1995 OPEN FORUM Abstracts
FEASIBILITY OF RECYCLING PEDIATRIC BICORE FLOW SENSORS.
Jim Keenan BS, RRT, Julie Ballard BS, RRT, John Salyer BS, RRT. Primary Children's Medical Center, Salt Lake City, Utah.
Introduction: The Bicore CP-100 bedside neonatal pulmonary function monitor uses a variable orifice pneumotachograph sensor that is labeled as "single patient use". We sought to test the the feasibility of recycling these items.
Methods: We used the unpublished Bicore recomended field verfication test procedure which includes; (1) the sensor attached to a Hans-Rudolph volumetric calibration syringe set at 60 mL, (2) a 3.0 ETT was attached to the other end of the sensor to simulate clinically encountered resistance. After self calibration, 10 excursions of the syringe plunger were performed. Inspiratory and expiratory tidal volumes are then noted. An acceptable range of readings was developed using the manufacturers reported inaccuracy of 7 % above and below the actual volume of 60 mL (55.8-64.2 mL). If a sensor had either inspiratory or expiratory volumes outside the acceptable range, it failed the test and was disposed of. Sensors were tested new, and after each of four cleanings, in between which sensors were used in the clinical environment. After each cleaning they were marked, and clinicians were instructed to return all sensors for recycling. If sensors were visibly soiled or damaged, they were discarded. Cleanings consisted of immersion in a deproteinizing agent (Klenzyme, Merck Co. Inc.) for = 5 minutes, followed by cold liquid sterilization in an activated gluteradehyde solution, followed by thorough rinsing with water. Sensors were dryed by being attached to an air flowmeter set at 3-5 L/m until dry.
Results: The table below lists our results.
New 3394% 26%
After1st Cleaning 1768% 832%
After 2nd Cleaning 1376% 424%
After 3rd Cleaning 9 69% 431%
After 4th Cleaning 0 0%4100%
Discussion: We found it disturbing that 6% of new sensors failed the manufacturer's recommended verification procedure. New sensors cost = $28 each and thus a recycling program could potentially result in considerable cost savings. It appears that more than three cleanings yields little benefit, although the low number (50%) of sensors still in the study after three cleanings may bias this finding. It is possible that some sensors were not returned from clinical practice for recycling because they failed while on patients secondary to being recycled and where discarded by practitioners at the bedside, although we received no anecdotal reports of this during the study. Conclusion: A program to recycle these sensors appears feasible. A 6% failure rate of new sensors seems unacceptably high.