Survival situations, in and of themselves, are dangerous. After all, your very survival is on the line.
To complicate the matter, survival situations often include elements beyond preventing starvation such as treating open wounds and closing up these wounds using stitches. But how do you sterilize your medical instruments to prevent introducing a new infection when you are doing this minor surgery in an emergency?
Fortunately, Dr. Joe Alton provides useful information about this issue. He notes, first of all, that sterilizing the instruments only is not enough; you have to keep an area sterile. In the medical field, they have access to drapes to lay over the part of the body that is being operated on. You may not have this advantage. Dr. Alton writes,
“Although there are commercially-prepared drapes with openings already in them (‘fenestrated drapes’), using a number of towels will achieve the same purpose, as long as they are sterile.
“The first step is to thoroughly wash any item you plan to reuse before you sterilize it. Using a soft plastic brush removes blood, tissue particles, and other contaminants that can make sterilization more difficult. Consider using gloves, aprons, and eye protection to guard against ‘splatter’.”
Dr. Alton also notes six ways to sterilize instruments:
“1. Simply placing them in gently boiling water for 30 minutes would be a reasonable strategy, but may not eliminate some bacterial “spores” and could cause issues with rusting over time, especially on sharp instruments like scissors or knives.
“Note: always sterilize scissors and clamps in the ‘open’ position.
“2. Soaking in bleach (Sodium or Calcium Hypochlorite). 15-30 minutes in a 0.1% solution of bleach will disinfect instruments but no longer or rusting will occur. Instruments must be rinsed in sterilized water afterward.
“3. Soaking in 70% isopropyl alcohol for 30 minutes is another option. Some will even put instruments in a metal tray with alcohol and ignite them. The flame and alcohol, or even just fire itself (if evenly distributed) will do the job, but eventually causes damage to the instruments.
“4. Chemical solutions exist that are specifically made for the purpose of high-level disinfection (not necessarily sterility) in the absence of heat, something very important if you have items that are made of plastic. A popular brand is Cidex OPA, a trade name for a solution with phthalaldehyde or glutaraldehyde as the active ingredient.
“Insert the instruments in a tray with the solution for 20 minutes for basic disinfection. Soaking overnight (10-12 hours) gives an acceptable level of “sterility” for survival purposes. There are test strips which identify when the solution is contaminated. If negative, you can reuse it for up to 14 days. As an alternative, some have recommended using 6-7.5% hydrogen peroxide for 30 minutes (household hydrogen peroxide is only 3%, however).
“5. Ovens are an option if you have power. For a typical oven, metal instruments are wrapped in aluminum foil or placed in metal trays before putting them in the oven. The oven is then heated to 400 degrees Fahrenheit for 30 minutes or, alternatively, 325 degrees Fahrenheit for 2 hours.
“6. Although ovens and microwaves have been used to sterilize instruments, probably the best way to guarantee sterility in an austere setting is a pressure cooker. Hospitals use a type of pressure cooker called an autoclave that uses steam to clean instruments, surgical towels, bandages, and other items. All modern medical facilities clean their equipment with this device (I hope).
“Having a pressure cooker as part of your supplies will allow you to approach the level of sterility required for minor surgical procedures. As you can imagine, this isn’t easy to lug from place to place, so it’s best for those who plan to stay in place in a disaster scenario.”
Now, obviously, the smartest move is, if possible, avoid a situation that could cause you to need surgery. These sterilization procedures are neither quick nor convenient, not to mention the recovery time necessary if surgery is done and the extra attention that the patient needs. But, if you must have surgery in a disaster situation, then it is better to try to do it with sterile utensils than risk infection.
What other tips do you have for sterilizing instruments in difficult situations? Share them below.