What's right?

[decon88]

I would like to know what some of you are using in your washer decontaminators as for as cleaners go. We are using just an enzymatic cleaner, which I think is falling way short of cleaning our product. What is anyone/everyone's take on the use of acid/alkiline detergents? Our prep room is saying that our instruments are coming out and that they smell of blood. Hit with all ya got.:p

[Guest]

I would like to know what some of you are using in your washer decontaminators as for as cleaners go. We are using just an enzymatic cleaner, which I think is falling way short of cleaning our product. What is anyone/everyone's take on the use of acid/alkiline detergents? Our prep room is saying that our instruments are coming out and that they smell of blood. Hit with all ya got.:p

ASK DON GORDON

[Scuda]

My facility uses this http://www.ruhof.com/CatalogProducts.asp?nProductsID=108 and we've had no problems with the smell of blood. You can request samples through thier website. Acid/alkiline detergents might damage the instruments. :(

[decon88]

We've have used the alkiline in the past with great results, you just have to use a neutralizer with it. Enzymatics alone don't really clean well. They are great at loosening bio-burden. The best method in my opinion if a facility can afford it is have a enzymatice pre-wash, followed by an Acid/Alkiline wash, the neutralizer and then a final rinse with DI water and a lube. Just trying to see what others are using.:cool:

[Guest]

I have relatively new Washer/Decontaminators -- These machines were designed to use ALKALINE detergents plus a neutralizer.

Recently some people have been convinced that improvements in soaps make enzyme products acceptable for use ... I have not seen the same success with enzymatic cleaners as I have with the Alkilaine products. NO where close. Talk with your reps and see what they say your system was DESIGNED to use. Soap makers will sell you anything, so will the equipment manufactures for that matter, but educate yourself first!

In my opinion, theirs no comparrison with the outcomes.

[Guest]

Automated washers are very dynamic machines which can work effectively with both enzyme/neutral detergents and/or alkaline detergents. Smelling blood may have nothing to do with the detergents at all. It is more likely something mechincal which is out of calibration. It could one or more of the following:cycle settings, water temperature or mechcanical issue such as blocked spinner arms or coupler system porblems.

My recommendation is to do a visual inspection of the washer rack and chamber - arms and bushings. Are they twisted or clogged. I would also recommend getting your exact cycle times - how long the water circulates per cycle, water temp per cycle and detergent (enzyme & neutral) dilution rates.

Once you have this information, please post the description here, review with the washer producer or contact myself - Steve Basile, Healthmark Ind. 800-521-6224.

Making sure your washer is performing is the 1st step in a successful sterilization process.

I hope this helps.

[sherwood]

Decon 88; As a chemist I recommend staying away from alkaline detergents. Not only will they corrode ( rust, harden plastic and rubber ) but to you need to use a neutralizer or have the instruments refurbished. Caustic detergents are very hard on all parts of the drainage system, creat toxic waste water and must not get on your skin. Don Gordons' hospital uses the best detergents I have seen currently on the market as far as all around safety, cleaning ability, having no odor, non-toxic and clarity. You don't need the harsh organic solvents ( VOC's ) or caustic alkalines.

[decon88]

Thank you all for your replys, it is greatly appreciated. Hopefully we will come to some decision here as far as what to use. What we currently are using is just not cutting the mustard at all. Don, can you send me the name of the cleaners you're using and a web address, I'd appreciate it so very much. :cool:

[dongordon]

Bo,

I sent you an e-mail and it came back as undelivered...I will try the "private message" route

Don

[Guest]

I have relatively new Washer/Decontaminators -- These machines were designed to use ALKALINE detergents plus a neutralizer.

Recently some people have been convinced that improvements in soaps make enzyme products acceptable for use ... I have not seen the same success with enzymatic cleaners as I have with the Alkilaine products. NO where close. Talk with your reps and see what they say your system was DESIGNED to use. Soap makers will sell you anything, so will the equipment manufactures for that matter, but educate yourself first!

In my opinion, theirs no comparrison with the outcomes.

BECAUSE YOU ARE NOT USING THE RIGHT ENZYMATIC DETERGENT....

[Guest]

enzymatic detergents can be very effective when used appropriately - equipment, soaking time, temperature, etc . I would evaluate the configuration and settings on the equipment in use and make sure if an enzymatic is being used, it is set up for use in initial wash / prewash cycle.
Is ther any manual pre-washing taking place? If so this an ideal place to use and soak in enzymatic detergents.
Make sure the pumps on the washer are in operation and pumping juice. If you are smelling organics you may not have enough contact with soiled instruments.
Also make sure the soak time at the end of cycle is more than 90 seconds, depending upon the type of enzymatic detergent in use - protease, lipase, amylase - in most cases require specific soak time to acheive desired results.

[Craig Nitschke]

We have two Steris 444 cube washers. We utilize VMueller concentrated detergents. We use their single enzme for the intial wash, their alkyline wash for the second, and it is followed up with a their instrulub. We have had great success. We were going to switch to Huntington Labs solids, because of the risk of my staff hurting themselves with the 5 gallon jugs, but VMueller came out with thier 2.5 gallon concentrates which are alot easier to manage.

