Patient Injury From Flash-Sterilized Instruments

Clinical Issues—January 2021

“…1 The surgical team should allow enough time for instruments to cool after sterilization before using them in the surgical wound. 8,10 However, there may be instances when instruments are needed before they are cool enough to be used in patient care. When this occurs, the scrub person may use a new sterile basin and freshly opened sterile water to cool the instruments to prevent placing hot instruments into potentially contaminated solutions.…”

Cleaning and Disinfection of Patient Care Items, in Relation to Small Animals

“…Typical conditions are 132 C for 3 minutes and 27 to 28 pounds of pressure in a gravity displacement autoclave. 3 Ineffective flash sterilization has been implicated as a cause of surgical site infections 4 and patient burns from hot instruments, 5 and this approach must only be used as an emergency measure. Typically, this method is indicated when an item is dropped (or otherwise contaminated) during surgery and no sterilized replacements are available.…”

Parental Perceptions about Required Influenza Immunization

“…3,4 A technical reference manual, fully detailing all aspects of theory and practice, has been freely available since 2010. 5 Conversely, the other approaches cited by Woeltje et al 1 variously fail to document underlying statistical theory such that their sample size appears arbitrary (thus lack statistical power details); oversample large hospitals while exempting smaller ones (thus may not build overall public confidence nor ensure all facilities subject to public comparisons are on a level playing field); fail to set and enforce a prespecified level of sensitivity and specificity performance (thus do not accomplish the quality assurance that validation is understood to provide in all other industries); and appear to require larger workloads than the method used by Washington State (thus may not be the most cost-effective). In my own experience, it is essential to review each entire clinical and laboratory record for "external" validation of sampled cases, best done on a site visit, and then discuss results with local program leadership, rather than to rely solely on laboratory information systems or remote access for "external" validation.…”