Job responsibilities of a histological laboratory assistant. Pathological anatomical research laboratory assistant job description. Subject to assimilation of educational practice

Staining preparations

Basic paints Carazzi and hematoxylin Mayer.

acid paints -

Simple - one paint applied

Double - two colors applied

Complex - three colors applied

histochemical coloring:

On slime

For amyloid- Congo mouth is red.

Staining for fat –

Identification of iron compounds.

(According to Perls)

(According to Tirman)

(Chic-reaction)

Staining of bacteria in sections.

By Gram.

Orders, resolutions, instructions regulating work in PJSC

1 the federal law dated 01/12/1996 No. 8-F3 (as amended on 11/25/2009) "On consumption and funeral business" (adopted by the State Duma of the Federal Assembly of the Russian Federation on 12/08/1995)

2 Order of the Ministry of Health and Medical Industry of Russia dated April 29, 1994, No. 82 “On Conducting Pathological Anatomical Autopsies”

3 The list of accounting and reporting medical documentation of PJSC approved by order of the Ministry of Health of the Russian Federation dated 04.10.1980 No. 1030

4 Instructions on the organization of work and compliance with the anti-epidemic regime of PJSC and departments of the bureau of forensic medical examination in cases of suspicion or detection of especially dangerous infections (approved by the Deputy Ministry of Health of the USSR on 12.12.1978)

5 Rules for the arrangement and operation of the premises of the pathoanatomical departments of morgues (pathoanatomical and forensic laboratories), medical and preventive and forensic medical institutions, institutes and educational institutions (to SNiP 02.08.02-89)

6 Works and services in the specialty of pathological anatomy in the nomenclature of works and services for the provision of medical care (Order of the Ministry of Health of the Russian Federation of July 26, 2002 No. 238)

REPORT on the work done by the paramedic-laboratory assistant-histologist

Pathological Anatomical Department of FGUZ KB-122 named after A.I. Sokolova L.G.

FMBA of Russia Platonova Nelya Alexandrovna.

After graduating from the 6th Leningrad Medical School in 1972 as a nurse, she was assigned to work in 81 clinics in the city of Leningrad. From October 1982 she worked at the KDL TsMSCh-122. Since 1984, she worked in the laboratory of urgent analyzes as an on-duty laboratory assistant. Since May 996 I have been working in the pathoanatomical department as a medical assistant-laboratory assistant-histologist, I have a certificate of a laboratory assistant-histologist and the highest qualification category of a medical assistant-laboratory assistant-histologist.

Responsibilities of the histologist laboratory assistant:

To carry out the reception of biopsy and surgical material delivered for examination from clinical departments and an operating flea.

Check the marking, computer number, code, compliance of the delivered material with the records in the accompanying direction.

Carry out preliminary washing of the material with running water from formalin.

Participate in cutting material.

Mark cut pieces, register their number, methods of subsequent histological processing.

Fill in the form-direction on the computer and the macro description of the material under the dictation of the doctor.

Carry out wiring, paraffin filling, histological processing, production of high-quality micropreparations and the studied surgical and biopsy material.

Participate with the doctor in the cutting of fixed sectional material.

Fill the cut pieces in paraffin and other media.

Stain sections and prepare slides.

To make urgent production of histological micropreparations on a freezing microtome.

Ensure proper sanitary and hygienic conditions in the laboratory.

Maintain order and cleanliness in the workplace.

Upgrade your skills in a timely manner.

Pathological anatomical department is a structural subdivision of KB-122 named after. Sokolova L.G. FMBA of Russia.

The pathology department includes the following laboratories:

Histological laboratory- examines surgical, biopsy, sectional material coming from the departments of KB-122

In 2016, 9192 patients were examined, 82228 examinations of surgical and biopsy material were performed, of which:

Total: I completed:

operating material 47862 pieces / 6258 pcs.

FGS-biopsy 10345 pcs. / 1515 pieces

Endometrial scrapings 17802 kus / 3103 kus.

biopsies 6219 kus / 703 kus.

54 urgent biopsies performed

77 autopsies performed

Cytological laboratory-

performs cytological and cytochemical studies of the material coming from the departments of KB-122

In 2016, 12274 patients were examined, 24048 cytological studies were performed:

Laboratory of immunohistochemical research methods -

performs and determines with high accuracy the nature of tumor processes, differentiates the degree of malignancy and sensitivity of tumor cells to hormonal and chemotherapy using special markers. The laboratory was founded in 2009.

In 2016, 601 patients were examined, 1838 immunohistochemical studies of surgical and biopsy material were performed.

According to job descriptions, the following work is performed:

Cutting of surgical and biopsy material

The material is delivered to the laboratory in a fixed form in a 15% formalin solution with a referral. For immunohistochemical studies, the material is delivered to the laboratory immediately after the operation. not fixed.

1. All material is sorted into surgical, biopsy, FGS biopsies and endometrial scrapings.

2. Registered in the alphabetical journal and entered into the computer. Each individual case is given its own number, which allows recording not only the number of pieces, but also the number of patients per year.

3. Under the doctor's dictation, there is a description of the surgical material (macropreparation - macrodescription). Then the material is started up in the wiring.

4. Posting goes in an Automatic tissue processor with software control for posting histological material.

5. The embedding of surgical and biopsy material is carried out at the LEICA 1150 paraffin embedding station.

6. Then the material is poured and cut on the microtome. After cutting, the material is placed in a thermostat at t-42 * for the night, and then the preparations are stained.

7. Urgent biopsy material is cut on the Cryostat LEICA RM 2125 with further coloring. The time for urgent examinations does not exceed 30 minutes. In case of an urgent biopsy, a preliminary conclusion is given by the doctor. The final answer is given according to the filled material.

Staining preparations

All paints used in histology are divided into nuclear or (basic) and diffuse (acid). For the vast majority of diagnostic studies, such simple staining methods as Hematoxylin-eosin and according to Van Gieson.

Basic paints. Of the nuclear (basic) paints, paints made from hematoxylin are most widely used. We use hematoxylin in our laboratory Carazzi and hematoxylin Mayer.

acid paints - constant use has eosin, acid fuchsin, picric acid. The last two colors are used in a special mixture with each other, called picrofuchsin or Van Gieson mixture.

In histological practice, depending on the number of coloring agents used, the following types of paints are distinguished:

Simple - one paint applied

Double - two colors applied

Complex - three colors applied

In all these colors, the main role belongs to the nuclear (basic) paint, which is used either alone or in combination with acidic (one or more). In histological practice, hematoxylin is used in combination with eosin (double) and hematoxylin with picrofuchsin (triple) - Van Gieson.

In some cases, apply histochemical coloring:

On slime- has great diagnostic value in some pathological processes - tumors, callogenoses.

Alcian blue, mucicarmine.

For amyloid- There are a number of special methods for the detection of amyloid, of which the most common are Congo mouth is red.

Staining for fat – Sudan III, Sulphate Nile blue.

When staining for fat, all sections should be after “freezing”.

Identification of iron compounds.

The material to be tested for iron must be fresh.

There are two reactions to detect iron:

Reaction to Prussian Blue(According to Perls)

Reaction to turbulene blue(According to Tirman)

Iron salts in both cases give blue compounds.

