Urgent question regarding autopsy

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Cica

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Hey

I have a question related to autopsy. Is it safe to take part in an autopsy (when pregnant) where the patient had lymphoma and was being treated with chemo AND was admitted to the hospital with neutropenic fever and an unknown infection. The patient died the day after and could not be resusitated.

I am concerned because of the threat of infection from an immunocompromised patient (CMV, tbc, etc.)

I have to decide if I will participate before tomorrow and would really appreciate any good advice (feel free to send a private message if need be).

Thank you in advance.
 
Cica said:
Hey

I have a question related to autopsy. Is it safe to take part in an autopsy (when pregnant) where the patient had lymphoma and was being treated with chemo AND was admitted to the hospital with neutropenic fever and an unknown infection. The patient died the day after and could not be resusitated.

I am concerned because of the threat of infection from an immunocompromised patient (CMV, tbc, etc.)

I have to decide if I will participate before tomorrow and would really appreciate any good advice (feel free to send a private message if need be).

Thank you in advance.
Click to expand...

Huh? WHAT THE HELL ARE YOU DOING IN HEALTHCARE?

yes, there are sick people in hospitals. Big shocker. Assuming you arent licking the skull pan of a patient with new variant CJD, you are fine.
 
Being a doctor you should know the risks to pregnant women in healthcare. Your post shows your ignorance!
 
Cica said:
Being a doctor you should know the risks to pregnant women in healthcare. Your post shows your ignorance!
Click to expand...

being a doctor, you should know the answer do your g.d.question!
 
Sorry to jump on your case but your question seemed a little naive for a pathology resident. the answer to your question is "it is ok to do it". I am assuming you use and are familiar with appropriate PPE (personal protective equipment like level c and ,if necessary , level b biohazard suits, etc) and universal precautions? you never know if the mundane myocardial infarct case you are posting has hiv, jc, tb, hep c or whatever. the literature shows no evidence that pregnant people are at higher risk of autopsy acquired infectious disease assuming the above precautions.
 
Cica said:
Hey

I have a question related to autopsy. Is it safe to take part in an autopsy (when pregnant) where the patient had lymphoma and was being treated with chemo AND was admitted to the hospital with neutropenic fever and an unknown infection. The patient died the day after and could not be resusitated.

I am concerned because of the threat of infection from an immunocompromised patient (CMV, tbc, etc.)

I have to decide if I will participate before tomorrow and would really appreciate any good advice (feel free to send a private message if need be).

Thank you in advance.
Click to expand...

All right, all snide posts aside, you know the answer to your question. If you are truly worried about your health or your baby's health, opt out of the autopsy. I don't think the chances are any higher of you contracting something from this autopsy than any other, but if you are freaking out due to worry, skip it. But really, with proper precautions, it doesn't matter what illness/etc the decedent had. You should be protected as long as you're not sticking yourself, not wearing a mask, etc.
 
icpshootyz said:
All right, all snide posts aside, you know the answer to your question. If you are truly worried about your health or your baby's health, opt out of the autopsy. I don't think the chances are any higher of you contracting something from this autopsy than any other, but if you are freaking out due to worry, skip it. But really, with proper precautions, it doesn't matter what illness/etc the decedent had. You should be protected as long as you're not sticking yourself, not wearing a mask, etc.
Click to expand...

I agree. I am always more afraid of catching something from a living patient (or anyone on the street) than a dead patient.
 
I think there has to be an inherent joke somewhere in a sentence containing "urgent" and "autopsy" posted in a Pathology forum. Feel free to make your own punchlines and chuckle quietly to yourselves.
 
OP you are the one ultimately responsible for your safety. You have to find a happy medium, pregnant or not, with risk and safety. Use appropriate PPE for infectious risks and you should be ok. Unless this guy recently returned from the Congo and is bleeding out of his eye balls, you should be ok. Don't forget about radiation risks- I did an autopsy on a person with radioactive seeds and no one could tell me NOTHING. So I wore lead and hoped for the best.

That being said, if you start asking coworkers to do the "dangerous" jobs you won't get much support, sorry to say it.
 
Cica said:
Being a doctor you should know the risks to pregnant women in healthcare. Your post shows your ignorance!
Click to expand...

Okay I read that and immediately realized, this being the internetz, the poster is probably in some far away land, perhaps a medical school in Aleppo, Syria.

