Teensie weensie biopsy specimens...

[brewerpaul]

I was at least part of a major flub last week. In a bladder biopsy case, the biopsy specimen vanished mysteriously. The lab called late in the day to say that the specimen cup contained only formalin. :-(

It's sort of complicated, and several people handled the specimen. I'm not trying to weasel out of responsibility: it was my room, and ultimately my responsibility.

I sure as heck don't want that to happen again, obviously. How do all of you handle those miniscule specimens (usually urology cases)?

We generally put them on a piece of Telfa or paper, and that goes into the cup of formalin, of which we have several ready and waiting.

Any other, better suggestions that I can take into our OR?

[brewerpaul]

(edited topic heading to hopefully get some responses)

[hotdog19d]

several people handled the specimen.

Any other, better suggestions that I can take into our OR?

There's your problem right there, don't let anyone handle the specimen once it's off the field except you. Everything else your doing sounds fine.

[IsseyM]

There's your problem right there, don't let anyone handle the specimen once it's off the field except you. Everything else your doing sounds fine.

Agree! I make sure i see the doc put the specimen on telfa, then the scrub will usually use 18g needle to pass off the tiny specimen to me into little vial already filled with formalin. I closely watch the specimen being placed into the vial and make sure its completely submerged.

[AussieRNinHI]

Agree! I make sure i see the doc put the specimen on telfa, then the scrub will usually use 18g needle to pass off the tiny specimen to me into little vial already filled with formalin. I closely watch the specimen being placed into the vial and make sure its completely submerged.

Yes i second that, i do the exact same thing!!

[openheartmary]

In urology, we use what we call "little pinks". These are little flat pink squares with tiny slits that contain a flat sponge inside them. We open the container, place the specimen on the sponge and then snap the container closed around the specimen. The container is then placed in a sterile cup or into a formalin cup depending on which type of lab specimen has been ordered. Thankfully, this has worked great for us.

[brewerpaul]

Can you find out the real name of those "little pinks" and where our OR can get them? After this error, I'd love to help our OR come up with a better, safer, more standardized way of handling these specimens.

[openheartmary]

I'll get that to you as soon as I can.

[NurseApe]

I think a sterile specimen cup on the field is a good way to go. The telfa with the specimen can be put in the cup on field and sealed, or a little sterile saline can be put in the cup and the specimen will slip into the saline and be easier to visualize. You put the formalin on it after it is passed off.