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Infection Control - Type N Autoclave

Discussion in 'General Issues and Discussion Forum' started by toughspiders, Aug 24, 2009.

  1. toughspiders

    toughspiders Active Member


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    Ok

    here is my dilemma. I have a type N autoclave - this is a steam autoclave with vacuum assist for air removal. It does not allow the sterilisation of bagged or pouched items.

    I have read through the apodc guidelines and i know that i need to use indicator strips.

    I have never used these before...is it just one per cycle?

    I may need to transport the instruments, how do i ensure sterility. I ideally would like to bag the items but obviously cannot sterilise the items bagged.

    Any suggestions would be good.

    Many thanks
     
  2. Nat Smith

    Nat Smith Active Member

    All instruments must be sterilised in pouches. There's no getting around it. You can't do them in steel trays and bag them afterwards..they will be contaminated. Sorry, I don't really see any way around this for you...I think you're going to have to buy or lease a new autoclave. What have you been doing previously or currently, because this has been fairly standard protocol for years?
     
  3. Graham

    Graham RIP

    Agreed. I use two Ritter M9 autoclaves. Both I got from ebay. Had serviced before use. Very good. You can do wrapped or pouches with these and most upper line autoclaves.
     
  4. Hi

    at university when we were taught how to use the autoclaves each set of instruments required their own strip per cycle.

    Hope this helps :)
     
  5. toughspiders

    toughspiders Active Member

    Thanks,

    I brought my Autoclave with me from the UK. I have read the APODC guidelines which say bagging is recommended, it doesnt prohibit the use of N autoclaves.
    I think ive already resigned myself to the fact that i may need to buy a new autoclave. Trouble is they seem so expensive here and there seems to be a shortage of second hand ones.

    Regards
     
  6. Graham

    Graham RIP

    Try ebay canada - ritter m9 -there are some really good deals. We use 110v same as the US.
     
  7. pgcarter

    pgcarter Well-Known Member

    $6 TO $7K gets you a lovely big chambered 23S or VS from Melag, up to 20 bags per cycle 4 kg of tools at once, great value in terms of operating cost. It's not that much compared to what you should be charging, and I can't believe you are not already bagging, it's been absolutely standard practice for at least 8 years. You should have a look at your liability insurance and find out if it will cover you for doing anything but recommended best practice, because it probably won't.
    regards Phill Carter
     
  8. pgcarter

    pgcarter Well-Known Member

    As a matter of interest, what is the difference about an N autoclave, if it gets to the same pressure and temp why would it not be OK for bagging tools?
    regards Phill
     
  9. toughspiders

    toughspiders Active Member

    I just moved here from the uk where bagging was not an issue. Before i moved here we moved onto disposable instruments. So the autoclave has not been used for some time. 6K is a lot of money really when you are trying to start up, especially with everything else as well and also if you are hoping to just have a small amount of patients to start.

    The N type autoclave is a steam autoclave mine also has a vacuum to drive out the air ...the problem with them is...or they reckon...if the instruments are bagged, there may be air pockets around the instruments that prevent the steam getting to all aspects of the instruments.

    So there we are....may have to go and sell my bod to pay for a new autoclave :eek:
     
  10. cpcpod

    cpcpod Member

    From what I understand we need to use a Type S autoclave. I have one but the printer has stopped working. I have been told that it cannot be repaired as it is a problem with the circuit board in the autoclave rather than the printer itself. it is a Siltex E model - no longer made (only 5 years old). Can anyone advise whether i will still meet standards if I do not use a printer - are test strips in each pack Ok and do these need to be kept for validation records of the cycles.
    If I need to get a new autoclave then any recommendations on good autoclaves that have good maintenance records. we have had a problem with Siltex over the years!!! We use a 23 litre machine to fit our instruments in!!
     
