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8/7/2019 danie slides

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Cold Chain Handling

y Department of Pharmaceutical Services

y Ministry of Health

Presented by :Daniel Wee Vui TeckPharmacist


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Cold Chain Handlingy Cold chain products are temperature sensitive (too

hot, too cold)

yAny exposure will reduce its efficacy ( 1 min, 5 min, 10min)

y Care must be taken when:

y Storing

y Transportingy Using / administering


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Storing cold chain products

Pharmaceutical Refrigerators vs Domestic Fridge Regulated tem erature, mi imum fluctuatio

Tem erature at +2C to +8C

Freezer : less tha -1 C ( refera ly -15C to -25C)


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Storing cold chain products

Thermometers monitor temperature.

Twice daily morning and evening.

Max-min thermometer to know the upper andlower most temperature.

Standard Operating Procedures should be attachedto the fridge for easy and quick referencing.


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Standard Operating Procedure


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SOP


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Fridgey Large space to hold maximum stock required

yWell maintained/serviced

y

Equipped with alarm and sensorsyAdding ice packs

y Bottom of fridge

y Small amount to be loaded at a time

y

Thermometer (sensor probe)y Middle part of fridge

y Do not put medicine blocking or near air inlety Maintain air circulation


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Small Pharmaceutical Fridge


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Thermometer and record sheet


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Picture example (correct storage)


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Picture (lining of icepacks)


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Air Inlet

Incorrect storage:Blocking air inlet


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Wrong storageOverloaded.Air cannot circulate

around the boxes.


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Domestic Fridge and Freezery Use in smaller clinics / MCH

y Temperature should be maintained and recorded

using thermometer twice dailyy Freezer to keep ice packs and Polio vaccine

yAvoid ice build-up

y Never keep items in shelves of fridge door

y Never keep items near the freezer compartment

y Do not put medicine blocking or near air inlet


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Domestic Fridge with Freezer


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Cold RoomyWarehouses, State Medical Store, Hospital Store

y Freezer Room or Cold Room

y Fitted with alarms (external) and continuoustemperature monitoring

y Temperature mapping mark hot and cold spots todetermine storage for certain products

y Free circulation of air between boxesy Space for packing, unpacking of medicines


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Standby Generator

Recommended to have at each health

establishment / supplier

, volta e re ulator is recommended to avoidfluctuations that dama e electronic e uipment

Have written procedures, contacts, in case ofbreak.


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Transporting CCP

Sturdy and appropriate container for transport

(Cool boxes, cartons, Styrofoam boxes)

Set up ritten procedures nature of products,local conditions ( eat er), special precautions

ac in is done to maintain temperature


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Transporting CCPRefrigerated vehicles or containers should be mapped andmonitored

Monitoring devices such as Vaccine Vial Monitor or ColdChain Monitor card can be used together with thecontainer

Review and audit to personnel, equipment and processshould be done regularly. Record should be maintained


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Cold Boxes


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Containers and labellingy Special handling requirements must be clearly stated

on the container

y Choosing the right containery Maintain temperature during transit

y Space available

y Shield from outside elements e.g. temperature, rain

y Length of time of transit

y Maintenance of containery Clean the inner surface and left to dry

y Inspect for cracks or leaks


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Cold/Ice Packsy The type, size and number of cold packs should

correspond to transport duration, required

temperature and amount of mediciney Packing done to maintain temperature

y Conditioning the pack allow to warm for fewminutes before putting in

yAvoid direct contact ensure barrier existed betweenice packs and medicine to avoid freezing


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Ice packs


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Receiving and documentationRecipient should examine the shipmentupon reception checklist or SOP

Products should e promptly transferredinto suita le stora e area.

Icepacks should not e put in the frid e.


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Receiving and documentationDocumentation should be done and

include time, recorded temperature rangeRecord action taken if temperature is notmaintained

Records should be kept for futurereference


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VaccinesUse a vaccine vial monitor to check the validity of the vaccine


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Take home messagesy Refer to Cold Chain Guideline

y Develop and update S.O.P.

y Proper arrangements in the fridgey Proper arrangements during transport

y Proper documentations

y Educate other staff


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The Endy Thank you for listening

Documents

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