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" <[email protected]> 
To: "Jeffrey Silverman" <[email protected]>, "o isaac24" 
<[email protected]> 
Cc: [email protected] 
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: [email protected] 
[mailto:[email protected]] On Behalf Of Jeffrey 
Silverman 
Sent: Sunday, February 21, 2010 12:20 PM 
To: [email protected] 
Cc: [email protected] 
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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