Page 131 - policy and procedure infection control

Policies and Procedures on Infection Control

• Limit the operators to three persons to reduce risk of contaminations and sharp
injuries.
• Instruments must never be passed from hand to hand during an examination.
They must be set out on a table for selection in accordance with the pathologist’s
preferred practice.
• If needles used for the collection of blood or body fluid, forceps are used to
remove the needles from syringe and discard into sharp bins. Needles must not
be re-sheathed.
• During dissection of the body, the only sharp instrument present on the table
should be dissection knives. Scalpel or scissors used whenever applicable.
• Blades or scalpels should not be changed until they have properly disinfected.
• Evisceration should not be undertaken by the staff until full risk assessment has
first been carried out by the pathologist/medical officer responsible for the
examination and method of evisceration of either Virchow or Rokitansky type
applied.
• In opening the rib cage, hand cutters used on the costal cartilage. The cut ends
and any other exposed bones covered with surgical gauzes/towels to prevent
accidental contacts that may cause cuts or puncturing the operator’s skin.
• Dissection of organs after evisceration may be carried out either at the autopsy
table on a non-slip and impervious surface.
• The weighing of organs should be undertaken in close proximity and great care
taken to avoid splashing and droplet dispersion.
• Intestines should be opened under deep sink but not running tap. Blunt end
scissors used when applicable.
• Particular care should be exercised when opening the skull for removal of brain.
Air powered oscillating saw with remote exhaust port is preferable than the
conventional saw.
• At the end of the examination, operators involved must ensure that all clothing,
etc worn during examination is disposed off correctly or treated as infected linen.
• Hands must be thoroughly washed with disinfectants following proper hand washing
technique.
2. High risk autopsy
• If suspicion of a high risk infection exists, the body should already be in a sealed
body bag. After checking the identity, details of the body should be entered into
the mortuary register. If it is not bagged, it should be done immediately and
placed in the refrigerator.
• The pathologist should then be notified that the body is in the main mortuary and
a time should be arranged when the post mortem can be carried out in an infection
isolation room.

120 Ministry of Health Malaysia