Site of Blood Collection Amount of Blood Collected at any one time, expressed as volume (ml) and as % of body weight (assume 1 ml = 1 gram) Number of Collections Time Interval(s) Between Successive Collections Volume (yes/no) Will anesthetics, tranquilizers, or analgesics be administered for blood collection? ► ( ) No anesthetics, tranquilizers, or analgesics will be administered for blood collection. Explain why it is appropriate or necessary NOT to administer pain-relieving agents: ► ► ( ) Yes. Describe the administration of pain-relieving agents, including the name of each and its dose (mg/kg), volume (ml), and route and frequency/duration of administration (Make sure this information is also included in Appendix 3): ► Will volume replacement be provided for blood that is collected? ► ( ) Volume will NOT be replaced for some of the blood collection listed. For each collection listed in Item 2.a, above, for which volume will NOT be replaced, explain why not. ► ► ( ) Volume WILL be replaced for some of the blood collection listed. For each collection listed in Item 2.a, above, for which volume WILL be replaced, describe the replacement(s) that will be provided (including the composition of the replacement(s), volume, and route of administration). ► Terminal Blood Collection. Will animals be euthanatized by exsanguination, for harvest of antibodies? ► ( ) No, this protocol does NOT involve terminal blood collection for harvest of antibodies. ► ( ) Yes, this protocol DOES require terminal blood collection for the harvest of antibodies. Make sure this is included in Item R of the ACORP, and complete Items 3.a., 3. b., and 3.c., below: Describe the method(s) to be used for euthanasia and exsanguination:
(Identify the specific agent, device, strain, construct, isotope, etc.) (Identify the vendor or colleague, or specify which animals on this protocol will serve as donors) Toxic Agent (Item 4) Infectious Agent (Item 5) -- Enter the CDC Biosafety Level (BSL 1, 2, 3, or 4) Biological Agent (Item 6) Radioactive Agent (Item 7) Contains Recombinant Nucleic Acid (Item 8) Routine Pre- or Post-Procedural Drug Euthanasia agent ( ) ( )BSL_ ( ) ( ) ( ) ( ) ( ) ( ) ( )BSL_ ( ) ( ) ( ) ( ) ( ) ( ) ( )BSL_ ( ) ( ) ( ) ( ) ( ) ( ) ( )BSL_ ( ) ( ) ( ) ( ) ( ) ( ) ( )BSL_ ( ) ( ) ( ) ( ) ( ) ( ) ( )BSL_ ( ) ( ) ( ) ( ) ( ) number of cells, mCi protocol will serve as donors) the xpected to be painful or distressing to the animals? inding agents)__Summary of How Materials will be Administered. Complete the table below for each of the materials shown in the table in Item 1 above: Material* (Identify the specific agent, device, strain, construct, isotope, etc.) Dose (e.g., mg/kg, CFU, PFU, number of cells, mCi) and Volume (ml) Diluent* or Vehicle* Route of admin Frequency or duration of admin Reason for Administration and Expected Effects Location of Further Details in this ACORP (specify “Main Body” or “App #”, and identify the Item) Administration Under Anesthesia, sedation, or tranquilization (Y/N)
Personnel. Complete the table below for each individual who will be involved in any of the surgeries on this protocol. Name Surgery #(s) (see Item 1) Role in Surgery Surgeon Assistant Manage Anesthesia Other (describe) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) Location of surgery. Complete the table below for each location where surgery on this protocol will be performed. Building Room Number Surgery #(s) (see Item 1) Type of Space Dedicated Surgical Facility Dedicated Surgical Space Other Space not Dedicated to Surgery ( ) ( )* ( )* ( ) ( *) ( )* ( ) ( )* ( )* ( ) ( )* ( )* *For each space that is not in a dedicated surgical facility, provide the justification for using this space for surgery on this protocol ► Pre-operative protocol. Pre-operative procedures. Complete the table below for each pre-operative procedure that will be performed to prepare the animal(s) for surgery.