[Histonet] Cryostat decon- what a pain in the butt

[Pamela Marcum]

Jeff, 



Can you give the reference for the CAP "adjustment" on decon for crystats please?  We have two working cryostats and average 6 to 10 cases (not specimens) a day.  This would effectively shut us down for frozens on some days.  We have third one that is currently in for repair. 



Thanks, 

Pam Marcum 

UAMS 

Anatomic Patholgoy Manager 





----- Original Message ----- 
From: "Tim Morken" <Timothy.Morken <@t> ucsfmedctr.org> 
To: "Jeffrey Silverman" <pathmaster <@t> yahoo.com>, "o isaac24" <o.isaac24 <@t> yahoo.com> 
Cc: histonet <@t> lists.utsouthwestern.edu 
Sent: Monday, February 22, 2010 10:23:17 AM GMT -06:00 US/Canada Central 
Subject: RE: [Histonet] Cryostat decon- what a pain in the butt 

Jeff, Do they give any references for the effectiveness of their proposed method? 


Tim Morken 
Supervisor, Histology / IPOX 
UCSF Medical Center 
San Francisco, CA   
  
-----Original Message----- 
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Jeffrey Silverman 
Sent: Sunday, February 21, 2010 12:20 PM 
To: o.isaac24 <@t> yahoo.com 
Cc: histonet <@t> lists.utsouthwestern.edu 
Subject: [Histonet] Cryostat decon- what a pain in the butt 

CAP is moving to more rigorous cryostat decontamnation methods - mandating a weekly shutdown and wet chemical disinfection with a tuberculocidal agent for machines used regularly. Now, if a lab is doing 1-3 frozens a week, is that used regularly? We must lobby the CAP for more sensible and practical guidlines. The old wipe down with 70% ETOH without bringing the machine will become non-compliant and useful only as an interim measure.   
By the way, the UV lamps do not satisfy the CAP standard, I believe. 
  
Our system has gone to a commercially available tuberculocidal, virucidal, and broad spectrum bacteriocidal moistened wipes the name of which I will post tomorrow when I get to the job. 
  
Here is a skeletonized basic procedure form what CAP will require: 
  
1: Remove all utensils and brush out and collect section debris disposing of this according to regulated medical waste protocol (red bag). 
2. Bring the instrument to room temperature. 
3: Wipe all working surfaces with the tuberculocidal wipes, visibly moistening all surfaces. Surface must remain wet for 2 minutes. Use multiple wipes as needed. Instruments can be similarly disinfected. 
4: Carefully dry all surfaces with gauze. Dispose of all wipes and gauze as biohazardous. 
5: Dry and lubricate the microtome as per manufacturer's instructions. 
6. Turn on crystat and bring to working temperature. 
7. Document procedure on your maintenance log. 
8. Look forward to doing it again next week. 
  
  
Look, this is a necessary procedure, but weekly??? Perhaps some workload- based formula or an alert system- like pathologists alert the lab when  a case with granulomas or caseating necrosis is sectioned.  Every lab will have to bring a tech in on weekends or at night, to do this, or have two cryostats to compensate for the fully one working day most machines will have to be down to be cleaned in this manner. 
  
Thoughts? 
  
Jeff Silverman 
  
  
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