Staining of pathogenic fungi and neutral mucus.

(Chic-reaction)

Mushroom staining with fuchsine sulfuric acid - Schiff reaction.

Staining of bacteria in sections.

Stained with Lefleur's methylene blue.

By Gram.

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Introduction

Chapter 1

2.4 Work planning taking into account the technical arrangement of the laboratory

2.5 The choice of technologies and equipment for the workplace of the histologist's laboratory assistant

2.6 Complex technological solutions in the work of a histologist laboratory assistant in the laboratory

Conclusion

Bibliography

Glossary

Introduction

laboratory assistant histologist biopsy risk

Histology (the term is formed by combining the Greek words "histos" - "tissue" and "-logia" - "science") is the study of the anatomy of cells and tissues of representatives of the plant and animal world on a microscopic scale. As a rule, it is carried out by analyzing tissues and cells using sectioning and staining, followed by examination under a light or electron microscope. It is possible to conduct histological studies using tissue culture, where living cells can be isolated and maintained in a proper environment outside the body in various research projects.

Histology, or more precisely histopathology, is a branch of the scientific and applied discipline "pathological anatomy", directly studying pathological changes in tissue to determine the patient's condition.

The purpose of this work is to study the work of a histologist laboratory assistant, analyze the work and develop separate proposals, create a new methodology, technology; opportunities for optimizing work.

The relevance of research. The development of technologies in medicine leads to the expansion of the capabilities of the histological laboratory.

In modern world medicine, the main activity of the laboratory of histology and cytology is aimed at intravital morphological diagnosis of pathological conditions of various organs and systems - current and future planning in work. This requires the latest automatic equipment such a laboratory. Histological and cytological examination of surgical and biopsy material is performed here. In the present, doctors need to provide the patient with the necessary and timely assistance in treatment. The terms for obtaining research results are accelerating (already within 1 working day, and for surgical material within 1-2 working days), immunohistochemical methods for studying infectious pathology are being introduced into work. For example, it is currently possible to diagnose herpes simplex virus types 1 and 2, cytomegalovirus, Epstein-Barr virus, human papillomavirus (oncogenic strains), parvovirus B19, pneumocystis (Pneumocystiscarinii), toxoplasma (Toxoplasmagondii), adenovirus infection in the biopsy, operating room and cytological material. Despite the actions aimed at labor protection, a laboratory assistant who meets with histological material runs the risk of contracting infections.

Such a laboratory should have a convenient and modern system for archiving materials received from patients, designed for long-term storage and quick search for diagnostic preparations if necessary.

Qualified pathologists should work in the laboratory. They are actively assisted by laboratory assistants histologists.

The role of a histologist laboratory assistant in such working conditions currently requires not only theoretical literacy, but also a certain optimization and modernization of labor, which will positively affect the work of the laboratory as a whole.

The object of the study is the algorithm of the work of a histologist's laboratory assistant, the presence of risk factors in the work of a histological laboratory assistant.

The subject of the study is the content, forms and activities of the laboratory nurses.

Research objectives:

study the legal framework governing the work of histological laboratories.

to study the methods of histological examination and the equipment of histological laboratories.

Scientific novelty of the research.

Despite the relevance of the problem, in this paper we will try to analyze in detail the risk factors in the work of a histological laboratory assistant.

The practical significance of the study.

Histological diagnostics is developing and becoming more and more in demand, and the analysis process is not automated.

Although the appearance disposable tableware And technical equipment reduced the risk of infection of medical personnel, it is not possible to avoid it.

Chemical reagents are also not safe, among them there are both toxic and flammable substances. The transition to modern analyzers has simplified the work of laboratories, but the lack of modern equipment and interruptions in the provision of consumables for them do not allow completely abandoning old methods.

Microscopy increases the load on the eyes, and if the lighting is not enough, then the risk of reduced vision increases. Insufficient equipment of the premises also adversely affects the health of laboratory staff.

The identification of risk factors and the determination of methods for the prevention of diseases associated with the working conditions of a histological laboratory assistant is an urgent problem of modern occupational medicine.

At present, there are not enough pathologists and laboratory assistants in the histological laboratory to fill vacancies in state structures healthcare.

Hypothesis:

The rational organization of the work of a histologist's laboratory assistant, based on approved standards and work procedures, the application and mastery of work using the latest technologies improves the quality of work, this is directly facilitated by saving time, saving labor costs, improving labor ergonomics, and optimizing the work of a histologist's laboratory assistant.

Chapter 1

The main task of practical health care is intravital morphological diagnostics. This is the main and important scientific and practical way to solve the diagnostic problems of many specialists. Intravital morphological biopsy functionally and organizationally requires the solution of many problems.

It should solve many issues of public health protection. Organized should be correct in structure and meet the needs of the clinic at optimal cost.

Pathological anatomical department (synonymous with prosecture, from Latin prosecare - dissect) - part of a medical (research) institution in which macro- and microscopic, and in the presence of special rooms - bacteriological, chemical and radiological examinations of corpses, morphological examination materials of operations and biopsies.

Organization and equipment of pathohistological laboratory

According to order No. 468-64 "rules for the arrangement and operation of the premises of pathological and anatomical departments and mortuaries (pathohistological and forensic-histological laboratories) of medical and preventive and forensic medical institutions, institutes and educational institutions (approved by the Ministry of Health)"

The head of the pathoanatomical department and (or) the histological laboratory should develop on the basis of these rules. The site where the department will be located should be away from the medical buildings, separated by a forest protection zone - a park or garden with a width of more than 15 m.

The site should be arranged with access roads, a separate entrance, which is necessary, as a rule, only for the use of the pathoanatomical department and the histological laboratory. In some cases, it can be combined only with the entrance to the economic zone.

Pathological and anatomical and forensic buildings and entrances to them should not be visible from the windows of the patients' rooms and from the garden for patients, isolated from adjacent residential buildings.

The department and the morgue cannot be located in the same building with the auxiliary services of institutions or treatment rooms and must have separate premises.

The room of the department consists of a sectional room where autopsies are performed, laboratory rooms in which material for sections and biopsies is prepared and processed; offices of the head and doctors and from a number of utility rooms: pre-section room, rooms for storing and issuing corpses, waiting rooms for relatives of the deceased, an inventory room, changing rooms for employees with individual wardrobes, etc. Isolated rooms with a separate exit are allocated for storing and issuing the corpses of those who died from infectious diseases to the street.

The total area of the premises of the pathoanatomical department in hospitals with up to 100 beds is 44 sq. m, and in hospitals with 100 or more beds per 1 bed. In hospitals with 100 beds 1.08 sq. m The area and set of mortuary premises are determined based on the population of these cities

The pathological department should be a facility for storing corpses at a low temperature. When storing corpses in a basement or semi-basement, an elevator is required to raise them to the sectional and return descent. The sectional room must meet three main conditions: free and well-lit places for autopsy, comfortable and sufficient in size for doctors and students present at the autopsy, convenient access to sectional tables with stretchers and gurneys. The sectional room is usually located on the first floor. Its area depends on the number of sectional tables (at least 15 m2 per table in small hospitals and 25 m2 in clinical ones). The floor and walls are tiled. Cold and hot water should be supplied to the sectional tables and to two large rectangular sinks. In large medical institutions there may be several sectional ones - large, small and for the corpses of those who died from infectious diseases.

