Did you read confusing STATIM information in the old APP Procedure Manual? (prior to 2013 edition)

• STATIM in the old APP Procedure Manual
  • The wrong impression?
  • Important sterilization facts
  • Correcting the misunderstanding:

STATIM in the old APP Procedure Manual

In the current 2013 edition of the APP Procedure Manual, I helped correct the previously confusing references to Statim autoclaves.

The current 2013 version of the guidelines refer to the Statim and the acceptable use of unwrapped sterilization methods.

Quotes from the 2013 APP procedure manual:

Sterilization Methods:

Benchtop Sterilization

• Steam under pressure (saturated steam/steam autoclave): 220-270 kpa pressure at 132° Centigrade (270° Fahrenheit) for 3-40 minutes depending on cycle.
  • Steam autoclave process types
    • Steam flush-pressure pulse (type S):
      “Another design in steam sterilization is a steam flush-pressure pulsing process, which removes air rapidly by repeatedly alternating a steam flush and a pressure pulse above atmospheric pressure. Air is rapidly removed from the load as with the prevacuum sterilizer, but air leaks do not affect this process because the steam in the sterilizing chamber is always above atmospheric pressure. Typical sterilization temperatures and times are 132°C to 135°C with 3 to 4 minutes exposure time for porous loads and instruments.” The Statim is an example of a type S steam flush pressure pulse autoclave, which is acceptable for sterilization.

 

Aseptic Field

The actual procedure surface is referred to as an “aseptic field,” and is a sterilized surface that becomes exposed to air contact only at the beginning of the piercing procedure. The aseptic field used by most piercers is the sterile inside surface of a freshly opened large autoclave or sterile glove package, Statim cassette, rigid sterilization container, or sterilized tray. Once the package is opened, sterile tools, needles, jewelry, and disposables can be dropped onto the inside surface for use. The exterior of sterilized packages such as those containing the jewelry should not touch the aseptic field; the contents should be carefully dispensed onto it.

DISPOSABLE SUPPLIES

To minimize the risk of cross-contamination and to ensure that piercing room procedures are as clean as possible, many components of the tray setup must be disposable. Unless supplies are purchased presterilized* or will be sterilized in an autoclave immediately prior to the procedure, all disposables must be individually packaged in autoclave bags, sterilized, and remain intact in their pouches stored in enclosed, nonporous drawers or containers until use. Disposable materials that must be sterilized include: marking implements, piercing needles, corks or synthetic stoppers, elastic bands, swabs, and gauze.

* This includes only FDA-cleared items that are commercially sterilized according to accepted medical standards. The supplier must make documentation of appropriate sterilization available.

The following is to clarify the inconsistencies in the previous editions:

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