Anatomical Pathology
Anatomical Pathology Muscle Biopsy Collection Pre Collection Only fresh specimens are suitable for analysis. At least the day prior to biopsy phone the SA Pathology Muscle & Nerve Laboratory (8222 3588) to provide biopsy and patient details. If calling after hours please ring on-call mobile 0435 960 022. The Biopsy Dispatch yy yy yy Please DO NOT use: yy yy yy Severely wasted muscle Intramuscular local anaesthetic - use subcutaneous infiltration Diathermy or muscle traumatising procedures. yy Recent EMG site Procedure yy yy yy yy yy yy yy yy yy Common biopsy sites include vastus lateralis, quadriceps, deltoid or gastrocneumius muscle. ADULT: Excise a free strip of muscle (at least 2cm x 1cm x 1cm) OR smaller fragments equivalent in total to these dimensions, all without adherent fascia. PAEDIATRIC: As much as practicable. Place muscle tissue directly into a sterile container. Leave fresh Never place sample in formalin, saline, ice or on cardboard, and never wrap in dry or saline moistened gauze. Label the container - Patient Name, DOB, biopsy site and time of removal. Complete an SA Pathology Request Form with patient details and treating clinician’s name. Specify tests - Histology, EM, enzyme histochemistry, IHC. Clinical history is mandatory - please complete p2. yy Cooling has a detrimental effect on biopsies - do not cool or use ice Label the request form: ‘URGENT – SA Pathology MUSCLE & NERVE LAB’ Place specimen, request form and clinical history into a specimen bag, esky or manilla envelope. Cut off and affix label below securely to outer package Specimen Pick Up Follow instructions appropriate to your site: Private hospitals / Rooms / Public Hosp Path Labs Phone SA Pathology Call Centre 8222 3000 yy yy Request a taxi (not SA Pathology courier) to ‘Deliver Urgent Fresh Specimen’ to SA Pathology Frome Rd. Give pick up location, your name & contact number. Public hospital theatres RAH - phone ext 23588 Muscle & Nerve Laboratory TQEH - phone ext 26490 Central Pathology FMC - phone ext 64155 Anatomical Pathology LMH - phone ext 29281 Anatomical Pathology WCH - phone ext 16315 Anatomical Pathology MOD - phone ext 2029 Specimen Reception RGH only (refer to private hospital despatch protocol above). You MUST NOTIFY the Muscle & Nerve Lab on 8222 3588 once specimen has been picked up by Taxi. Except for RAH & WCH. URGENT MEDICAL DELIVERY direct sunlight. To: SA IMVS Pathology Specimen Specimen Reception ON ARRIVAL Phone Reception Frome Road, Adelaide, SA 23588 immediately(Muscle & Nerve Contains Specimen FromeFresh Road, Lab) sunlight. Adelaide, NO ICE. DoSA Not Cool. Keep out of direct PUB-0013 v3 After Hours 0435 960 Contains Fresh Specimen ON ARRIVAL Phone 23588 immediately(Muscle & Nerve Lab) 022 NO ICE. Do Not Cool. Keep out of After Hours 0435 960 022 Page 1 of 2 Anatomical Pathology Muscle Biopsy Collection Clinical History The investigations carried out on this tissue sample will be determined by the clinical context of the case hence we require specific clinical information before the biopsy can be further investigated. Delay in receiving clinical information may result in delayed processing and reporting. Please provide details requested below, and send this form with the specimen to SA Pathology or fax to 8222 3392 prior to biopsy. Family name DOB Ethnicity / Given names / UR Aboriginal and/or Torres Strait Islander Other (Please specify) Presenting complaint Approximate duration of symptoms Cramping after exercise? Yes No Relevant past medical history Relevant family history Relevant drug history On steroids at time of biopsy? Yes No CK Levels EMG findings Treating Clinician’s Name and Contact Details PUB-0013 v3 Page 2 of 2
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