# STANDARD OPERATING PROCEDURE - 4006 

**[PREPARING AND REMOVING LOADS FROM STERILIZERS]{.underline}**

PURPOSE: To establish a standard operating procedure that identifies
processes that will ensure proper item placement and removal from the
sterilization carriage.

POLICY: Loading procedure for the sterilizer must allow for free
circulation of sterilant around each package and item.

RESPONSIBILITY: SPD Technicians

PROCEDURE:

1\. Loading:

a\. The sterilizer carts and baskets must be loaded in an orderly
manner.

b\. Adequate space must be provided so that the sterilant can freely
circulate. A

> vertical hand should be able to easily pass between the individual
> packages.

c.  Small items should be placed in a wire basket or similar container
    to keep

> items from moving around during the sterilization cycle. The container
> must
>
> allow for free circulation of the sterilant.

d.  All textile packages are placed on edge to promote passage of steam
    through the pack.

e.  Materials capable of holding water, such as basins and solid bottom
    trays, must be positioned on edge, faced in the same direction to
    allow for condensation elimination.

f.  In a mixed load, linen items should be placed on top shelf and metal
    items on bottom shelf.

g.  Packaging systems such as peel packs are to be placed on edge, paper
    to plastic and properly spaced to allow for free circulation of the
    sterilant.

h.  Peel packs may be used to isolate small items in container systems.

i.  All perforated sterilization containers must be placed flat on the
    cart to assure effective sterilization.

j.  Items placed on the sterilization cart must not come into contact
    with the sterilizer wall. Allow at least three inches between the
    sterilizer chamber and the top most package of the load.

2\. Unloading:

a.  Items that have been removed from the sterilizer should not be
    handled during the cooling process.

b.  During the cooling process, the sterilization carriage should be
    placed in a low traffic area where no air conditioning or other cold
    vents are in close proximity.

c.  Warm items must never be transferred from the carriage to cold metal
    racks or shelving.

d.  Items must be handled as little as possible to avoid the increased
    risk of contamination.

e.  Items removed from the cart after cooling should be inspected for
    any compromise in packaging.

f.  Lot control numbers and expiration dates are then applied. The lot
    control number is a six-digit number with the first number being the
    sterilizer number, the next three numbers are the Julian date and
    the last two digits are the cycle number. Shelf life date -- 30 days
    or one year.

3\. Other considerations:

#### Steam Sterilization

a.  Sterilization of items such as reusable specialty needles, reusable

> suction instruments, etc. will be more effective by adding moisture or
> injecting water into the lumen.

b.  Items for steam sterilization requiring lubrication must be
    lubricated with an approved water soluble instrument lubricant.

> [Ethylene Oxide (EtO)]{.underline}

a.  Items for EtO must be completely dried.

#### Sterrad

a.  Items that are made of cellulose materials such as paper, cloth,
    wood, and cotton will not be processed in the Sterrad.

b.  Observe estrictions on lumen size and length for successful
    processing.

c.  Items must be completely dried.

d.  Packaging must be of an approved container or wrapping material.

e.  Flexible endoscopes and implantable items are not to be processed in
    Sterrad.

References: AAMI-SSA-1992, 4.7, 4.72

> VA Handbook 7176, Supply, Processing and Distribution Operational
>
> Requirements

Manufacturer's Guidelines

##