This Flow Chart is a Summary of Actions for a Surgical Procedure. Is the patient undergoing a procedure where higher-infectivity tissue (Table 1) will be exposed? Yes Is the patient classified has high risk (Appendix 1) or low risk (Appendix 2) for CJD? No – Proceed using routine processing of instruments Is the patient undergoing a procedure where higher-infectivity tissue (Table 1) will be exposed? Yes Use additional procedures (Table 3) Incinerate instruments immediately after use OR For those patients who are awaiting determination of risk status reprocess reusable instruments separately and quarantine instruments pending determination of risk status of patient (then incinerate if deemed high or low risk or reprocess and put back into circulation if risk is found to be background) OR Reprocess reusable instruments separately and keep for the exclusive use of an individual patient involved in a course of therapy (then incinerate when no longer required)