Laboratory Autoclave Steam Sterilization Cycles, Part 10: Immediate-Use (Flash) Sterilization Cycle Written by: Arthur Trapotsis MS Biochemical Engineering, MBA, Consultant There has been much debate around the antiquated term “flash sterilization.” A concerted effort has been made by the Association for Advancement of Medical Instrumentation (AAMI), the Joint Commission (JC) and the Food and Drug Administration (FDA), to clarify the use of flash sterilization, which these organizations now refer to as “immediate use” sterilization. This sterilization cycle is not intended for routine instrument sterilization but only when specific instruments are needed for an emergency procedure. Immediate-Use Cycles are shorter than the typical Gravity or Vacuum cycles that are performed at 250°F (121°C). The cycle time for an Immediate-Use Cycle is typically 3 – 10 minutes in length. In order to achieve sterilization in this “short” amount of time, an Immediate-Use Cycle is performed at the elevated temperature of 270-275° F (132-135° C). Unwrapped goods will sterilize on the shorter end of that time frame (3-5 minutes) while wrapped goods run for 6 – 10 minutes, depending on the make and manufacturer of the autoclave as well as the device. All Immediate-Use Cycles are conducted as gravity cycles (i.e. without pre-vacuum pulses). Some dental practices use this sterilization cycle for processing all of their instruments because of the shorter sterilization cycle or because the practice may not have a large inventory of handpieces (i.e. the faster turnaround greatly improves operating efficiency). These reasons, however, do not justify what has become the misuse of the Flash Cycle. Performing correct, albeit longer, sterilization cycles (see gravity and pre-vac cycles) is the prudent choice. Immediate-Use Cycles are typically found on smaller autoclaves with chamber volumes of less than 300L, ideal for the operating room or a dental practice. Examples of standards and practices for Immediate-Use sterilization can be found with the Association for the Advancement of Medical Instrumentation (AAMI), the Association of periOperative Registered Nurses (AORN), and the Centers for Disease Control and Prevention-Healthcare Infection Control Practices Advisory Committee (CDC-HICPAC). All personnel operating the autoclave should be educated regarding the different types of steam sterilizers (i.e., gravity versus vacuum) and the different types of steam sterilization cycles. Immediate-Use sterilization should NOT be performed on the following devices: Implants Post-procedure decontamination of instruments used on patients who may have Creutzfeldt–Jakob disease (CJD) or similar disorders Devices or loads that have not been validated with the Immediate-Use Cycle Devices that are sold sterile and intended for single-use only Note: The Immediate-Use or “Flash” Cycle is not typically performed in laboratory autoclaves, but is quite common in healthcare autoclaves. Resources: Association for the Advancement of Medical Instrumentation. ANSI/AAMI ST79: 2010 & A1:2010—Comprehensive Guide to Steam Sterilization and Sterility Assurance in Health Care Facilities. Arlington, VA: Association for the Advancement of Medical Instrumentation, 2010. [Source] Association for the Advancement of Medical Instrumentation. ANSI/AAMI ST40—Table-top Dry Heat (Heated Air) Sterilization and Sterility Assurance in Health Care Facilities. Arlington, VA: Association for the Advancement of Medical Instrumentation; 2004. [Source] Recommended practices for sterilization in the perioperative setting. In: Standards, Recommended Practices, and Guidelines. Denver, CO: AORN, Inc; 2010. [Source] Recommended practices for cleaning and care of surgical instruments and powered equipment. In: Standards, Recommended Practices and Guidelines. Denver, CO: AORN, Inc; 2010. [Source] Centers for Disease Control, Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008. [Source] 17 Questions to Ask Before Buying Your Next Autoclave With so many models, sizes, options and components to choose from, how can you ever really know exactly what you need to make the most out of your investment? These questions will help you to make informed decisions by outlining what is most important to consider and know about owning an autoclave. First Name* Last Name* Company/Organization* Email* Job Title*Select OneArchitectGeneral ContractorLab ManagerFacilities ManagerService TechnicianScientistSterile Processing TechnicianDistributorOtherDescribe "Other"* Country*AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabweState*Select OneAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAre You Looking to Purchase an Autoclave?*Select OneYes, ImmediatelyYes, within 6 monthsYes, later than 6 monthsNo, just researchingAre you in a medical/healthcare (patient use) or life science (laboratory) setting?*Select OneMedical/HealthcareLife Science Yes, I'd like to receive occasional tips on sterilization best practices. Comments (Optional)This field is for validation purposes and should be left unchanged. Δ Tweet Like Share
