Question: My OR manager insists that we place an internal chemical indicator in every pack, regardless of the type of package or the contents. I contend this is a waste of time and money, as an internal indicator is not a guarantee of sterility, nor does it guarantee that we did our job properly. Who is right?
Answer: You are right on both counts. Indiscriminate use of internal indicators is a waste of time and money and will often give a false sense of security to those who do not understand how monitors should be used (see "How to Monitor Your Steam Sterilizer," November 2000). Nevertheless, the proper use of chemical indicators is an important part of a complete sterilization monitoring system.
Internal chemical indicators will change color in the presence of steam. When internal indicators don't change color, you can deduce these three things:
- There was no steam where the indicator was.
- There was air where the indicator was.
- Therefore, no sterilization could take place.