The height of the main premises in the pathological department and in the morgue should be 3 m.

The layout in the building of the pathoanatomical department and the mortuary must be in accordance with the following requirements. Separated by a vestibule or corridor from the histological laboratory, rooms associated with the transportation of corpses inside the building. Premises for autopsy, processing and storage of non-fixed sectional and biopsy material, separate rooms for doctors and attendants, a museum, a shower room and a sanitary unit, as well as other rooms.

All rooms in the building for the pathological department and the histological laboratory must be dry.

A shower room should be provided for the medical staff of the department and the morgue, in medical institutions with a number of beds of 400 or more, a sanitary check is provided.

Walls and partitions are constructed from waterproof inorganic materials.

The walls of the cabinets should be painted with oil paint up to half the height, and the walls of the sectional, pre-sectional, room for storing corpses and the sanitary unit should be equipped with panels lined with glazed tiles.

In the pathoanatomical department and the mortuary for washing the hands of working personnel, there should be water sinks located separately from the sinks intended for washing equipment and instruments.

Exhaust ventilation with mechanical induction should be equipped with all premises of the pathoanatomical department and the mortuary (laboratories). The rooms must be equipped with built-in fume hoods with mechanical stimulation.

In large laboratories, complex techniques of various colors are always used. There it is necessary to equip a table with an individual exhaust device.

All areas of the department and laboratories should use direct natural lighting. Standard window areas to the floor area should have a ratio: in the sectional and laboratory - 1:4 - 1:5, in other rooms - 1:6 - 1:8.

In pathological departments and laboratories, all furniture should be painted with light-colored paint. Tables should be made of waterproof material and with an easy-to-clean surface (marble, mosaic tiles, galvanized iron, stainless steel), for the application of frequent washing with disinfectants. It is not allowed to use wooden sectional tables without metal sheathing.

The histological (pathomorphological) laboratory is located in a standard or specially adapted room. It must be equipped with the necessary equipment, tools, laboratory glassware and chemicals.

Equipment for pathology laboratory

The histological (pathomorphological) laboratory should be equipped with the necessary equipment, laboratory glassware, instruments and chemical reagents.

Working premises of the laboratory - a room in which sectional, biopsy or experimental material is cut; working room of laboratory assistants; equipment room and washing room.

Workrooms must be equipped with supply and exhaust ventilation.

In the laboratory, it is necessary to strictly observe the rules of fire safety and work with volatile and toxic substances.

The working room of the laboratory assistant should have a fume hood, chemical and physical tables, a cabinet and a safe for storing chemical reagents.

Laboratory furniture, preference should be given to special laboratory furniture made of metal and plastic, which is equipped with sliding parts, water supply, vacuum, air and gas. The work chair should have an adjustable seat and back height and be easy to move across the floor.

Scroll necessary equipment laboratory includes technical and analytical balances, a pH meter, microtomes (sledge, rotary, freezing), a cryostat or cryo kit, a water bath, a table for melting paraffin sections, sets of automatic pipettes, thermostats, refrigerators, microscopes, automatic material transfer, etc.

Uninterrupted work of any histological laboratory is possible only if there is a sufficient set of laboratory glass and utensils. The most commonly used are Petri dishes, jars with ground stoppers, bottles, cuvettes, chemical cups, slides and coverslips.

Petri dishes - for cutting biopsy material, flat, wide glass dishes with lids are used - they can be stained with "free floating" sections, put histoenzymatic reactions in a thermostat, etc.

Jars with ground stoppers with a capacity of 1 - 3 liters are more often used for preparing museum macropreparations, storing and fixing pieces of tissue, degreasing glass slides in Nikiforov's mixture or acids. Large jars are used to store volatile substances. Banks with a capacity of 50 - 200 ml are more often used - in such a container, the material obtained from a biopsy, as well as puncture biopsies, is carried out.

For histological staining and histochemical reactions, bottles of cups of various capacities (usually 10-100 ml) with a ground stopper are used. For setting up the reaction on celloidin and frozen sections, flat weighing bottles with a diameter of about 50 mm are used.

When carrying out histological, histochemical, enzyme-chemical reactions for the simultaneous staining of several sections pasted on glass slides, cuvettes are applicable - rectangular cups of various heights with lids. Chemical cups with a capacity of 50-100 ml are used for histochemical and enzymatic reactions.

For the preparation of histological preparations, there are glass slides measuring 76 x 26 mm and 2 mm thick. For carrying out histochemical, including histoenzymatic, reactions, it is desirable to use glasses with a thickness of 1 mm.

Cover glasses are thin and fragile glass plates 0.15-0.2 mm thick. The most commonly used coverslips are 18 x 18 and 24 x 24 mm.

The laboratory also needs to be equipped with funnels of various sizes, porcelain cups, mortars and volumetric utensils (flasks, glasses, cylinders and beakers). Flasks made of heat-resistant glass allow you to prepare reagents that require heating. Large flasks, as a rule, serve for running and distilled water, and small ones with ground-in stoppers are suitable for storing chemical reagents.

When setting up histochemical reactions and preparing reagents in pathohistological laboratories, simple and graduated pipettes are used with a capacity of the latter from 0.1 to 100 ml. All used laboratory glassware should be labeled and rationally placed to avoid errors in its use.

The set of instruments used is supplemented by tweezers (surgical, anatomical and ophthalmic), scissors (anatomical, surgical and ophthalmic), scalpels, dissecting needles, spatulas - straight and curved metal blades (often used in the preparation of sections on a freezing microtome and celloidin sections), surgical knives for cutting material and knives with a double blade for obtaining thin sections of brain tissue.

Proper record keeping allows employees of the histopathological laboratory to effectively use their working time and facilitates work with archival material.

Documentation includes: alphabetical journal for registration of biopsy and surgical material; biopsy log and sectional material log; referral for pathological examination.

The elder sister (senior laboratory assistant) should have books for accounting for alcohol, toxic chemicals, precious metals, medicines and a catalog for accounting for chemicals, by which it is easy to find the reagent needed for work.

Before starting work with all newcomers to work and employees of the pathoanatomical departments and morgues, a detailed safety briefing should be carried out annually.

The registration of the briefing should be recorded in the appropriate briefing log.

Administration medical institution must regularly supply workers of pathoanatomical departments and morgues (laboratories) with overalls, footwear and personal protective equipment in accordance with the standards approved by Order of the Minister of Health of the USSR of April 18, 1962 N 187.

Medical staff should wear a gown other than the normal work gown designed for work in the dissection room and when cutting biopsies.

Gowns and caps should be washed as they become soiled, and aprons, gloves, and sleeves should be washed and disinfected after each opening.

When an infected corpse is opened, all linen, sanitary clothing and overalls that come into contact with the corpse must be disinfected, depending on the type of infectious agent.

Dressing gowns, caps and other linen of pathological departments and laboratories, when washed in a general hospital laundry, should be washed separately from the linen of other departments.