Laboratory Autoclave Steam Sterilization Cycles, Part 10: Immediate-Use (Flash) Sterilization Cycle Written by: Arthur Trapotsis MS Biochemical Engineering, MBA, Consultant There has been much debate around the antiquated term “flash sterilization.” A concerted effort has been made by the Association for Advancement of Medical Instrumentation (AAMI), the Joint Commission (JC) and the Food and Drug Administration (FDA), to clarify the use of flash sterilization, which these organizations now refer to as “immediate use” sterilization. This sterilization cycle is not intended for routine instrument sterilization but only when specific instruments are needed for an emergency procedure. Immediate-Use Cycles are shorter than the typical Gravity or Vacuum cycles that are performed at 250°F (121°C). The cycle time for an Immediate-Use Cycle is typically 3 – 10 minutes in length. In order to achieve sterilization in this “short” amount of time, an Immediate-Use Cycle is performed at the elevated temperature of 270-275° F (132-135° C). Unwrapped goods will sterilize on the shorter end of that time frame (3-5 minutes) while wrapped goods run for 6 – 10 minutes, depending on the make and manufacturer of the autoclave as well as the device. All Immediate-Use Cycles are conducted as gravity cycles (i.e. without pre-vacuum pulses). Some dental practices use this sterilization cycle for processing all of their instruments because of the shorter sterilization cycle or because the practice may not have a large inventory of handpieces (i.e. the faster turnaround greatly improves operating efficiency). These reasons, however, do not justify what has become the misuse of the Flash Cycle. Performing correct, albeit longer, sterilization cycles (see gravity and pre-vac cycles) is the prudent choice. Immediate-Use Cycles are typically found on smaller autoclaves with chamber volumes of less than 300L, ideal for the operating room or a dental practice. Examples of standards and practices for Immediate-Use sterilization can be found with the Association for the Advancement of Medical Instrumentation (AAMI), the Association of periOperative Registered Nurses (AORN), and the Centers for Disease Control and Prevention-Healthcare Infection Control Practices Advisory Committee (CDC-HICPAC). All personnel operating the autoclave should be educated regarding the different types of steam sterilizers (i.e., gravity versus vacuum) and the different types of steam sterilization cycles. Immediate-Use sterilization should NOT be performed on the following devices: Implants Post-procedure decontamination of instruments used on patients who may have Creutzfeldt–Jakob disease (CJD) or similar disorders Devices or loads that have not been validated with the Immediate-Use Cycle Devices that are sold sterile and intended for single-use only Note: The Immediate-Use or “Flash” Cycle is not typically performed in laboratory autoclaves, but is quite common in healthcare autoclaves. Resources: Association for the Advancement of Medical Instrumentation. ANSI/AAMI ST79: 2010 & A1:2010—Comprehensive Guide to Steam Sterilization and Sterility Assurance in Health Care Facilities. Arlington, VA: Association for the Advancement of Medical Instrumentation, 2010. [Source] Association for the Advancement of Medical Instrumentation. ANSI/AAMI ST40—Table-top Dry Heat (Heated Air) Sterilization and Sterility Assurance in Health Care Facilities. Arlington, VA: Association for the Advancement of Medical Instrumentation; 2004. [Source] Recommended practices for sterilization in the perioperative setting. In: Standards, Recommended Practices, and Guidelines. Denver, CO: AORN, Inc; 2010. [Source] Recommended practices for cleaning and care of surgical instruments and powered equipment. In: Standards, Recommended Practices and Guidelines. Denver, CO: AORN, Inc; 2010. [Source] Centers for Disease Control, Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008. [Source] 17 Questions to Ask Before Buying Your Next Autoclave With so many models, sizes, options and components to choose from, how can you ever really know exactly what you need to make the most out of your investment? These questions will help you to make informed decisions by outlining what is most important to consider and know about owning an autoclave. First Name* Last Name* Company/Organization* Email* Job Title*Select OneArchitectGeneral ContractorLab ManagerFacilities ManagerService TechnicianScientistSterile Processing TechnicianDistributorOtherDescribe "Other"* Country*AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabweState*Select OneAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAre You Looking to Purchase an Autoclave?*Select OneYes, ImmediatelyYes, within 6 monthsYes, later than 6 monthsNo, just researchingAre you in a medical/healthcare (patient use) or life science (laboratory) setting?*Select OneMedical/HealthcareLife Science Yes, I'd like to receive occasional tips on sterilization best practices. Comments (Optional)This field is for validation purposes and should be left unchanged. Δ Tweet Like Share
7.12.23 Cordyceps Sterilization: How to Kill “The Last of Us” Parasite → In HBO’s recent adaptation of “The Last of Us,” a popular action-adventure video game, life as we know it is upended by a parasitic fungus that transforms its human hosts into zombies. The culprit? Cordyceps, a real-life genus of fungus which is best known for infecting insects (most famously ants) in much the same manner […]
6.30.23 Top 13 Sterile Processing Mistakes in Hospitals → When it comes to ensuring patient safety in hospitals and ambulatory surgery centers (ASCs), the Sterile Processing Department (SPD) is among the last lines of defense. It’s this department’s sole responsibility to make sure that reusable instruments and devices are properly decontaminated, sterilized, and ultimately safe to use in future procedures — protecting patients from […]
6.22.23 Sterilization vs. High-Level and Low-Level Disinfection [a 3-Point Comparison] → In a 1939 paper, microbiologist Earle H. Spaulding introduced a system for determining which medical devices and instruments needed disinfection and which ones required sterilization. In it, he proposed that critical instruments would need to be subjected to more stringent disinfection protocols than non-critical patient care items. Today, this framework is fittingly known as Spaulding […]
