Conventional and hazardous air sterilization techniques like fumigation and ozonators are inefficient in handling sterility of air, which is the most important aspect. Most of the cross-infection occur through air as all microorganisms travel through air borne particles. Fumigation technique has a very momentary effect as far as sterilization of air is concerned.

1. Ema
15 Years of Dedicated Efforts in
Controlling Hospital Acquired Infections
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2. Your Nobel profession is to save
patient’s life. You have built your
reputation by dedicated efforts
for several years & there is
always a pressure to maintain it.
Today by international data,
hospital acquired infection can
create havocs for operative &
post operative conditions. The
sterile air (which is generally
neglected) plays major role
under infectious conditions in
operation theater. This is
unknown challenge to your
reputation !!!!!!!

3. The Facts & Figures
Source: Khuri SF, Daley J, Henderson W, et al, Risk Adjustment of the post operative
mortality rate for the comparative assessment of the quality of surgical care: Results of
the National Veterans Affairs Surgical Risk Study. Journal of the American College of
Surgery, 1997; 185: 315-340

4. Attributable Mortality Rate Due To Hospital Acquired
infections
(Report By WHO)

5. Importance of Sterility In Hospitals
A. Medical Mistakes (source: Kaiser Permanente, the largest HMO in America)
B. Prescription Drug Side Effects (source: Annals of Internal
Medicine)
C. Hospital Induced Infections (source: Journal of the AMA)
D. Lung Cancer (source: Centers for Disease Control)
E. Stroke (source: Centers for Disease Control)
F. AIDS / HIV (source: Centers for Disease Control)
G. Auto Accidents
H. Airline Accidents
(source: International Chiropractic Association)

6. •In advanced countries hospitals are highly
equipped & patients are educated, most
importantly they expect best possible
efforts from doctors.
•While in India the doctors are expected to
do miracles ! On other side doctor’s are
facing many difficulties on many fronts.
This in turn increases the psychological
pressure on doctor.
•In addition, the consumer protection act,
heavy competition, costly apparatus and
high labor costs makes the matter more
challenging! for the doctors.

7. Existing Methods And Their Limitations
•Very Old and Effective In
Surface Sterilization but NOT
as much for Air Sterilization.
•Basically Formalin Gas Is
Used Which Is Carcinogenic.
•Fumigation Does Not
Maintains Sterility Of Air For
Long Time.
Fumigation Can Not Take Care
Of Sterility Of Air During
Surgery since Fume Has To
Be Drained Out Before
Surgery.

11. Laminar Air Flow & Limitations
•The heart of Laminar Air Flow is
HEPA filter.
•HEPA filters are designed to filter
nuclear dust and NOT for medical
application.
•The bacteria are collected and
not killed.
•There is always fear of leakage.
•It has Very high Capital and
Running costs.
The Testing method is “Particle-
count” and not “CFU-count”.

12. Geeta Mehta, Professor and Head, Dept of Microbiology, Lady Hardinge Medical College, New Delhi
Air as a Source Of Infection
Air borne contamination is mainly derived from the
personnel in the operation theatre and their activities.
The bacterial count in operation theatre is influenced
by the number of individuals present, ventilation and
air flow. Exogenous infections of surgical wounds are
caused predominantly by Staphylococcus aureus and
S. epidermidis is an important pathogen in implant
surgery. S. aureus and S. epidermidis are shed into
the environment in skin scales of which 106 are shed
by an individual each day. Studies in a number of
operating theatres have suggested that there is a
general relationship between total air count and risk
of infection. Counts in the range of 700-1800/m3 were
related to significant risk of infection and when they
were under 180/m3 the risk was slight.

13. Empty Operation Theatre
There should be less than 35 colony
forming units (cfu) of bacteria /m3 of air
and less than one cfu of Clostridium
perfringens or Staphylococcus aureus in 30
m3.
During operation : less than 180 cfu/m3
Direction of air flow
In addition to the bacterial load of the air,
the direction of air flow is also important
and should be from clean to less clean
area. Recommended air flow rates are
0.28-0.47 m3/sec across an open door to
prevent back flow into cleaner areas.

14. Procedure When to do it Method
1. Airflow check and ventilation. (Not truly a
microbiological procedure, performed with help
of engineering dept.)
1. At commissioning and refurbishing after
completion of:
Direction of air flow by Smoke test
a) All engineering work Air velocity by hot air anemometer.
b) Vacuum cleaning of ducting
c) Plant has been running at full power for
24 hours.2) Yearly thereafter
2) Air Microbial Sampling 1) At commissioning and refurbishing as
above
Settle plate using 5% sheep Blood or
Slit sampler.
2) Weekly
3) Monitoring of Sterilisation
A. Steam
1) With every cycle/Load Physical (time and temperature record,
manual or automatic)
2). Daily Bowie - Dick test,
3) Weekly B. stereothermophillus spores
B. Ethylene Oxide Gas (ETO) Every cycle Physical - (time and temperature
record) Concentration of ETO moisture
contentB. Subtilis spores
C. Equipment and
instrumentsSterilised/disinfected by liquid
chemicals(eg : gluteraldehyde)
Weekly Spot check for sterility by Swab rinse
method
4) Testing of Desinfectants and antiseptics 1) At introduction of disinfectant into
hospital
Use dilution Kelsey-Sykes capacity test.
2) Weekly In use test
5) Surface Sampling 1) At commissioning and refurbishing Rodac plate and Swab rinse method
2) During outbreak if epidemiologically
indicated.6) Testing for carriers among staff 1) At entry, employment Nasal Swab, Throat swab,rectal
swabs/stool culture
2) During outbreak Routine culture techniques using
selective media.
Note : The laboratory should establish protocol for carrying out surveillance with consultation of HICC. Interpretation of
results and action there-upon are critical factors for meaningful surveillance.

15. The contaminated air from the environment is taken in. Passes through
different filters and ESP. The air-oulet is 100 % sterile (certified by an ISO
9001: 2000 lab) Air-flow is of 120 cfm and washes the air inside the closed
environment and drastically reduces the cfu count to a minimum level.

17. HOW PLASMA CLUSTER DISTROI
THE CELL WALL OF BACTERIA
Plasma clusters surrounds
the bacteria
OH radicals remove oxygen
atom from cell wall of bacteria
Fastest way to kill the
bacteria in air

18. INACTIVATION OF VIRUS

19. Infection is one of major cause
for death in I.C.U.

20. BGM- ICU Air Sterilizer
In medically advance country like U.S.A.,
I.C.U. is a serious cause for noscomial
infections!
The Fatality Analysis Reporting Systems
Organisation (FARSO) reported 37043 fatal
crashes in 1999 in the US compared to
estimate 88000 deaths in the 2 million
patients who developed hospital acquired
infections. As reported by CDC (Center for
Disease Control) those admitted in intensive
care unit are 5 to 10 times more likely to
acquire nosocomial infections than other
hospital patients.

21. BGM's Operation Theatre
Air Sterilizer
Infection causing
submicron size air-borne
particles are electrocuted
& trapped in the E.S.P. &
HEPA filter ( 0.3 micron
filtration ) and thus
chances of infection are
reduced to great extents.
As BGM PRION-CID Air
Steriliser can work round
the clock, it cuts down the
preparation time
effectively by bringing the
particle count to a
dramatic minimal level...
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clarification Please
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without any hesitation.