In the pathohistological and forensic-histological laboratories or in the pre-sectional laboratory, biopsy and sectional material is cut out.

A special table must be equipped for cutting. The tool kit must only be used for this purpose.

Fixation of the material should be carried out only in a fume hood. Storage of histological material should be in a special room (fixation room, using good ventilation).

Preparation of solutions, pouring of formalin and strong acids is also permissible in a fume hood.

Cutting material should be carried out in an apron and rubber gloves.

Tools, gloves, a table and a board after cutting should be thoroughly washed and treated with a disinfectant solution.

Material after cutting used as an archive should be stored in well-closed jars in 10% formalin solution.

All jars must be signed, listing the autopsy or biopsy numbers stored in it.

Storage of archival material in a specially designated storage facility should be within a year.

Archival materials at the expiration of the storage period, as well as organs entering the pathoanatomical department (from surgical and gynecological departments, maternity hospitals) after cutting are stored in a special storage in jars with fixative liquid. They must be burned regularly in a special furnace. All waste must be periodically sent to special disposal sites if there is no furnace.

All poisonous substances used in the laboratory should be stored in a separate room under lock and key in metal cabinets or safes. In a specially allocated internal compartment of these cabinets or safes, especially poisonous agents (mercuric chloride, etc.) are stored.

The windows of the room where poisonous substances are stored are provided with iron bars, and the doors must be upholstered with iron.

Rooms or cabinets (safes) in which poisonous substances are stored must be locked. After the end of the working day, rooms and safes are sealed with a wax seal or sealed.

The keys where poisonous substances are stored, as well as the seal or seal must be kept by the person responsible for the storage of poisonous substances, by the head of the laboratory or by a person authorized to do so by order of the institution.

Packaging, grinding, weighing and measuring of toxic agents is carried out in fume hoods using specially designed instruments and utensils (scales, mortars, funnels, cylinders, etc.).

Especially toxic agents after work are locked in metal cabinets (safes) in which they are stored. Other poisonous agents are placed in a cabinet in a locked cabinet in the working room.

Upon receipt of toxic agents to the laboratory, the responsible person is obliged to personally check the compliance of the received toxic agents with the accompanying documents.

The release of toxic agents for current work is possible only with the written permission of the head of the institution and only upon a written request signed by the head of the laboratory, indicating in it the name of the person receiving this agent. Each package is labeled with:

a) the name of the poison;

b) with the image of symbols in the form of crossed bones and a skull with the inscription: "POISON" and "Handle with care."

Before releasing poisonous substances, the person responsible for their storage is obliged to personally verify the validity of the release, compliance this tool accompanying documents and the correct packaging and sign the copy of the demand.

Poisonous substances must be subject to quantitative accounting in special books, numbered, laced and sealed and signed by the head of the institution.

The account form looks like this:

1) receipt - the date from which it was received and the number of the document, quantity;

2) expense - date, to whom it was issued - for what it was spent, amount;

3) the remainder.

Cabinets in which potent agents are stored are locked after work is completed.

All chemical volatile substances should be stored in a tightly closed glass container in a closed cabinet away from heating devices and open flames (xylene, toluene, chloroform, aniline, formalin, etc.). Volatile substances are opened only at the time of direct use of this substance and should be stored in bottles and jars closed with ground stoppers.

Separate from reagents and paints, acids and alkalis should be stored in glassware with ground stoppers on the lower shelves of cabinets.

When diluting strong acids, the acid should be added to the water to prevent splashing, not the other way around.

Do not close the dishes when boiling reagents (test tube, flasks) with a cork.

Heating electrical and gas appliances (electric stove, water bath) should be located away from explosive and combustible substances, on stands made of refractory material.

Flammable and explosive substances must not be placed on tables where there are electrical appliances and devices with open fire (gas, burner, spirit lamp, etc.).

Explosive and combustible substances must not be placed in thermostats (for example, ether) and film must not be dried in them.

The knife, after working on the microtome, should be immediately removed and placed in a case for permanent storage. It is forbidden to leave the knife in the microtome or move it around the laboratory without a case.

The purpose of the histological laboratory is:

clarified intravital diagnosis of diseases by pathomorphological and cytological examination of surgical and biopsy material;

establishing the cause and mechanism of death of the patient by conducting a pathoanatomical autopsy of the corpses of the dead;

analysis of the quality of diagnostic and medical work together with the attending physicians of medical and preventive institutions by comparing clinical and pathological data and diagnoses.

Chapter 2. Organization and formation of the work of a histologist laboratory assistant

2.1 Study of the complexity of biopsy material research

Histology, or more precisely histopathology, is a branch of the scientific and applied discipline of pathological anatomy that directly studies pathological changes in tissue to determine the patient's condition.

So, what material is sent for histological examination? Biopsy material, tissues of the organs of the corpse during autopsy, all tissues and organs removed during surgical interventions (operations) are sent for histological examination. A biopsy is a diagnostic operation in which tissue is taken from the body in vivo for diagnostic purposes. Nowadays, work with biopsies is 90% of the work of the histological laboratory. Due to the development of non-invasive diagnostic methods, such operations are most often performed in order to confirm the diagnosis of a malignant neoplasm (tumor), but not only for this.

There are certain rules for histological diagnosis regarding the volume of material and the order of its collection in various cases: prenatal diagnosis, gastrobiopsy, trephine biopsy for bone marrow examination, skin biopsy, etc. These rules are reduced to the reasonable sufficiency of the material provided that it is representative and informative.

The special role of histological diagnostics in oncological practice is due to the fact that specific methods of histological examination are most suitable for determining the degree of tissue atypicality (cancer, precancer, etc.), determining the nature of the interaction of tumor tissue with healthy tissue (invasion, microinvasion, etc.). etc.), determining the tissue affiliation of the material under study (important in determining metastases) and other types of studies that are fundamentally important for the diagnosis of tumors and the staging of oncological diseases.

According to the regulations in force in Russia, without histological confirmation of the diagnosis of a malignant neoplasm (tumor), specialized oncological therapy (chemotherapy, radiation therapy, etc.) cannot be prescribed.

By combining traditional histological methods with innovative methods, a pathologist can diagnose a tumor, verify it in accordance with international classifications, and evaluate prognostic and predictive factors. At the same time, a predictive assessment is understood as an assessment of the effectiveness of a specific drug therapy for a specific patient (the principle of personalized medicine), which is critically important for an oncologist who is faced with the task of curing this patient, and, of course, pharmaceutical companies producing anticancer drugs.

The prospects for the use of histological methods in new, high-tech areas of medicine are not limited to oncology, they are already in demand, for example, in transplantology, dermatology, and gastroenterology.

Workflows in the histology laboratory represent an ordered path that incoming material must follow in order to produce a histological report (Fig. 1). This path consists of a set of strictly obligatory and obligatory in some cases stages, operations at these stages are specific to the histological laboratory and are discrete (discontinuous). Not only does there not exist such a thing as a “histological conveyor”, when one could place a container with material on one side of an imaginary device, and on the other side receive an answer in one form or another (verbal, digital or some other), but also many stages of histological examination are still not automated.

