Sterile Supply

Children with special health care needs will require additional considerations during mass casualty or disaster care. These considerations include decontamination procedures following radiation or chemical exposure for children using wheelchairs, ventilators, or oxygen and decontamination procedures for children with gastrostomy tubes, tracheostomy tubes, indwelling bladder catheters, and indwelling central venous catheters. Replacement supplies would be needed once the cutaneous decontamination is completed. Such supplies may not be readily available, so provisions must be made to secure these items or to have comparable clean or sterile supplies on hand. 

Decisions as to whether a chemostat or a batch reactor is preferable for use in a particular application depend on a number of factors. However, an important consideration is whether or not the enhancement in productivity associated with the use of a continuous fermentation process is sufficient to offset the difficulties associated with this mode of operation the need for continuously feeding sterile supplies of the growth medium and (if appropriate) either air or oxygen, the potential for other modes of contamination of the fermentation broth, the potential for mutation of the microorganism, and so on. As an introduction to these considerations, let us consider the relative productivities of... 

Some scientific studies indicate that the gam in performance obtained through the use of anabolic steroids is small This may be a case though in which the anecdotal evidence of the athletes may be closer to the mark than the scientific studies The scientific studies are done under ethical conditions in which patients are treated with prescription level doses of steroids A 240 pound offensive tackle ( too small by todays standards) may take several ana bolic steroids at a time at 10-20 times their pre scribed doses in order to weigh the 280 pounds he (or his coach) feels is necessary The price athletes pay for gams in size and strength can be enormous This price includes emotional costs (friendships lost because of heightened aggressiveness) sterility testicular atro phy (the testes cease to function once the body starts to obtain a sufficient supply of testosterone like steroids from outside) and increased risk of prema ture death from liver cancer or heart disease... 

Table 3. Minimum Exposure Periods for Sterilization of Hospital Supplies ...

Batch processing A processing technique in which a bioreactor is supplied with substrate and essential nutrients, sterilized and inoculated with microorganisms, and the process is run to completion followed by removal of products. 

The medium was contained in a 100 liter stainless steel baffled fermenter, agitated by a TA inch vaned disc impeller at 140 rpm. Sterile air was supplied at 75 liters per minute and the tank incubated for 72 hours at 26°C. 

Sterile air was supplied at 1,200 liters per minute. Antifoam was added in 25 ml amounts as required. (10% Piuronic LSI in soybean oil.) The fermentation was controlled at 26°C until a maximum yield of clevulanic acid wes obtained between 3-5 days when 200-300 /.Ig/ml of clavulanic acid were produced. 

The spores from an inclined culture of Fusarium lateritium Wr, CSB 119.63 on a gelose medium are extracted with sterilized distilled water to obtain a suspension containing about 600,000 spores per ml. This suspension is then used to seed the medium prepared as earlier described. The contents of the flask are left to incubate at 27°C. Sterile air is injected into the liquid to effect thorough agitation and uniform supply of oxygen into the medium. 

The mold isolated by Alexander Fleming in early 1940s was Penicillium notatum, who noted that this species killed his culture of Staphylococcus aureus. The production of penicillin is now done by a better penicillin-producing mould species, Penicillium chryso-genum. Development of submerged culture techniques enhanced the cultivation of the mould in large-scale operation by using a sterile air supply. 

In a batch production of penicillin, 40 m3 capacity of the plant, sterile air is required to be supplied. The bioreactor requires 1 vvm (volume of air/volume of broth, min). The incoming air contains 3000cells/m3 of air, for 100 hours operation. Calculate the depth of filter, if the penetration of bacteria is 1 in 1 million. 

A batch production of penicillin of 40 m3 capacity is required to supply sterile ah through bioreactor at 1 volume of ah per volume of culture per min (1 win). Incoming ah contains... 

In radiation sterilization of disposable supplies such as hypodermic syringes, needles, catheters, and sterile dressings in medicine. 

Filtered air may be used to purge a complete room, or it m be confined to a specific area and incorporate the principle of laminar flow, which permits operations to be carried out in a gentle current of sterile air. The direction of the airflow may be horizontal or vertical, depending upon the type of equipment being nsed, the type of operation and the material being handled. It is important that there is no obstruction between the air supply and the exposed product, since this may resnlt in the deflection of microorganisms or particulate matter fiom a non-sterile surface and canse contamination. Airflow gauges are essential to monitor that the correct flow rate is obtained in laminar flow units and in complete suites to ensure that a positive pressure fiom clean to less clean areas is always maintained. 

Steam for sterilization can either be generated within the sterilizer, as with portable bench or instrument and utensil sterilizers, in which case it is constantly in contact with water and is known as wef steam, or can be supplied underpressure (350-400kPa) from a separate boiler as dry saturated steam with no entrained water droplets. The killing potential of wef steam is the same as that of dry saturated steam at the same temperature, but it is more likely to soak a porous load creating physical difficulties for further steam penetration. Thus, major industrial and hospital sterilizers are usually supplied with dry saturated steam and attention is paid to the removal of entrained water droplets within the supply line to prevent introduction of a water fog into the sterilizer. 

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