[Guest]

We have two Steris 444 cube washers. We utilize VMueller concentrated detergents. We use their single enzme for the intial wash, their alkyline wash for the second, and it is followed up with a their instrulub. We have had great success. We were going to switch to Huntington Labs solids, because of the risk of my staff hurting themselves with the 5 gallon jugs, but VMueller came out with thier 2.5 gallon concentrates which are alot easier to manage.

WHAT IS YOUR HOSPITAL'S INFECTION RATE LIKE?
BOTH PRODUCTS YOU HAVE RECOMMENDED ARE THE LEAST EFFECTIVE IN REMOVING ANY TYPE OF BIO-BURDEN.
REMEMBER YOU CAN NOT STERILIZE IF THE INSTRUMENT IS NOT PERFECTLY CLEAN.
ORDER A DRUM ROLLER.

[Guest]

Eco-lab Block System

1.great Concept But Not Practical
If The System Breaks Down You Have No Product Being Dispensed.
Freeze Dried Enzymes Are Not Effective In Cleaning
Maybe For Laundry Detergent Or Dental Use.

2.if Safety Is The Only Advantage What Is The Point.
Your Patients Will Suffer.

[mfennel]

I have been all over the country to many facilities that use various equipment from a number of different manufacturers. I have also seen a wide variety of chemicals used to clean their instruments. Enzymatics for pre-cleaning of instruments and destroying protein (blood) are in wide use with a great deal of succcess. I recommend that you follow the manufacturer's instructions for the greatest success. The smell of blood is often really the smell of the cleaner. Check another enzymatic if thats your problem. You still need to use a detergent to clean the instruments. The enzymatics are more for a first step in the cleaning process. Make sure you are using them correctly for the best results.
I am always happy to pass on recommendations of products that I have run across that show good results...I can usually find a consumer who can make pros and cons on those items. If I can be of help you can email me at: mike.fennel@cardinal.com
Hope I have been of some assistance

[Ray Taurasi]

Enzymatic cleaning agents consist of proteins or conjugated proteins produced by living organisms and functioning as biochemical catalysts. they need to be sotred away from high temperatures. Excessive heat will actually distroy the enzymes affecting their efficacy - the distroyed organisms / enzymes will produce a fowl order. Enzymatic cleaning agents are usually used during the pre cleaning process when cooler water is utilized - Sometimes the odor present following the cleaning process may be the result of the distoryed enzymes when exposed to the higher temperatures used in the actual cleaning stage in auto washers.
Ray Taurasi
director professional services
Case Medical Inc.

[Guest]

Mr. Taurasi, I agree that enzymes create odors when breaking down. But if stabilized properly this won't happen. I also agree that every enzymatic detergent out there has an odor especially in hot water and some are very strong from VOC's EXCEPT ONE. My group has tried all of the major products and only one is odorless even in hot water. Try Pro-Lines line of detergents ( just click on the above add for details. They are also the only H2E compliant product. This is the company that makes the Pry Paste that everyone is familiar with.

[Guest]

Enzymatic cleaning agents consist of proteins or conjugated proteins produced by living organisms and functioning as biochemical catalysts. they need to be sotred away from high temperatures. Excessive heat will actually distroy the enzymes affecting their efficacy - the distroyed organisms / enzymes will produce a fowl order. Enzymatic cleaning agents are usually used during the pre cleaning process when cooler water is utilized - Sometimes the odor present following the cleaning process may be the result of the distoryed enzymes when exposed to the higher temperatures used in the actual cleaning stage in auto washers.
Ray Taurasi
director professional services
Case Medical Inc.

CASE MEDICAL IS A DISTRIBUTOR NOT A MANUFACTURER OF ENZYMATIC PRODUCTS.
NO ONE CLEANS SURGICAL INSTRUMENTATION IN COLD WATER..
IDEAL TEMPERATURES FOR ENZYMATIC DETERGENTS ARE 90-110 DEGREES
WARM--HOT WATER.

[Guest]

Presoak / pre cleaning procedures generally utilize lower temperatures (cooler) water than the cleaning process, which usually utilizes temperatures in excess to 140 F - in automated processors - these higher temperatures will indeed destroy enzymes thus resulting in unpleasant odors. Cooler or "lower" water temperatures are used for presoaks to prevent the coagulation of organic protein soils and will not adversely affect enzymes.
Ray Taurasi

[Guest]