Histological material changes its shape twice as it passes through the stages of the study.

After the histological cutting step, representative sections travel around the laboratory in the form of histological blocks.

A histological block is a preparation embedded in a special paraffin medium, usually in the form of an irregular cube (hence the name "block"). And after the stage of microtomy - a process consisting in cutting tissues for analysis with the required thickness of 2 to 5 microns - in the form of a preparation on a glass slide (the professional name for such a preparation is "glass").

In this case, the incoming material can be divided into several blocks, and several glasses can be made from each block.

The drug ends its journey in a specialized archive, which is an important part of the laboratory. (Figure 1)

Rice. 1. Sequence of workflows in the histology laboratory

According to the regulations in force in our country, the patient's preparation (both the block and the glass) are subject to indefinite storage (the tissue in the paraffin block practically does not change its morphological, biological and chemical characteristics over time). The rationale for this is clear - the histological conclusion is confirmation of the need for surgery, or the appointment of a specialized type of treatment, and it is not clear when exactly such confirmation may be needed. On the other hand, oncological patients, unfortunately, can return after primary treatment with relapses or complications, and to find out what is happening with the patient (recurrence of a previously treated tumor, new tumor, metastasis), it is necessary to have a complete picture of the medical history, including previously collected material.

2.2 Risk factors related to working conditions

Risk factors related to working conditions include poor room lighting, low or high room temperatures, poor air ventilation, high noise levels, stressful layout of workspace and equipment, poor orientation in buildings, lack of personal protective equipment, ionizing radiation, electromagnetic fields and radiation, lack of laboratory security.

When assessing working conditions important role plays an assessment of injury safety. It is carried out on the basis of inspection of equipment (documentation for equipment), tools and fixtures, as well as the availability and completion of safety briefing logs and relevant entries in them for compliance with regulatory documents.

Among the risk factors, emotional and stressful loads should also be assessed. Most health facilities lack qualified staff and are overburdened with existing staff.

The laboratory should be lit with natural or artificial light, the level of which should be optimal for safe work. In addition, distracting and glare reflections should be minimized.

Any equipment must be isolated from the general workspace if it radiates excessive heat or cold. Personnel must be provided with personal protective clothing, including heat protective gloves and appropriate clothing, for comfort and personal safety.

The ambient temperature in the laboratory should be kept as comfortable as possible for laboratory workers.

Any equipment capable of emitting excessive smoke, steam, heat, odor or toxicity should be placed under a suitable fume hood and isolated from the general work area. If this is difficult to do, then it is necessary to carry out a partial special re-equipment to create comfortable conditions for workers.

If, as a result of certain processes handmade formation of unpleasant or sickening odors occurs, the use of mechanical or local natural ventilation is recommended.

The movement of air and the humidity of the environment in the laboratory must comply with the requirements for the safety of laboratory workers and be comfortable.

The air flow rate in the laboratory should prevent the dispersion of potentially infectious agents and toxic fumes and provide adequate ventilation.

The ventilation ducts of the fume hoods should be separated from the general workspace to avoid dispersion or air transfer in case of infectious agents or odors to another part of the workspace.

There should be no excessive noise in the workplace. It is necessary to take into account the influence of individual elements of equipment on the overall noise level in the workplace when selecting and placing items. Appropriate measures must be taken to reduce and muffle the resulting noise generation.

The workspace, laboratory activities, and equipment (eg chairs, laboratory work sets, computer keyboards and monitors), as well as vibrating equipment, ultrasound, should be located so as to reduce the risk of ergonomic distress or accidents.

All laboratories working with live biological agents should be designed to meet moderate to high risk personal protection against micro-organisms. Laboratories intended to work with high-risk organisms should be provided with more protective design features.

Laboratories should have emergency exits, signs at each entrance and exit. Signage at each location should combine internationally accepted hazard indicators (eg, biohazard, fire hazard, radioactivity) and other safety-relevant signs.

The laboratory must have lockable doors. In emergency situations, constipation on the doors should not prevent exit. Access to the laboratory is made only by authorized personnel. Locks may also be required for internal doors to prevent personnel from entering during high-risk sample processing. If high-risk samples, cultures, chemicals or devices are stored, additional security measures such as lockable doors, closed refrigerators, restricting unauthorized access to the laboratory, etc. are necessary. Appropriate measures must be taken to prevent the threat of theft or deterioration of biological agents, samples, medicines, chemicals or confidential information.

2.3 Biological risk factors associated with work in the histology laboratory

Work in a histological laboratory is associated with a number of hazards due to:

A) autopsy of those who died from various diseases, it means infectious;

c) constant use in the work of substances harmful to the body such as formalin, chloroform, xylene, toluene, benzene, dioxane, mercury salts, aniline, etc.

d) the use of flammable substances in the work - alcohol, ether, etc.

The effect of formalin on the human body.

Formaldehyde (from lat. formoca "ant") is a colorless gas with a pungent odor, highly soluble in water, alcohols and polar solvents. Irritant, toxic. Formaldehyde is the first member of the homologous series of aliphatic aldehydes, aldehyde formic acid.

Application. An aqueous solution of formaldehyde (methanediol), stabilized with methanol - formalin - causes protein denaturation, therefore, in the leather industry, it is used as a tanning agent and in the production of film for tanning gelatin. Formaldehyde is a good antiseptic because of its strong tanning effect. REMOVE This property of formalin is used in medicine: in the form of an antiseptic (formidron, formagel and similar preparations) and for the creation of anatomical and other preparations as a preservation of biological materials

One of the main sources of formaldehyde and urea in the production of urea-formaldehyde, melamine-urea-formaldehyde resins and for the treatment of urea against caking is an aqueous solution of formaldehyde (methanediol) stabilized with urea - KFK; for the production of plywood, chipboard is used in the woodworking and furniture industries, etc.

The main part of formaldehyde is used to produce thermoplastic polymers in the form of phenol-formaldehyde, urea-formaldehyde and melamine-formaldehyde resins. It is often used in the production process in industrial organic synthesis (pentaerythritol, trimethylol propane, etc.). At temperatures below 9 during storage, the formaldehyde solution becomes cloudy, a white precipitate forms in the form of paraformaldehyde.

Formaldehyde is toxic. When exposed to the body, symptoms of chronic poisoning appear. A dose of 60-90 ml of ingestion is fatal. Symptoms of formaldehyde poisoning: loss of strength, pallor, loss of consciousness, depression, breath holding, headache, often night cramps.

In the case of acute inhalation poisoning, conjunctivitis appears, acute bronchitis, which subsequently develops up to pulmonary edema. Dizziness, fear, unsteady gait, convulsions, symptoms increase gradually as the central nervous system is affected. In case of poisoning through the mouth, a burn of the mucous membranes of the digestive tract occurs. There is swelling of the larynx, reflex respiratory arrest.

There is pain in the throat, burning along the esophagus, pain in the throat, if it enters the stomach, vomiting occurs with bloody masses, diarrhea. Develops hemorrhagic nephritis, anuria.

