specimen in
question comes from an outpatient source, our lab client service center
would call the tech on call to see how to handle fresh or saline soaked
specimens.  We do have them refrigerate saline soaked specimens
overnight depending on the testing to be performed.
 Phew...that was a long one !!!  Hope it helps..
Vicki  Gauch
AMCH

>>> "O'Brien, Sue" <sobrien <@t> bthosp.com> 5/11/2006 12:51:33 PM >>>
I was wondering how other hospitals handled specimens submitted from
the
OR (Operating Room). Currently, our routine specimens (ones that do
not
require special testing and submission) are submitted in 10% NBF
(Neutral Buffered Formalin). 

Thank-you for taking the time to respond!

How are routine specimens submitted to your lab from the OR (chose
one)?

     a. in formalin (e.g. 10% NBF)

     b. in saline

     c. fresh

     d. other (specify): 

A. For specimens are received by OR in formalin:

    Is the specimen placed in formalin in the OR procedure room? 

If yes, how is it done? 

a.       under a fume hood

b.       placed in container which has formalin 

c.       other (specify):

           If no, how is it done?

a.       specimen placed in container and taken fresh to another room
where formalin is added

b.       other (specify): 

           Does the OR have a fume hood available for use (to put
specimens into formalin under it)?

B. For specimens submitted by OR in saline:

    a. How long (generally) is the specimen in saline until it is
placed
into formalin?

    b. What volume of saline is used? (e.g. enough to keep moist, or
enough to submerge 

        specimen)?

     c. Who transfers the specimen into formalin? (e.g. histo or lab
tech at time of receipt, or does it 

         wait until the Pathologist grosses it? If it waits for the
Pathologist, then for how long, and how 

          is it refrigerated?)

    d. Are specimens refrigerated? If yes, where (e.g. in OR, in lab,
in
histology).

C.  For specimens submitted fresh:

     a. how long (generally) is the specimen fresh before placement
into
formalin?

     b. How do you keep the small specimens from drying out?

     c. Who transfers the specimen into formalin? (e.g. histo or tech
at
time of receipt, or does it 

         wait until the Pathologist grosses it? If it waits for the
Pathologist, then for how long, and 

         how is it refrigerated?)

     d. Are specimens refrigerated? If yes, where (e.g. in OR, in lab,
in histology).

If you receive specimens either in saline or fresh (and they are not
refrigerated immediately):

a.	How do you feel they compare to specimens that were immediately
placed into formalin? (e.g. better morphology, 

      worse morphology, etc).

b.	Who handles specimens submitted after hours? (e.g.
weekends/holidays; are they left at room temp, refrigerated, 

      or does someone (who?) transfer them into formalin (how?).

Sorry for the length, but I would really appreciate knowing how others
handle this.

Sincerely,

Susan O'Brien, Histology Supervisor

Burdette Tomlin Memorial Hospital

Cape May Court House, NJ  08210

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