Samples are labeled with “Special Respiratory Isolation” stickers, available from HES. Retrieval, transport, and processing of specimens should be carefully coordinated with laboratory senior staff and study investigators. All specimen container surfaces are wiped with CC approved disinfectant before placing in a plastic bag. All specimens are double-bagged, with the transmittal sheet place in the outer bag pocket.

Reminder:  Document the collection of research specimens using form NIH-2803-1.

A. Cytology Specimens:

• Obtain 120-ml specimen cups containing 60 ml of 10% neutral buffered formalin from the Histology Section (Building 10, Room 2A28).

Caution: The solution contains formaldehyde which is a toxin and chemical hazard. A blank patient label and a “formalin caution” label are affixed to these containers.

• Label the specimen cup with patient name, medical record number, date and time of collection, and a “Special Respiratory Isolation” sticker.
• Mix specimen thoroughly (if greater than 40 ml) and add specimen (up to 40 ml) directly into the collection vial.

Note: The Cytology Lab does not need excess volumes. DO NOT add more than 40 ml of specimen. If specimen is greater than 40 ml, mix gently by inversion before adding to the cup. Discard excess as biohazard waste or use for research in accord with IRB-approved protocol.

1. Screw the lid tightly onto the container. Double-check to make sure the lid is secure and the cup does not leak.
2. Wipe the outside of specimen container with NIH Clinical Center (CC)-approved disinfectant (e.g., Dispatch, 95% EtOH).
3. Change gloves.
4. Place specimen in bag.
5. Clean outside of specimen bag with CC-approved disinfectant.
6. Place bagged specimen in secondary bag.
7. Place transmittal sheet in outer pocket of secondary bag.
8. Place specimen in refrigerator outside the Cytopathology Lab (Building 10, Room 2A21).

B. Surgical Pathology (Tissue Exam) Specimens:

• Obtain 120-ml specimen cup containing 60 ml of 10% neutral buffered formalin (fixative) from the Histology Section (Building 10, Room 2A28).

Caution: The solution contains formaldehyde which is a toxin and chemical hazard.

Note: If specimen is greater than 1/10 the volume of fixative (e.g., larger than about 1 x 2 x 3 cm, use a larger container containing formalin. Containers and formalin and caution stickers are available in the Histology Section or Frozen Section Lab.

1. Label the specimen container with patient's name, medical record number, date and time of collection, and “Special Respiratory Isolation” sticker. Place a “Formalin Caution” sticker on large containers if these are not already affixed.
2. Place specimen directly into the collection container.
3. Screw the lid tightly onto the container. Double-check to make sure the lid is secure and the cup does not leak.
4. Wipe the outside of specimen container with CC-approved disinfectant (e.g., Dispatch, 95% EtOH).
5. Change gloves.
6. Place specimen in bag.
7. Clean outside of specimen bag with CC-approved disinfectant.
8. Place bagged specimen in secondary bag.
9. Place transmittal sheet in outer pocket of secondary bag.
10. Deliver to refrigerator outside the Histology Section (Building 10, Room 2A28) or place in specimen refrigerator in the Frozen Section Lab (Building 10, Room 2C433). Record the specimen information in the log book.

C. Ultrastructural (EM) Pathology Specimens (only if clinically indicated):

• Obtain collection vial containing gluteraldehyde from the refrigerator outside the Ultrastructural (EM) Section (Building 10, Room 2A10).

Caution: The solution contains 2.5% gluteraldehyde which is an irritant chemical hazard, and is labeled as such. Keep collection vial refrigerated, DO NOT store at room temperature.

1. Label the vial with patient's name, medical record number, date and time of collection, and “Special Respiratory Isolation” sticker.
2. Place specimen directly into the collection container.
3. Screw the lid tightly onto the container. Double-check to make sure the lid is secure and the vial does not leak.
4. Wipe the outside of specimen container with CC-approved disinfectant (e.g., Dispatch, 95% EtOH).
5. Change gloves.
6. Place specimen in bag.
7. Clean outside of specimen bag with CC-approved disinfectant.
8. Place bagged specimen in secondary bag.
9. Place transmittal sheet/EM order sheet in outer pocket of secondary bag.
10. Deliver specimen to refrigerator outside Building 10, Room 2A10.

D. Autopsy:

1. Follow special bagging, disinfecting, and transport procedures developed by CC nursing and NCI-CCR-LP.
2. Notify Admissions of Special Respiratory Isolation precautions, so they can communicate this information to the autopsy staff and funeral home.

E. All Other Laboratory of Pathology Specimens:

1. Call the Section Chief of the lab to discuss special arrangements in advance of collecting specimen.
2. Obtain proper collection containers specified for the particular test desired.
3. Label the container with patient's name, medical record number, date and time of collection, and “Special Respiratory Isolation” sticker.
4. Place specimen directly into the collection container. Tighten lid securely. Double-check to make sure it does not leak.
5. Wipe with CC-approved disinfectant.
6. Change gloves.
7. Place specimen in bag.
8. Place bagged specimen in secondary bag.
9. Place transmittal sheet in outer pocket of secondary bag.
10. Deliver to appropriate location as communicated by Section Chief.