Those working with technical formalin develop chronic poisoning, which is manifested by weight loss, dyspeptic symptoms. Damage to the central nervous system manifests itself in the form of persistent headache, poor sleep, mental agitation, trembling, ataxia, visual disturbances. Organic diseases of the nervous system (thalamic syndrome) are described, there is a disorder of sweating, temperature asymmetry. Cases of bronchial asthma are possible. Under the action of formalin vapors, for example, in workers engaged in the manufacture of artificial resins or in direct contact with formalin or its solutions, pronounced skin lesions in the form of dermatitis of the face, forearms and hands, brittleness, softening of the affected nails are noted, especially in the first days of work. The appearance of dermatitis and eczema is associated with the allergic nature of the impact. After suffering poisoning, there is an increased sensitivity to formalin. There is scientific evidence that indicates an adverse effect on specific functions of the female body.

Formaldehyde is included in the list of carcinogenic substances GN 1.1.725-98 in the section "probably carcinogenic to humans". Its carcinogenic effect on animals has been fully proven. The connection of formaldehyde, used in the production of resins, plastics, paints, textiles, as a disinfectant and preservative has been proven (according to official data from the International Agency for Research on Cancer). There is an increased risk of developing cancerous tumors of the nasopharynx.

The effect of chloroform on the human body.

Chloroform (aka trichlormethamn, methyltrichlorimd, hladomn 20) is an organic chemical compound with the formula CHCl3. Under normal conditions, it is a colorless volatile liquid with an ethereal odor and a sweet taste. Practically insoluble in water. It forms solutions with water with a mass fraction of up to 0.23%. Chloroform is miscible with most organic solvents. Phosgene poisoning may occur when working with chloroform, which has been stored in a warm place for a long time.

Application. In the late 19th and early 20th centuries, chloroform was used as an anesthetic in surgical operations. For the first time, chloroform was used as an anesthetic in surgical operations in England by the doctor Simpson (1848). In Russia, chloroform was first used by N. I. Pirogov as a means for general anesthesia. In the future, in the role of anesthesia, chloroform was later replaced by safer substances.

Chloroform is used for the production of freon (freon-22). Chlorodifluoromethane. Upon receipt by the reaction of the exchange of chlorine atoms for fluorine as the treatment of chloroform with anhydrous hydrogen fluoride in the presence of antimony (V) chloride (according to the Swarts reaction). Chloroform is used as a solvent in industry for the production of dyes and pesticides.

Chloroform contains deuterium (CDCl3). It is a solvent often used in nuclear magnetic resonance (NMR).

In the process of cleaning. First, chloroform in combination with sulfuric acid is shaken, washed with water, dried over calcium chloride or magnesium sulfate, followed by distillation. Chloroform is checked for purity by evaporation from filter paper. In the presence of chloroform, no odor should remain. When a musty, pungent, irritating smell remains, this proves the presence of impurities of chlorine, hydrogen chloride, or phosgene.

When exposed to the body, inhalation of chloroform has a detrimental effect on the functioning of the central nervous system. With a chloroform content of about 0.09% (900 ppm) in the air, dizziness, fatigue and headache can occur in a short time. Long-term toxic exposure to chloroform can contribute to the development of liver and kidney disease. An allergic reaction to chloroform entails an increase in body temperature (up to 40 ° C) - the presence of such a reaction in approximately 10% of the population has been proven. Chloroform often causes vomiting - the incidence of postoperative vomiting is on average 75--80%.

In rats and mice that breathed air with a chloroform content of 0.003% (30 ppm) in animal studies, the dependence of chloroform on the course of pregnancy was proved, that miscarriages occurred. This has been observed in rats given oral chloroform. The effect on offspring has been proven: the next generations of rats and mice that inhaled chloroform had a higher percentage of birth defects than healthy individuals.

The effect of chloroform on offspring in humans is poorly understood. A lethal outcome is possible with prolonged exposure to the respiratory tract and mucous membranes of a person (2-10 minutes). Presumably chloroform has a mutagenic and carcinogenic effect. Such properties appear when the permissible concentration of chloroform in the air is exceeded.

When ingested, chloroform is quickly excreted with exhaled air: after 15-20 minutes. - 30-50% chloroform, within an hour - up to 90%. The rest of chloroform in the body as a result of biotransformation turns into carbon dioxide and hydrogen chloride. The effect of xylene on the human body.

Xenobiotics (from the Greek. oEnpt - alien and vyapt - life) - chemicals alien to living organisms that are not naturally included in the biotic cycle. This is a conditional category for designation.

Due to human activities, there is an increase in the concentration of xenobiotics in environment. Pesticides, some detergents (detergents), radionuclides, synthetic dyes, polyaromatic hydrocarbons, etc. - this is an incomplete list of xenobiotics. When released into the environment, drugs can cause allergic reactions, death of living organisms, changes the variability of hereditary traits, lowers immunity, disrupts the entire spectrum of metabolism, disrupts the course of processes in natural ecosystems, affecting the biosphere as a whole.

Examples of xenobiotics - xylene, styrene, toluene, acetone, benzene, gasoline or hydrogen chloride vapors - can be classified as xenobiotics at the moment when the maximum allowable concentration exceeds the norm. This accumulation in the environment in much higher concentrations can occur during industrial production.

The biological effect of xenobiotics, for example, with a slight inhalation of benzene vapor, immediate poisoning does not occur. For a long time, the procedure for working with benzene was not particularly controlled.

At high doses of benzene, nausea and dizziness appear, and in some cases, severe poisoning can lead to death. Euphoria is the first sign of benzene poisoning. Benzene vapor can penetrate the upper layers of the skin. Liquid benzene may cause skin irritation. With prolonged exposure to benzene in small quantities on the human body, the consequences become serious. A strong carcinogen can cause leukemia and anemia as a cause of chronic benzene poisoning.

Acute poisoning. At ultra-high concentrations, there is an instant loss of consciousness and lightning death. Bluish coloration of the face, mucous membranes acquire a cherry-red tint. At lower concentrations - similar to alcoholic excitation, then drowsiness, malaise, general weakness, dizziness, nausea, vomiting, headache, accompanied by loss of consciousness. Unstable muscle twitches can turn into tonic convulsions. The pupils are often dilated and unresponsive to light. Increased breathing is replaced by a stop. Hypothermia of the body is sharply reduced. Tachycardia, rapid pulse, small filling. Arterial pressure goes down. possible cases of cardiac arrhythmias.

Long-term health disorders are observed after severe poisoning; they do not lead directly to death, sometimes. There may be pleurisy, inflammation of the upper respiratory tract, diseases of the eyes - cornea and retina, toxic liver damage, cardiac disorders, etc. A case is described shortly after acute poisoning with benzene vapor. There was a vasomotor neurosis with swelling of the face and limbs, sensitivity disorders and convulsions in such cases, death occurs a long time after poisoning.

