Autoclave failed DART tests

[CanadianTech2]

Recently our facility had it's yearly steam shut-down day for maintenance and repair. We have 3 autoclaves that we performed 3 DART tests and 3 biological tests on before it was used, as per our hospital policy. On one machine, all 3 DART tests failed yet all biologicals passed. The decision was made to continue using this machine as no information could be found regarding failed DART tests. Any input would be appreciated. CT

[Harvey Johnson]

I believe the DART test is to verify sterilizer efficacy, the air removal and steam penetration through the pack and trays of items to be sterilized. This process is one of the steps an autoclave must pass to assure all parameters of sterilization have been met.
I would not process in an autoclave with a failed DART test.

[sheper1]

Failed Dart test show that the air removal process failed. As spd stated this is one of the steps in assurance that the sterilizer is operating properly. I would not use it until the Dart test passed. Are your sterilizers setup to run a leak test?

[SHIRLEEN VANOCKER]

I also agree with these answers. I would not use a sterilizer that didn't pass the Bowie Dick test.


on a different subject: We have been asked to sterilize regular metal table spoons for a new Surgeon. We are supposed to have Manufacturers sterilization instructions for anything we process....of course we don't for this! Has anyone else been asked to do anything similar, and what would be your response to the surgeon? Would you just do it, knowing you could? Thanks...all input welcome

[Harvey Johnson]

You know, first it's a spoon, then it's a vise grip from sears, next thing you know you are sterilizing the whole tool box..;)
I would ask the Doc if after repeated processing (when the plating starts to flake away) would it be "ok" to use if the Doc was on the table.
We have adhered to the rule of requiring manufacturer's instructions and after time the word gets out and the requests go away. I'm sure there is a spoon manufactured for surgical procedures that will tolerate repeated reprocessing and will have manufacurer's instructions.

[SHIRLEEN VANOCKER]

spd soup. My sentiments exactly, however this surgeon insists and the O.R. manager isn't backng me up...she got the spoons from the kitchen herself! My next step is talking to IC. Does anyone know of a manufacturer of sterilizable spoons? that would solve the problem. Thanks

[David Freeman]

What is he using the spoon for? Perhaps you could offer an acceptable alternate We used to use a spoon as a backstop for sternal wire awls so they don't poke through the heart. (bad technique) We gave them a ribbon retractor which worked just fine.

[chipmoore]

The dart test is one of the toughest B-D test out there. It mimics the Mfg validation test of 1 mm/min leak rate over a timed period (performed manually). The fact that they did boiler maintenance could mean higher % of air/non condensable gases in your steam supply. When you have air in your water, extended flushing helps. Same applies with steam. You could run several empty chamber cycles on all your CS sterilizers or have traps designed to remove air installed at the sterilizer. In any event, need to pass the B-D test before putting them back on line. Finally, if your sterilizers have an automatic air leak cycle, run the cycle on each to find out if they pass or fail. It’s a good benchmark to see if the sterilizers are tight.
Chip Moore
Rochester, NY
Retired but involved