High Risk Autopsy Randal 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) HEPA Vacuum(Mar-Med Inc.) 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,6.2UN1 fiberboard box602 Affecting humans2814X 10g (Prions, PrP-Sc) Dry Ice 9UN III10kg OVERPACK USED Emergency contact: NAME / PHONE NUMBER Prior arrangements as required by the IATA Dangerous Goods Regulations have been made.

Useful Websites CDC CJD – WHO TSE – WHO Shipping – HEPA Respirator –