Friday, April 15, 2011

Grossing stinks!

Grossing stinks

Not figuratively, but literally.

Specimens come in preserved in formalin, which has its own smell... sort of a dusky chemical smell, not sharp like alcohol, but pervasive. What is worse though is that it fills your sinuses and it burns. Your eyes weep from the fumes. Old histotechs and lab assistants seem to take pride in how tolerant they are and how after decades of marinating in it they can stand calmly while the rest of us writhe on the floor gasping for fresher air. The CAP standards for ventilation are pretty high though so formalin stink isn't that big a deal anymore. Just don't open a large formalin filled specimen container that has been in the back of a hot courier car because the vaporized fumes hurt!

It should also be noted that formalin fixed feces still smell like feces. And anything that is putrefied still smells just as bad as it did before formalin was dumped on it. You would think that because formalin is killing the bacteria that is causing the rot, some of the stench would go away but you would be wrong. Oh, so very wrong.

There's a smell that you get when you cut bones on a band saw...It is hard to explain and I've only ever smelled it when doing that so it is rather hard to compare it to anything. All in all it isn't a bad smell, just one that is unique to grossing. My best comparison would be dry dog food...but hot dry dog food.

Skin and fat removed with a cautery pen sitting in a specimen container with no formalin on it? That smells like burnt rubber, but more like a pencil eraser rubber than burnt tire rubber. Expect this with breast reductions, pannectomies, etc. It isn't horrible, dissipates quickly, and seems to be lessened by the addition of formalin.

Autopsies tend towards B/O, methane, blood and urine. Although, not necessarily in that order. The morgue has a faint slaughter house funk, a definite hint of offal. Not overwhelming in the places I have been but noticeable and persistent.

And of course a blog entry on grossing and stench would not be complete without mentioning cyst cheese*. Cyst cheese... after you cut into a big nasty cyst you have no choice but to stop 

This is cyst cheese, avoid it at all costs
what you're doing and disinfect your station. Your gloves stink, your forceps, your scalpel blade reeks. Even after putting it all back into a formalin container with a screw on lid they can still be overpoweringly rank. We once had a case so bad that even with the ventilation in our gross room (which was built in 2009 with amazing ventilation) there was a 10 foot radius of stink. We put it in several layers of gloves and tied it off, then double bag it in ziplocked specimen bags before it was down to a tolerable level. The worst part is that even after going through processing with formalin, alcohol and xylene, cyst cheese still stinks and will contaminate the embedder's forceps and the histotech's microtome.

So yeah, just a heads up.

I'm not saying everything stinks or that it is something that makes my job miserable. More that it is something that comes with the territory and if you're getting into grossing as a tech or a pathologists' assistant that you should be aware of it.

*Not the technical term.

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