In chronic poisoning, there is a headache, fatigue, shortness of breath, dizziness, weakness, nervousness, sleep suffers: drowsiness or insomnia, digestive disorders: nausea, sometimes vomiting, decreased appetite, increased urination, menstruation, persistent bleeding from the mucous membrane may appear mouth, especially gums, and nose. Bleeding can last for hours or even days. Sometimes persistent bleeding is observed to occur after tooth extraction. Small petechial hemorrhages in the skin are characteristic. Blood in stools, uterine bleeding, retinal hemorrhage. Direct bleeding and the accompanying hyperthermia (temperature up to 40 ° and above) leads to hospitalization. In such cases, the prognosis is always serious. Secondary infections are superimposed: cases of gangrenous inflammation of the periosteum and necrosis of the jaw are known, there may be ulcerative inflammation of the gums, general sepsis with septic endometritis.

In severe poisoning, symptoms of damage to the nervous system occur. Variety of symptoms: Increased tendon reflexes, bilateral clonus, positive Babinski's sign, deep sensory disorder, disorders with paresthesias, ataxia, paraplegia and movement disorders (signs of damage to the posterior columns of the spinal cord and pyramidal tract).

blood changes are most typical. The number of erythrocytes is usually sharply reduced. The content of hemoglobin falls. The color indicator in some cases is low, sometimes close to normal, and sometimes high (with thickening of the blood during bleeding). Anisocytosis and poikilocytosis and the appearance of nucleated erythrocytes, an increase in the number of reticulocytes and the volume of erythrocytes are noted. Accompanied by a sharp decrease in the number of leukocytes. Sometimes initially leukocytosis, quickly replaced by leukopenia, accelerated ESR. Changes in the blood do not develop simultaneously. Most often, the leukopoietic system is affected earlier, later thrombocytopenia joins. Erythroblasts are affected even later. As a result, a picture of severe poisoning occurs in the form of aplastic anemia.

Dry skin, cracks, itching are observed, with frequent contact of hands with benzene. There may be redness (usually between the fingers), swelling, millet-like blisters. The maximum permissible concentration is 5 mg/m3.

As a rule, xenobiotics inhibit to some extent the nonspecific resistance of the organism. Humoral and cellular immune responses suffer. There are various hypersensitivity reactions (types 1-5, certain reactions of the immune system in this case increase). These reactions may be a manifestation of the immunotoxicity of xenobiotics, as well as suppression of the immune response. It happens when one of the components providing immune homeostasis increases while others are suppressed.

The effect of ethanol (alcohol) on the human body

Ethanol (ethyl alcohol, often colloquially just “alcohol”) is a monohydric alcohol with the formula C 2H 5O H (empirical formula C2H6O), another option: CH3-CH2-OH, the second representative of the homologous series of monohydric alcohols, volatile under standard conditions, flammable, colorless transparent liquid. Ethyl alcohol is also used as a fuel, as a solvent, as a filler in alcohol thermometers, and as a disinfectant (or as a component thereof).

Application.

In medicine, ethyl alcohol is primarily used as a solvent, extractant and antiseptic, as a disinfectant and drying agent, externally; drying and tanning properties of 96% ethyl alcohol are used to treat the surgical field or in some methods of treating the surgeon's hands;

solvent for drugs, for the preparation of tinctures, extracts from plant materials, etc.;

preservative for tinctures and extracts (minimum concentration 18%);

defoamer when oxygen is supplied, artificial ventilation of the lungs;

in warm compresses;

for physical cooling during fever (for rubbing);

a component of general anesthesia in a situation of shortage of medications;

as a defoamer for pulmonary edema in the form of inhalation of a 33% solution;

ethanol is an antidote for some toxic alcohol poisoning, such as methanol and ethylene glycol. Its action is due to the fact that the alcohol dehydrogenase enzyme, in the presence of several substrates (for example, methanol and ethanol), performs only competitive oxidation, due to which, after timely (almost immediately, following methanol / ethylene glycol) intake of ethanol, the current concentration of toxic metabolites decreases (for methanol - - formaldehyde and formic acid, for ethylene glycol - oxalic acid)

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it is 6 months without presenting requirements for work experience.

With this in mind, the administration of the Bureau of Forensic Medical Examination, on the basis of the Order of the Ministry of Health and Social Development of the Russian Federation No. 541 dated July 23, 2010, “On Approval of the Unified Qualification Directory for the Positions of Managers, Specialists and Employees”, decided to train all medical registrars who do not have a secondary medical education, majoring in Medical Registrar. Specialists of LLC Consulting Group "Platon", who have a license for this type of activity, were involved in the training. On-the-job training was completed by 80 people.

Medical registrars studied the basics of labor legislation and labor protection of the Russian Federation; internal rules work schedule Bureau of SME; Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens; professional standard requirements and job responsibilities of a medical registrar. During the training, medical registrars mastered the basics professional activity, including the procedure for registration and acceptance of cadaveric material in accordance with the order of the Ministry of Health of the Russian Federation No. 346 dated May 12, 2010 “On approval of the procedure for organizing and conducting forensic medical examinations in state forensic institutions of the Russian Federation”; received first aid skills; mastered the work with computer information systems. Classes were held in the form of distance lectures, tests, self-study followed by qualifying exams.

The quality of work of the State Budgetary Institution of Healthcare of the Moscow Region "Bureau of Forensic Medical Examination" depends on the quality of administration at all levels, from the head of the bureau to medical workers second and third echelons, including medical registrars. Having received appropriate training, medical registrars can carry out their functional responsibilities up to the mark.

LABORATORY HISTOLOGIST: YESTERDAY AND TODAY

L. V. Danchenko

Bureau of Forensic Medical Examination of the Moscow Region (head - Doctor of Medical Sciences, Prof. A. A. Klevno)

Annotation: The report is devoted to the peculiarities of the work of the laboratory assistant of the histological department

at the present stage of development of histology as a medical discipline.

Keywords: histology, laboratory assistant, laboratory, histological preparation, diagnostics

INTRODUCTION

Histology is the science of studying tissues and organs using a microscope. This medical discipline is an integral part of pathological anatomy and forensic medicine. Histology as a science received its active development in the 18th century, and in the 19th century it became an integral part of the diagnosis of various pathological processes. It was during this period that the need arose for the emergence of such a specialty as a laboratory assistant. The main task of the laboratory histologist is to make

preparation of histological preparations from pieces of organs and tissues, which the doctor then examines under a microscope. Since the emergence of histology as a discipline to the present day, the basic principle of preparation preparation remains the same.

The processing of tissues taken for histological examination is a very laborious, complex and lengthy process. On average, the preparation time of the drug can take 5-7 days. This is due to the fact that this process is still carried out manually. Various chemicals are used to treat tissues, many of which are toxic. Under these conditions, various errors in the technological process are possible. All this affects the quality of the histological preparation and, as a result, the quality of the histological examination itself, which is carried out by the doctor. Therefore, the laboratory assistant requires special theoretical knowledge, strict adherence to all stages and time parameters of tissue processing, as well as possession of special practical skills. At the same time, the laboratory histologist must not only be professionally trained, but also have attention, perseverance, patience and responsibility.

