When three consecutive cycles show negative biological indicators and chemical indicators with a correct end point response, put the change into routine use. Pack Control Pack control is the monitoring and issuing of packs for use based on the readout of the chemical indicator inside the package. Internal chemical indicators document that the sterilant or critical parameters of the sterilization process has penetrated and reacted with the chemical indicator inside of individual packages. Integrating chemical indicators, commonly referred to as integrators, are designed to approximate the response of biological indicators to all the critical parameters of the sterilization process but do not contain spores. Chemical integrators cannot replace the use of biological indicators as discussed in load control monitoring.
Some people question the use of internal chemical indicators.
Chemical indicators can respond differently than biological indicators or other chemical indicators that are a short distance apart. If a BI for the load indicates a successful sterilization process but the CI for a specific pack indicates a problem, the pack cannot be used. Other packs in that load should be carefully examined when opened and not used if the chemical indicator has not reached its end point response. If the BI results are positive, every pack in the load must be recalled and reprocessed. The most stringent recommended practices for pack control monitoring are to use an internal chemical indicator inside each package or tray.