Yes, yes there are serious risks to pregnant women in healthcare. Run, run now!:laugh:
 
Thank you for the serious reponses. For those of who think this is funny, well not all countries use the same protective gear as in North America. I thought this was a supposed to be a supportive and serious forum. Its pretty amazing to see how many pathologists out there actually have time to sit and write rubbish responses to an unknown person across the planet!

Thanks again to the ones who have given sensible and informative responses on this forum so far.
 
Cica said:
Its pretty amazing to see how many pathologists out there actually have time to sit and write rubbish responses to an unknown person across the planet!
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inb4: "it's amazing to see a pathologist out there actually have time to sit and write a rubbish question to unknown people across the planet".

Or some variant of the above response. Everyone have a drink.

beer_toast-912.jpg
 
Cica said:
well not all countries use the same protective gear as in North America.
Click to expand...

I was RIGHT! Bazinga.

You should have started the post with correct information then for example: I am in Syria, Brazil, Cuba, North Korea etc.
 
I think this OP is in one of the Nordic countries, which I thought had high safety standards.
 
Cica said:
Its pretty amazing to see how many pathologists out there actually have time to sit and write rubbish responses to an unknown person across the planet!
Click to expand...

I think it's amazing when the opposite happens.

You should be commended for being concerned about your child's safety first of all.

What did you decide about performing the autopsy? For future cases I would think as long as you use PPE and you immunocompetent you're pretty unlikely to catch (and pass on) something that caused the death of an immunocompromised patient.

If you ever do decide you don't want to help with an autopsy or any other procedure you feel endangers your or your child's health you could offer to instead write the first draft of the report (which I HATE doing. I'd gladly do all the dissection and note taking if someone offered to take those notes and write a draft of the report). Or some other division of labor that is even to a little bit more work on your end. You'll prevent resentments and show that it's not laziness at all influencing your decisions.
 
At my program, pregnant women don't gross and don't perform autopsies.
 
I would tell them last you checked you don't get paid any extra to do autopsies while you are pregnant. Tell them everything has a price and then name yours. Then ask who signed the contract with the hospital which included autopsies under scope of service. When you find that name, proceed to that office and tell them it looks like it is his or her responsibility.
 
Thrombus said:
I would tell them last you checked you don't get paid any extra to do autopsies while you are pregnant. Tell them everything has a price and then name yours. Then ask who signed the contract with the hospital which included autopsies under scope of service. When you find that name, proceed to that office and tell them it looks like it is his or her responsibility.
Click to expand...

Yes do that, then be labeled appropriately as difficult to work with, be unemployed and post on here about the crappy job market.
 
BrainPathology said:
Yes do that, then be labeled appropriately as difficult to work with, be unemployed and post on here about the crappy job market.
Click to expand...

Aren't residents supposed to be taught autonomy and business skills?

👍👍
 
Although I have no particular data to support this so you shouldn't put faith in it, I suspect a pregnant person would be at higher risk walking through the average daycare than performing an autopsy. There's probably a bit higher risk for -anyone- performing -any- autopsy, but I don't know that whatever extra things a pregnant individual has to be concerned about catching are any more prevalent in the autopsy population. But, do your own research on the topic -- pregnancy risk has been hot to write about, though not always well evidenced. I only vaguely remember looking at this issue during residency when we had a couple of folks get pregnant, but for the most part they were off grossing/autopsy rotations by pre-planning (the main concern voiced was about formalin), and I really don't remember what I found at the time.

Doing a very quick internet search just now only brought me to a few resident manuals, one of which pointed out the 1978 Pregnancy Discrimination Act, and which they interpreted to mean a pregnant employee cannot be removed from their job solely because of pregnancy or possible risk to the fetus and therefore their rotations would not be changed just because they were pregnant (although they could request a change and the program would try to accommodate), unless they were -unable- to perform their duties. There's a fine line there somewhere. Anyway, it sounds like it was being used as an out for residency programs to not bother even looking up or providing data driven risk information. However.. that may be something that your local occupational health department should feel responsible for.
 
This woman did field work all the way until the moment of labour. That MUST mean something. :meanie:

Temperance_Brennan.jpg
 
Anyway her stomach seems incredibely flat. I'm sure she has a nice navel too
 
KLPM said:
This woman did field work all the way until the moment of labour. That MUST mean something. :meanie:

Temperance_Brennan.jpg
Click to expand...

this woman isn't real! however I know plenty of real life pathologists who work while pregnant and know the risks.
 
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