Stage/station Technologist Role Possible Quality assurance Health and safety

mistakes/Artifacts and (how do you know the quality/output is good)

causes

Receive the specimen -Receive the specimen -Check and match the request form with its PPE to avoid the bio
and label it, prepare the without fixation, this specimen and ensure they have the same info. and chemical hazard
cassettes for it and print causes: Autolysis, growth -Ensure that the whole tissue immersed in 10% from the tissue and
barcodes. of microorganisms. formalin. formalin.
Accession -Receive the specimen
without a request form or
mismatch the request form
with kind of specimen.
Wrong labeling on
cassettes or containers
these lead to misdiagnosis.
-lose the tissue.

According instruction of No marks on the tissue or -Ensure no. and type of specimen. -PPE to avoid the
pathologist: marks without any -a representative sample must be taken. bio and chemical
Count no. of specimens, explanation leads to wrong hazard from the
Grossing
and record the orientation and then tissue and formalin.
measurement and the misdiagnosis.
description of the tissue. -Taking care when
dealing with sharp
material (knife)

Put the tissues in 10% -In adequate fixation. = -ensure an adequate amount and time for -PPE to avoid the
formalin. Autolysis, growth of fixation, it should cover all whole tissue. chemical hazard
Put grossed tissues in microorganisms. from the formalin.
Fixation
the cassettes. -overfilled of the cassettes -The concentration and the pH of the fixative
or is not closed tightly = must be taken in the consideration.
lost of tissue.

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 Put the tissue (cassettes) -Improper fixative removal -Daily maintenance for the machine and -PPE to avoid the
in automated machine cause appearance of reagents. chemical hazard.
for: fixative crystals.
washing, dehydration -Improper water removal -QC -Practice and having
Processing and clearing. causes impaired paraffin knowledge about
infiltration. the machine is
QC -High concentration of important.
alcohol direct after the
water cause call shrinkage.

Paraffin wax infiltration. Tissue spreads in the water -Ensure correct temp. of the paraffin wax. -PPE
infiltration bath too rapidly due to -Taking the time in consideration. -Take care when
inadequate infiltration. dealing with the
wax. (Hot wax)

Transfer the tissue from -In correct orientation of -Make sure the tissue in the correct side and -PPE
the cassettes to a mold the tissue. check the orientation. -Take care when
to cover it with paraffin -One side of the tissue not -Check the wax temp. dealing with the
Embedding
wax to provide solid covered by the wax. -Give enough time for the block to solidify. wax. (Hot wax)
blocks suitable for -Appearance of air bubble. -Make sure that all of tissue is covered by the
cutting. -Wrong temp. of the wax wax.
(not hot)
-Insufficient cooling down
of the block.

-Epithelial cells of fingers

Place the block on the -Block is not solid enough. - Ensure that blade is sharp. (change every 25 -PPE
microtome, Trimming -Knife is old, not sharp and blocks) -Be careful when
-Placing the blade tightly in its place.
and sectioning (cutting) loose = wrinkles folded, using microtome.
Cutting -Cool the blocks and ensure that is placed
unequal sections and correctly on the microtome. -check safety lock
marking the tissue. on after finishing.
-Contaminated blade.
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 -Take sections from -The water bath is -Check the temp. of the water bath. -PPE
microtome to a water contaminated with dust or -Clean the surface of the water bath and change
bath to flatten them. microorganisms. the water regularly.
-Picking up the sections -Picking up residual from -Use clean slides
from water bath using previous tissues = may -Ensure labeling the slides.
microscopic slide after lead to misdiagnosis.
labeling. -Unclean contaminated
slide = e.g. fibers.
Slide preparation -Cold water bath = wrinkle
sections.
-Hot water bath = melting
wax.
-Improper drying the slide
= no adherence of the
tissue on the slide.
-No label on the slide.

Transferring the slides -Over stain = dark color -Check all reagents. -PPE to avoid the
to an automated stainer: -Under stain = pale color -QC chemical hazard.
Clearing, rehydration -Unfiltered stains produce
staining
washing, staining, precipitations. -Practice and having
washing, dehydration, (Eosin flakes) knowledge about
clearing. -Alcohol contains water = the machine is
water bubbles. important.

-Broken of coverslip
-Cover the tissue with -Air bubbles -Remove air bubbles using sharp material. -PPE
an adequate amount of -Wrong size and position -Check the cleanness of coverslip and mounting
mounting media. of coverslip. media.
Mounting
-The cover slip is used -Fibers and dust from -Determine the write position and size of the
above the mounting unclean coverslip and cover slip.
media. ( an automated mounting media. -Use adequate amount of mounting media.
machine may be used) -Inadequate amount of MM
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 The pathologists will -Broke the slide. -Double check patient info.
Preparing for reporting examine the slides after -unlabeled slides
preparation. -lose the slides

Other activities required of a histotechnologist in the lab

-Preparing a positive -Expired reagents = false -positive control is a critical step in this -PPE
control. negative. procedure. -Practice and having
-Automated machine is -machine out of reagents = -Check All reagents. knowledge about
used: Put the slides into. false negative. -Daily maintenance. the machine is
1 - Immunohisochemistry (Adding specific Ab for -No positive control. important.
antigen of interest then
labeled Ab and substrate
to produce a color)
-Antigen retrieval.

-Freezing gel is used for -The cryostat is not cold -Check all materials are available -PPE
immediate preparation enough. -Check cryostat Temp. -Be careful when
for frozen tissue. -Same problem with using microtome.
2 Frozen sections
-place the block on the routine microtome. -check safety lock
microtome, start cutting. -Delay of preparation. on after finishing.
-Send it for diagnosis.

-All of steps seems -All of problems and Same as routine stain -PPE
routine stain, differ in artifact with routine stain -Check all reagent required. Same as routine
type of the stain and its may appear with special -Make sure you follow and use stains that is stain.
3 Special stains
procedure. stains. mentioned in the request form.

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 -Examined slide and its -lost slides or blocks -check the date and no. of slides and blocks
4 Filing the sample blocks are stored in the -wrong order or date and before storage.
storage room for later place of the sample.
using. -Accumulation of dust

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