Guest guest Posted October 22, 2006 Report Posted October 22, 2006 G, Totally right , glad to find another fellow traveller whose feet touch the ground because of the effects of gravity....exactely which idiot put use by dates on A/ water and B/ plastic gallipots...? Gents we are the ones who are supposed to keep our heads whilst everyone else is losing theirs....! P thomas greaber <tom5255@...> wrote: Hi jen not offended but do wonder that the only reason you want expiration dates on ET tubes or plasters for that matter is someone made a law saying they need expiration dates? Must be the same guys who mandated hard hats for high wire acts recently in the U.K...................... Show me evidence based studies and I will change my mind but until then will contiune to view expiration dates on non medication items as silly and a waste of money. Cheers Tom G >From: >Reply- >Remote Support Medics >Subject: Re: Sterilized surgical equipment >Date: Sat, 21 Oct 2006 17:12:11 +0100 > >Hi Goesta, > >Thank you. I appreciate your comments. > > > I know anesthetists who would happily use a non sterile but clean ET >tube. I > > for one, am an Intensive Care Paramedic, who would. I also use non >sterile > > eating utensils. > >Well, now you know one who isn¹t happy with a ³clean² one. The word ³clean² >hasn¹t much of a meaning in medicine. It gives me the shiver, and it makes >me remembering Ignaz Semmelweiss... > >So why did it take so long to find one, you might ask yourself (well, I am >facing the same question at the moment...). The entire discussion about the >need for an ETT tube to be sterile is a very old one and has been discussed >amongst Anesthetists for ages. I thought such discussion to be generally >over by now (whilst accepting the fact that there will always be someone >who >just wants to do things his own way, and different to others), but after >reading all the comments, I think I will bring this topic up again in some >anesthesia meetings. > >However, in the end it all came down to few points which I will try to put >down as plain & simple as I can. I¹ll spare you (and myself) time with not >digging through statistics, research etc and as I think some simple >arguments do the trick (well, they did it so far). > >1. It¹s an invasive procedure that bears a significant risk of injury, >(even >minor injury opens the gate for infection), and is you obligation to >minimize all potential risks. >2. Medical law is very clear about expiry dates (for a reason), and you¹re >not doing your patient and yourself any good if you break it. >3. Best practice / professionalism. Yes, we can do a lot of things, the >human body can cope with a lot of what we are doing to it, -but- there will >always be one who won¹t (kinda like ¹s Law). However, harming just >one >(infection etc), by softening your regime on patient safety - is one too >much. In other words: ³in dubito pro aegroto². If you¹re in doubt - decide >in favour of your patient. > > > I agree that we need to stick to sterilization standards when we can. >But > > there is no doubt that a valid point was made in the post below that >throws > > suspicion on the motives behind the regulations. > >Yep, but that¹s an entirely different discussion topic, isn¹t it? I.e. >³should medical practitioners/lawyers question expiry dates² >Right now I see us discussing ³should one apply what is present medical law >and best practice² > > > When it comes to drug expiration, I have had personal communication from > > manufacturers who grant extensions of the expiry dates. In fact some >state > > categorically that they are happy with their drug being used two years >past > > their announced expiry dates, as long as it is checked with them first. > >I think, ³as long as you check with them first² is the key sentence in what >you¹ve written. > >Goesta, one significant aspect I seem to have totally missed in all >discussions, is the fact that ³expired² is very much depending on how a >drug >was stored, handled etc. Talking remote places you will surely have seen >drugs expiring even before the actual date on i.e. the ampoule? Maybe this >was because the item was exposed to heat, significant temperature changes, >intense sunlight, repacked, humidity etc and all those factors one needs to >keep in mind before giving drugs, doing procedures etc ³at the end of the >world² - often in an environment that can barely be called ³clinical². So >if >this is the environment you and your drugs are exposed to & shy; I am sure >you¹ll >agree that it makes ³sense² to be ³conservative² (well, I could say >³patient >focused²), and working as ³safe² as possible?... > > > No problems with a Hippocratic Oath, however, I am wondering which one > > though. Since you mention " The ....Oath " I figure you refer to the >classic > > one, and there I have a problem with Panacea. > >Not really. I am old, but not that old Lets use a more modern version... >Most of who are working in the field, will have a copy of the Oxford >Handbook of Clinical Medicine (if not & shy; it¹s a good one to have), and my >trusted version comes with a 1998 revision of ³the² oath. The one I am >bound >to in regards to what I am doing professionally. Hm, some relevant >professional bodies have gone even more modern; have come up with ³codes of >conduct², and there are some very good ones in regards to i.e. best >practice, and patient advocacy. However, in the end it all comes down to >³do no harm². > > > Cheers, > > Gösta > >All the best, >J > > Re: Sterilized surgical equipment > >Date: Fri, 20 Oct 2006 06:35:32 -0700 (PDT) > > > >, > >I have been told by surgeons that in our environment (remote sites) that > >the stuff is good until it has been opened or gets wet or is dusty or > >dirty. If your kits are well wrapped (that is triple wrapped in plastic >so > >they cannot be contaminated unless opened you are good until they are > >opened. Some may have arbitrary or subjective rules about the expiry of > >these things but there is little objective documentation to support them > >that I have found. > >Cheers, > >Steve > > > > Rundle > > >wrote: > > Hey All, > > > > I was wondering if anyone out there can help me with the following > >question. > > > > How long can one keep pre-packed and sterilized surgical equipment >before > >it > > needs to be sent back for re sterilization? > > Thanx in advance > > -- > > Rundle > > Offshore Medic/ Health and Hygiene > > P.O. Box 257 > > Gordon's Bay > > South Africa > > 7151 > > Cell: +27 (0) 82 656 9747 > > > > Quote
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