It sounds like we need a little more understanding of enzymes and enzymatic detergents. As a chemist who has worked with the enzyme and enzymatic detergent manufacturers, I have found many who have been misled by distributers of these detergents. To keep it shorter and simple. Yes unstablized enzymes break down with excess heat ( 80 F and above ) but more slowly at the lower temperatures. There are several stabilizers but most include corrosives and volatile organic compounds that are not safe to breath, put on surgical instruments or in waste water. The corrosives are sodium and potassium hydroxides and triethanolamine which are the alkalines. The VOC's are alcohol, isopropanol, fragrances and other organic solvents. When stabilized properly, enzymatic solutions can be realitively stable up to 150 F for as much as a few days. In hospital these detergents are diluted in water and the excess water is what activates the enzymes. Now the IDEAL water temperature for enzymes to work at there optimum when diluted is 90 to 110 F. A little higher makes them work a little faster but then they won't last as long. Also, not all enzymes are as effective as others. Example, enzyme manufacturers know that different protease sources make better enzymes. Another bad ingredient to look for is glutraldehyde, because it when used and on setting it breaks down and releases formaldehyde. You will get a fowl odor from enzymes as they break down but almost all of the odor from enzymatic detergents comes from the oganic solvents, fragrances, and organic corrosives ( triethanolamine, etc. ). An over used term, biodegradable, everything for the most part is biodegradable. As a chemist, for the safety of all and the environment, I suggest using products that have the least odor ( little to no odor ), no toxic or hazardous ingredients and comply to New Yorks environmental ( H2E ) green product regulations.
Gods Speed

[Guest]

It sounds like we need a little more understanding of enzymes and enzymatic detergents. As a chemist who has worked with the enzyme and enzymatic detergent manufacturers, I have found many who have been misled by distributers of these detergents. To keep it shorter and simple. Yes unstablized enzymes break down with excess heat ( 80 F and above ) but more slowly at the lower temperatures. There are several stabilizers but most include corrosives and volatile organic compounds that are not safe to breath, put on surgical instruments or in waste water. The corrosives are sodium and potassium hydroxides and triethanolamine which are the alkalines. The VOC's are alcohol, isopropanol, fragrances and other organic solvents. When stabilized properly, enzymatic solutions can be realitively stable up to 150 F for as much as a few days. In hospital these detergents are diluted in water and the excess water is what activates the enzymes. Now the IDEAL water temperature for enzymes to work at there optimum when diluted is 90 to 110 F. A little higher makes them work a little faster but then they won't last as long. Also, not all enzymes are as effective as others. Example, enzyme manufacturers know that different protease sources make better enzymes. Another bad ingredient to look for is glutraldehyde, because it when used and on setting it breaks down and releases formaldehyde. You will get a fowl odor from enzymes as they break down but almost all of the odor from enzymatic detergents comes from the oganic solvents, fragrances, and organic corrosives ( triethanolamine, etc. ). An over used term, biodegradable, everything for the most part is biodegradable. As a chemist, for the safety of all and the environment, I suggest using products that have the least odor ( little to no odor ), no toxic or hazardous ingredients and comply to ( H2E ) green product regulations.
Gods Speed
HOSPITALS FOR A HEALTHIER & THE EPA have started a program for HOSPITALS called H2E COMPLIANT. This program is enforcing stringent requirements to eliminate all TOXIC AND HAZARDOUS ingredients from cleaning products by the YEAR 2010.

[Guest]

I would like to know what some of you are using in your washer decontaminators as for as cleaners go. We are using just an enzymatic cleaner, which I think is falling way short of cleaning our product. What is anyone/everyone's take on the use of acid/alkiline detergents? Our prep room is saying that our instruments are coming out and that they smell of blood. Hit with all ya got.:p


Ours was also smelling of blood. We switched to ECOLAB products and all of the smell has gone away. Plus our instruments are much cleaner and presently we do not even have to use a lub cycle.

[greenegldn]

I firmly believe in using the product that your equipment says should be used to ensure that the machine works correctly. Once we have done research sometimes we are able to use a product that is cheaper and gives the same great results. :)

[johnfmartin]

Enzymatic cleaners are excellent and that is our preference. You may need to do the following:
Test your washer efficacy with the Healthmark TOSI kits(Proformance). The kits include water temperature checks as well. If you have failures, do the following:
Make sure water temperature per type of cycle is within spec
Check the mechanical arms in your washer-Need to be dissambled and cleaned.
Check your soap qty's per cycle. One way is to mark your container with date and time and see how much is being used per shift.-Depending on the concentration, you may need to increase the amount of soap per cycle. Check with your manufacturer how to either increase or decrease your soap dispensing.
You may need to have the machine serviced. We found out after using the TOSI kits , one machine consistently failed. The high speed pump had been non working for years!
Healthmark can be reached at 800-521-6224. The test kits (Proformance) are set up depending upon on the basket type you are using. That is 3 shelf or 4 shelf etc. Documentation sheets are included in the kits.
We no longer have failures and feel assured that our washers are working at optimum.

[sonny1388]

We are also currently using the EcoLab 2.2lb blocks. We switched to these from the 15gal drums, and let me tell you, it has made a world of difference! We have more space, less waste, and as long as the amounts of chemicals used are kept in check, our instruments look great. We are running an alkaline detergent, an acid rinse, and neutral rinse (as a lube), and an enzyme. Everyonce in a while it gets out of whack, and we get a good buildup of scale, but it is usually due to water quality issues.