September 30, 1994
VA HVAC Design Manual for EtO exhaust
Sonic Cleaner
system design requirements.
When surgical instruments and similar
hospital type hardware are brought to SPD for
decontamination and sterilization, they are
Auto Transport System
placed in the sonic cleaner. Sonic cleaners are
Distribution of medical and surgical supplies
single or double chamber devices using sonic
and equipment is accomplished by a combination
energy to clean instruments in a water-soap
of manual vertical and horizontal transport
solution.
systems.
The distribution process is often
cumbersome, time consuming, and requires
many personnel (as with nurses) whose primary
Washer/Sterilizer
responsibilities pertain to patient healthcare.
After the instruments have undergone
This has prompted the VA to explore the
ultrasonic cleaning, they are placed into the
possibilities of installing an automatic transport
washer/sterilizer. The instruments are washed a
system. An automatic system replaces a portion
second time before final sterilization. Again it
of the manual labor involved in materials
should be noted that after the secondary wash
handling with one of a number of varieties of
cycle, the instruments are decontaminated, but
electromechanically
controlled
apparatus
not sterilized.
It is at this point that the
designed to transport supplies between where
instruments can now be sterilized in the washer/
they are stored or cleaned and where they are
sterilizer. The difference between a washer/
needed.
sterilizer and a typical sterilizer is that the
The carts for the system are equipped with
washer/ sterilizer is for decontaminating as well
container modules where supplies can be sealed,
as terminal sterilization. The steam sterilizer is
therefore eliminating the possibility of cross
solely for terminal sterilization.
contamination. From a central control station,
the carts can be guided to make one or a series
of stops throughout the hospital. When it has
Sterilizers (Steam)
completed its distribution cycle, it can be used to
After surgical instruments and utensils are
return soiled items to the hospital's central
cleaned, either manually or through a sonic
processing area.
After the cart has been
cleaner, they are decontaminated, but not sterile.
emptied, it goes through an automatic washer-
Steam is often used as a sterilizing agent
sterilizer, where the carts are decontaminated
because it is the most effective and efficient way
and sterilized.
of sterilizing equipment.
There are several VA medical centers that
have installed an automatic distribution system in
their hospitals. The first one to have done so is
Sterilizers (Ethylene Oxide)
the medical center in San Diego, California,
Although steam sterilizers are cost effective
which was installed in the early 1970s. Since
and efficient, certain equipment is not suitable for
then some other VA medical centers that have
sterilization in steam sterilizers because they are
followed suit are:
Minneapolis, Minnesota;
not able to withstand intense heat. In this case,
Houston, Texas; and Bay Pines, Florida. The
ethylene oxide gas is used. EtO sterilization
installation of an automatic transport system is
however can cause skin irritation and severe
not standard for newly constructed or newly
burns to SPD staff.
Proper aeration must
renovated medical centers and should be
therefore follow the process.
considered on a project by project basis.
A dedicated exhaust system should be
It must be noted however, that the
provided to exhaust air from EtO sterilizer
installation of an automatic transport system is
mechanical chase to the outdoors. Consult the
not the sole decision of SPD, although SPD
VA Design Guide -- Supply, Processing, & Distribution
Page 2-7
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