In the last decade, there has been an active development of the histological method of research. This is due to its widespread use in the lifetime diagnosis of various diseases in pathological anatomy. In forensic medicine, an increase in the number of histological studies is associated with a change in the structure of mortality (the predominance of non-violent), the complexity of the material entering the histological department, and the range of issues to be resolved. To expand the possibilities of the histological method of research, the laboratory assistant-histologist must have the skills to carry out various types of stains. The recommended list of stains, which allows solving more diagnostic problems, includes more than 20 items. All this increases the volume of histological examination by increasing the number of preparations. However, the number of preparations and additional staining methods are not taken into account when determining the workload of a laboratory assistant. In addition, the number of available rates often does not correspond to the volume of work performed in laboratories. All this, unfortunately, does not stimulate the introduction of additional new stains and methods of histological examination (morphometry, polarizing microscopy, etc.).

In order to facilitate the work of a laboratory assistant and due to the need to conduct a large number of histological studies in a shorter time and with high quality, over the past 10-15 years, semi-automatic and automatic devices have been actively developed that can be used at each stage of material processing. Changing from manual to automatic method tissue processing allows you to maximize the quality and reduce the time of the process of fixing, wiring, pouring and staining preparations. These devices can be used around the clock, have a delayed start. This reduces the production time of histological preparations from 7 to 3-4 days, even in cases where a large number of objects of study are received.

In connection with the introduction of new technologies in the production process of preparations, new requirements are imposed on the laboratory assistant of the histological department. This is additional special knowledge for working with complex equipment and a computer, programming skills. General knowledge in the structure of tissues and organs, the main general pathological processes, is necessary. This is due to the introduction into practice of using

monitoring the quality of manufactured histological preparations under a microscope by the laboratory assistants themselves.

Thus, I would like to note that at the present stage, the possibilities of the histological method of research are not fully used everywhere. This is associated with many difficulties, and primarily with funding opportunities. In order to introduce new technologies and increase the number of ongoing research, high-tech equipment and expendable materials, which requires large financial investments that not every medical institution can afford.

We bring to your attention a typical example of a job description for a laboratory assistant, a sample of 2019/2020. Job description of a laboratory assistant should include the following sections: general position, duties of a laboratory assistant, rights of a laboratory assistant, responsibility of a laboratory assistant.

The following items should be reflected in the job description of the laboratory assistant:

Job responsibilities of a laboratory assistant

1) Job Responsibilities. Performs laboratory analyses, tests, measurements and other types of work in research and development. Participates in the collection and processing of materials in the course of research in accordance with the approved program of work. Maintains and maintains laboratory equipment. Prepares equipment (instruments, apparatus) for experiments, carries out its verification and simple adjustment in accordance with the developed instructions and other technical documentation. Participates in the implementation of experiments, carries out the necessary preparatory and auxiliary operations, conducts observations, takes instrument readings, and keeps work logs. Provides the employees of the department with the necessary equipment, materials, reagents, etc. Processes, systematizes and draws up, in accordance with methodological documents, the results of analyzes, tests, measurements, and keeps records of them. Produces a selection of data from literary sources, abstract and information publications, normative and technical documentation in accordance with the established task. Performs various computational and graphic works related to ongoing research and experiments. Participates in the preparation and execution of technical documentation for the work performed.

The lab should know

2) The laboratory assistant in the performance of his duties must know: guidance, normative and reference materials related to the subject of work; methods for conducting analyses, tests and other types of research; current standards and specifications for the developed technical documentation, the procedure for its execution; laboratory equipment, instrumentation and rules for its operation; methods and means of performing technical calculations, computational and graphic works; fundamentals of economics, organization of labor and production, rules of operation computer science; fundamentals of labor legislation; internal labor regulations; labor protection rules and regulations.

Laboratory qualification requirements

3) Qualification requirements. The average professional education without presenting requirements for work experience or initial vocational education and work experience in the specialty for at least 2 years.

1. General Provisions

1. The laboratory assistant belongs to the category of specialists.

2. A laboratory assistant accepts a person who has a secondary vocational education without presenting requirements for work experience or primary vocational education and work experience in the specialty for at least 2 years.

3. Laboratory assistant is hired and dismissed _____ (director, manager) organizations on the submission of _____ (position) .

4. The laboratory assistant must know:

guidance, normative and reference materials related to the subject of work;
methods for conducting analyses, tests and other types of research;
current standards and specifications for the developed technical documentation, the procedure for its execution;
laboratory equipment, instrumentation and rules for its operation;
methods and means of performing technical calculations, computational and graphic works;
fundamentals of economics, organization of labor and production, rules for the operation of computer technology;
fundamentals of labor legislation;
internal labor regulations;
labor protection rules and regulations.

5. In his activities, the laboratory assistant is guided by:

the legislation of the Russian Federation,
Charter (regulations) of the organization,
orders and directives _____ (CEO, director, leader) organizations,
this job description,
The internal labor regulations of the organization,

6. Laboratory assistant reports directly to: _____ (position).

7. During the absence of a laboratory assistant (business trip, vacation, illness, etc.), his duties are performed by a person appointed ______ (position) of the organization in the prescribed manner, who acquires the appropriate rights, duties and is responsible for the performance of his duties.

2. Job responsibilities of a laboratory assistant

Laboratory assistant:

1. Performs laboratory analyses, tests, measurements and other types of work in research and development.

2. Takes part in the collection and processing of materials in the process of research in accordance with the approved program of work.

3. Monitors the good condition of laboratory equipment, carries out its adjustment.

4. Prepares equipment (instruments, equipment) for experiments, checks and easily adjusts it in accordance with the developed instructions and other technical documentation.

5. Participates in the implementation of experiments, carries out the necessary preparatory and auxiliary operations, conducts observations, takes instrument readings, and keeps work logs.

6. Provides the employees of the department with the equipment, materials, reagents, etc., necessary for work.

7. Processes, systematizes and draws up, in accordance with the methodological documents, the results of analyzes, tests, measurements, keeps records of them.

8. Makes a selection of data from literary sources, abstract and information publications, normative and technical documentation in accordance with the established task.

9. Performs various computational and graphic works related to ongoing research and experiments.

10. Takes part in the preparation and execution of technical documentation for the work performed.

3. Rights of the laboratory assistant

The laboratory assistant has the right:

1. Submit proposals for management consideration:

to improve work related to the provisions of this responsibilities,
on the encouragement of distinguished workers subordinate to him,
on bringing to material and disciplinary liability employees who violated production and labor discipline.

2. Request from structural divisions and employees of the organization the information necessary for him to perform his duties.

3. Get acquainted with the documents that define his rights and obligations in his position, the criteria for assessing the quality of performance of official duties.

4. Get acquainted with the draft decisions of the organization's management regarding its activities.

5. Require the management of the organization to provide assistance, including the provision of organizational and technical conditions and execution of the established documents necessary for the performance of official duties.

6. Other rights established by the current labor legislation.

4. Responsibility of the laboratory assistant

The laboratory assistant is responsible in the following cases:

1. For improper performance or non-performance of their official duties provided for by this job description - within the limits established by the labor legislation of the Russian Federation.

2. For offenses committed in the course of their activities - within the limits established by the current administrative, criminal and civil legislation of the Russian Federation.

3. For causing material damage organizations - within the limits established by the current labor and civil legislation of the Russian Federation.

The job description of a laboratory assistant is a sample of 2019/2020. The duties of a laboratory assistant, the rights of a laboratory assistant, the responsibility of a laboratory assistant.

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