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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