THE COLD CHAIN

Presented by: Jacqueline Francis Wright PHN Browns Town Health District September 29th, 2011

OBJECTIVES:

At the end of the session, participants will be able to: Define the cold chain Describe the cold chain equipment used in the health centre State the recommended storage temperature for vaccines List persons responsible for maintenance of the cold chain

1. 2. 3.

4.

OBJECTIVES CONTD
5. Discuss the correct way to load cold chain equipment in the health centre 6. State how to monitor temperature of equipment

OBJECTIVES
Define the cold chain The cold chain is the people, equipment and procedures that keep vaccines cold during their journey from the manufacture to the patient. (EPI Manual, 2007)

A cold chain therefore includes three elements: Equipment for safe storage and transport of vaccines

Personnel: who use and maintain the cold chain equipment and provide the health services
Procedures: to manage the programme and control the distribution and use of vaccines

2. Describe the cold chain equipment

A. Refrigerators: These are indispensible and must store only vaccines and their diluents. They must be in good operating conditions and well maintained.
Vaccine

refrigerators must have a main section for storing vaccines, in which the temperature should be between +2C and + 8C

A freezer for freezing ice packs and storing vaccines that should be frozen. This section should be kept below 0 C.
The vaccine refrigerator should store only vaccines, water bottles, ice packs and diluents In addition, half the total space must be kept empty to allow for circulation of air around the vaccines

Reliable electrical supply with alternate

B. Vaccine Carriers
Vaccine carriers are insulated containers that can be lined with frozen ice packs to keep vaccines and diluents cold for 24 72 hours. They are used by health centre staff to collect and store vaccine supplies from the parish and central stores
To

store vaccines and diluents during; 1. Immunization clinic sessions

2. On outreach visits 3. When the refrigeration is malfunctioning or being defrosted

Different types and sizes of carriers are available. The right one is chosen based on the amount of vaccines and diluents to be stored, the transportation and the cold life needed. Ice Packs: are square, flat, plastic bottles that can be filled with water and frozen. (Improvise)

The recommended storage temperature for vaccines

According to WHO vaccines should be stored as follows: +2C +2C - +8C to + 8C 0C DPT Hepatitis B MMR Pentavalent Penatvalent, IPV OPV Hib DT, DPT, (Paed. / Adult) Yellow fever

BCG, HIB

List the persons responsible for maintaining the cold chain

All

health workers working in the health centre, primarily: PHN R/N RM PHN CHA Orderlies

5. Discuss how to load the equipment

Equipment must be loaded correctly to maintain the temperature.

Steps to load the refrigerator include: 1. Store ice packs in the freezer 2. Plastic bottle with water on the bottom shelf 3. Ice packs and water bottles 2 - 5 centimeters

4. Put vaccines and diluents on the top and middle shelves of the main section - OPV and MMR on the top shelf or in the freezer - BCG, DPT, DT, Hep B, Hib and Pentavalent in the middle shelf - Diluents next to vaccines with which they were supplied Arrange vaccines in rows so that air can circulate.

Vaccines must be stored in perforated trays so they do not stand in water and lose their labels.
Do not store in door shelves

Do not keep expired vaccines in the refrigerator

Close the door

Loading the vaccine carrier

1. 2.

3.
4.

5.

Quickly take all the ice packs from the freezer and close the door Remove extra ice from the surface and allow icepack to sweat Place the packs against the four sides of the carrier Quickly take all the vaccines you need from the refrigerator and close the door Put the vaccines and diluents in the

-Do not let vaccines or vials directly touch the ice. Put newspaper or gauze around them or use a galipot or substitute. -Put a thermometer and ice packs on top of the vaccines -If you have a foam pad, place it on top of the ice packs -Close the carrier lid tightly and do not expose directly to sunlight

VACCINE CARRIERS

CARRIERS CONTD

CARRIERS

Monitoring cold chain

Purpose of cold chain equipment is to keep track of the temperature that vaccines and their diluents during transportation and storage. To monitor, you need temperature chart - thermometer The temperature is read every day, first thing in the morning & last thing in the, preferably at the same hour each day,

After the evening reading, document by plotting the higher of the two in the middle column. -If the temperature is not within normal range, check the door seal and water supply. Remember to document and report.

THE END ANY QUESTIONS??