Most homes have a system for cleaning up dirty things. Laundry gets thrown in a bin, sorted, washed, dried and ironed before redistributing. Similar for dishes. Also similar for hospitals managing the endless loop of reusable medical equipment that needs to undergo stringent cleaning before being used on you or me or someone we love.
I wanted to see how it happens in person, so I made an appointment with the manager of Sunnybrook’s Medical Devices Reprocessing Centre for a tour. It’s an airy space filled with aluminum sinks, trolleys, giant dishwashers and staff donned in the necessary safety gear. Like any household, everyone knew their role and navigated the expanse like a fine waltz.
There are several steps to this 24/7 process, where there is zero room for error. Carts of soiled equipment are brought down and first soaked in a specialized solution that literally breaks away blood, body fluids and other contaminants. Next, equipment is loaded onto special metal carts that are automatically pushed into giant washers called Turbo 88s. They look like an industrial dishwasher, but pound tornado-funneled water at a speed ten times greater than a car wash. Sunnybrook was the first hospital in North America to use this device during reprocessing, now held as the gold standard. Much like Las Vegas, what happens in the Turbo 88 stays in the Turbo 88: no viruses or bacteria can survive. Oh yes, and the equipment is also given a lubricant coating, preventing scissors and clamps from ever getting sticky.
The next step has the equipment being sorted by hand to customize it for the user. (That means every time a surgeon reaches onto their tray during surgery, they’ll know exactly what piece of equipment they are getting.) These trays are then wrapped, barcoded and placed in massive steamers for final sterilization. I can only describe them as very large metal pizza ovens, but they are no place for food. It gets so hot in there that a raw chicken would literally be incinerated.
So what do you think the most widely used instrument at Sunnybrook is? I guessed scalpel (wrong). It’s actually a device called the Bookwalter Retractor. This clamp gives surgeons easy access by propping open the abdomen during certain procedures. I’d never heard of it, but will take this tidbit of trivia with me to my next dinner party.
And of course, after surgery, screening or treatment, the whole loop starts over. Much like my laundry pile at home, the work is really never done.
