The CDC finished updating its latest version of the Guidelines for Disinfection and Sterilization in Healthcare Facilities in November. The new publication represents the first comprehensive overhaul of this document since the 1980’s. At a hefty 158 pages, this isn’t exactly light reading. However, it is definitely written with an emphasis on clarity. The terminology is simple enough for an entry level hospital technician to easily grasp. This booklet will make a valuable addition to the library of any employee responsible for following proper disinfection protocols. It is available for download at the CDC website in Adobe format. Of special interest is the section on flash sterilization issues.
This controversial decontamination technique has been the source of much discussion in the past and that certainly hasn’t changed. Flash processing is the quick and “dirty” version of steam processing medical instruments. This method is used when there is no time to run a full length autoclave cycle and there are no spare instruments available. In the middle of a life or death surgery, doctors must make the call on how to clean an item that falls on the floor or otherwise becomes contaminated. If there is no replacement, they may choose to simply have it run through a fast cycle and put it back to work.
The CDC publication states “correctly performed flash sterilization is an effective process for the sterilization of critical medical devices”(p60). The problem is that proper procedures are sometimes ignored. In the rush to get instruments back to the operating room, mistakes can be injurious or fatal. The risk of surgical site infection skyrockets if any steps in this complex procedure are skipped. Burns have also been known to occur when items are not cooled to a safe temperature before use.
Possible Dangers And Some Solutions
Because instruments are cleaned in open trays or pans, they can quickly become re-contaminated with microbes. This can happen even on the short trip from the sterilizer back to the OR. For this reason, some hospitals are now choosing protective packaging that allows steam penetration but still provides a shield against airborne bacteria. Other facilities locate the sterilization room as close to operating theaters as possible to reduce transit time.
Since the run time for a flash cycle is only 3 minutes or so, the risk of some organisms being left alive is higher than with regular processing. To find out if a particular load was indeed sterile, a bio indicator test must be run. These usually take 24-48 hours to deliver results. Obviously, by this time the surgery is over and any damage has already been done. Even with newer tests that can be read within an hour, the problem still persists. Records must be kept for each load so that personnel can follow up. Patients who were accidentally exposed to inadequately sterilized instruments require close monitoring and additional antibiotics.
This method should never be used simply for the sake of convenience. Maintaining sufficient inventory of all instruments is one way to avoid circumstances in which flash processing is necessary. This type of sterilization should only be done by employees who fully understand the consequences of a mistake. As always, proper training is the best protection against errors. Having the right information makes all the difference.
Whether your facility performs regular steam autoclaving or other forms of sterilization, you can benefit from access to current information also. We provide this report on autoclaves free of charge so you can make the right choice for your next equipment upgrade.