Monitors the temperature of the cold chain during transport and storage of vaccines.

Transcription

1 Sheet 8 Cold chain monitoring equipment The temperature of vaccines and of the cold chain itself (refrigerators, freezers, cold boxes and vaccine carriers) must be monitored regularly and continually throughout the entire period of storage, transport and use of the vaccines. There are a number of tools available, each having a specific use. The main ones are described briefly below for more detailed information, see the PCOL section in the Logistics catalogue. Supplied with vaccines 3M cold-chain monitor card (PCOLCONT1C-) Monitors the temperature of the cold chain during transport and storage of vaccines. A cold-chain monitor card is included with each batch of 3,000 doses of vaccine sent by the laboratory. It should be activated by the supplier. It should not be put into the batch at any later stage as that could conceal earlier errors. (If in spite of this warning it is put in later it should be pre-cooled to a temperature of less than +10 C for at least 30 minutes before being act ivated.) During the maintenance of the refrigerator the monitor card should not be left in the refrigerator but should be put with the vaccine in the cold box. It should be filled in by the person responsible for the vaccine stock each time vaccine is moved. This will assist in identifying and correcting any error in the cold chain. The card has an indicator with two temperature ranges : the first marked ABC corresponds to temperatures above +10 C ; the second marked D to temperatures above +34 C. MSF/B January 2006 Pocket Guide Measles Sheet 8 1

2 The front of the cold-chain monitor card has : A record form that the person responsible for the cold chain fill in to show when vaccine shipments are received and dispatched. An indicator that is a heat-sensitive strips with four windows marked A, B, C and D. Instructions explaining what to do if vaccines have been exposed to heat. A space to be filled in by the supplier : date of dispatch and type of vaccine. The back of the cold-chain monitor card has : Instructions on use. A table with information on the time and temperature characteristics of the indicator. How to monitor temperature The cold-chain monitor card is entirely heat-stable until it is activated by pulling out the small tab on the left side of the indicator, which then registers temperature above +10 C (windows A, B and C) and above +34 C (window D). When the indicator is exposed to temperatures above +10 C : The first window (A) gradually turns blue. If the temperature falls below +10 C the blue colour stops spreading. MSF/B January 2006 Pocket Guide Measles Sheet 8 2

3 Each time the indicator is exposed to temperatures over +10 C, the blue colour spreads further across the windows from A to C. This colour change is irreversible : the colour change can stop spreading, but never disappears. The higher the temperature, the faster the blue colour spreads. When the indicator is exposed to temperatures above +34 C : Window D turns blue within two hours. This change is irreversible : D will never turn white again. How to interpret the temperature readings A simplified interpretation guide explains how to interpret the colour changes on the indicator in relation to the vaccines packed with the cold-chain monitor card. The following combinations colour change are possible : Windows A, B, C and D completely white no blue showing : This means the cold chain is working properly ; the temperature has remained below +10 C and the vaccine has been stored correctly. Measles : vaccines may be used. Window A completely blue, other windows white : Measles : vaccines may be used. Windows A and B completely blue, other windows white : Measles : Use vaccines within three months. Windows A, B and C completely blue, window D white : Measles : Ask for advice on the use of those vaccines from the person responsible for vaccinations in the Medical Department, making sure to keep the vaccine refrigerated. Windows A, B, C and D completely blue : Measles : Ask for advice on the use of those vaccines from the person responsible for vaccinations in the Medical Department, making sure to keep the vaccine refrigerated. N.B If all the windows are completely blue... You have a major problem with your cold chain. It should be checked and repaired as a priority. How to use the cold chain monitor card When a cold-chain monitor card arrives, with a vaccine shipment, the storekeeper fills in : The date the shipment arrives The index (A, B, C or D) registered on the indicator The location of the store. When a cold-chain monitor card leaves the store, with a vaccine shipment, the storekeeper fills in : The date the shipment leaves The index (A, B, C or D) registered on the indicator. In practice, the cold-chain monitor card should stay with its batch of vaccine for as long as possible. As each batch contains 3,000 doses, the card will stay with the batch until it is put into a cold box to be taken to the place where the vaccination campaign is being carried out. The batch will then be divided among the various teams (in vaccine carriers) and it will from that moment no longer be possible for the card to be kept with the batch. MSF/B January 2006 Pocket Guide Measles Sheet 8 3

4 What to do If the cold chain breaks down? Vaccine : Look at the instruction guide on the front of the cold-chain monitor card. Cold chain : The weak link can be identified by checking the entries on the upper part of the front of the cold-chain monitor card. Every breakdown in the chain must be investigated and appropriate measures taken to prevent its recurrence. Supplied with the Kit Immunization KMEDKIMM3- Stop!Watch Refrigerator monitor card (PCOLCONT2R) Monitors the temperature of a refrigerator. Place the card in the refrigerator. Activate the card 10 minutes after placing it in the refrigerator. This card is used to monitor temperatures in a refrigerator over time (below 0 C and above +10 C and +34 C). MSF/B January 2006 Pocket Guide Measles Sheet 8 4

5 Twice daily temperature monitor card (PCOLCONT4CT) Form used to monitor the temperature inside refrigerators twice daily This form should be stuck to the door of the refrigerator. The temperature should be checked twice daily (morning and evening), every day of the week and noted on the card. (See Sheet 9 Twice daily temperature monitoring form to be printed locally) Moëller Alcohol Thermometer, 40 to + 50 (PCOLTHER1A) Monitors the temperature inside refrigerators, freezers, cold boxes and vaccine carriers. To be placed in any cold chain equipment. MSF/B January 2006 Pocket Guide Measles Sheet 8 5