  11. Nat Smith

    Nat Smith Active Member

    cpcpod
    I don't think you necessarily need to have a printer, as long as you keep an accurate logbook for cycles and use indicator strips to ensure that sterilisation is reached. Also doing a yearly service and biological test.

    toughspiders
    I would highly recommend the Melag series of S class autoclaves. I was under the impression that the S class was the required standard here, correct me if I'm wrong anyone? At $6-7K brand new they are indeed quite pricey for a pod starting up...why don't you look at leasing one? Contact Medfin or someone of that ilk who you can lease it off...it should only be a $100 or so a month and a lease is tax deductable in your quarterly BAS..talk to your accountant there for advice on that score.

    Phil
    I have a Melag 23S and use a stand-up style tray..I can only get 12 pouches in a cycle...how do you get 20 in?..do you use some other tray set-up? I try to not let the bags touch or lie on each other in any way.
     
  12. pgcarter

    pgcarter Well-Known Member

    The specs for the machine say max 20 bags and specify a max total weight (about 4kg from memory) of tools for a cycle. I use a toast type rack and you can fit a tray in above that if you want. The limit seems to be the drying capacity, which is limited by the fact that the S is a displacement type machine not a VS with the vacuum assissted emptying of the chamber, which more effectively pulls the humidity out of the chamber at the end of the cycle meaning that the bags and contents dry better. I tend to put 12 sets plus small single bits etc. Next time I buy one I am going to buy a VS which should dry better, it's only about $1K more. The size of the investment is all relative, for 20years I was a retailer with $6-800K of capital at risk every time it did not snow and I never made as much as I do out of podiatry, so at a total capital investment of about $50k including a well equipped workshop, I think the whole caper is set up pretty cheaply, and it snows every week in this business.
    regards Phill
     
  13. Heather J Bassett

    Heather J Bassett Well-Known Member

    Hi I think you do need to have a print out to comply with the latest standards and very packs has its own test strip. Still need to log and calibrate and biological test as well.
    Vs is set up for hollow intruments that we do not generally use? Is this right?
    The cost of the machine is only one part to look at. You then need someone to calibrate it. The cost and the competency of this varies dramatically. Depending on where you are as to who you can get to service ti, calibrate it, and if you do not have your own biological testing equip, then they need to be able to do this for you too.

    Cheers

    Cheers
     
  14. toughspiders

    toughspiders Active Member

  15. cpcpod

    cpcpod Member

    Thanks for the reference. Looking thru this it seems that printers are not necessary as long chemical indicators type 4,5 or 6 are used in each load. Calibration, Validation and biological testing annually still needs to be done. Thanks for your input!
     
  16. Mint80

    Mint80 Welcome New Poster

    Hi Toughspiders
    if you are just starting out and don't want to buy a new autoclave till you can justify it, try contacting local hospitals or other podiatry services and see if you can contract out your sterilising. This will be more economical while you still have a small client base.
    Sam
     
  17. vickyg

    vickyg Welcome New Poster

    Re: Infection Control - Autoclaves

    Hi

    I am new to this sight...but came across this thread whilst surfing the web, for an assignment.

    I am currently studying the Foot Health Diploma and at present have an assignment to complete regarding current sterilisation methods opposed to disposable instruments. I have alot to say re price, infection, disposing of such instruments etc.....finding the info to back me up is difficult.

    I would like to know if anyone can advise me what policies do Podiatrists follow? where do you get such policies from? as I have nothing to back me up so to speak, that sterilisation is the current method...and I see from this thread, there maybe changes to the use of an autoclave, where do you gain such information from?

    Any info I would really appreciate.

    Kind Regards Vicky
     
  18. pgcarter

    pgcarter Well-Known Member

    There is a link in one of the above posts
    Phill
     
  19. erin

    erin Member

    Hey! I am a new grad and have been given the task of finding an autoclave for a second clinic (currently we are ferrying instruments to the more established clinic to sterilise) and i've been confused by the infection control guidelines.

    I was under the impression that i needed a class s steriliser however the guidelines make no mention of this, they call them assisted air removal, pre-vacuum bench top and basic bench top.

    so my question is have they just been re-named or is there a difference?? and if so, what is it? do they make those named above as separate models to be able to carry out the different class cycles or is each one just each class renamed??

    (sorry if that doesnt make sense im a tad confused)
     
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