Wednesday, September 11, 2013

Excuse me - How cold is the Dry Ice in that Cooler?

 Dry ice maintains a temperature of -80ºC which makes it a perfect shipping medium for blood products, frozen foods, and other temperature labile items

If you are a manager, supervisor, head, chief or otherwise known as leader in your organization you know full well being placed in the "Hot-Seat" becomes a comfortable position par for the course that comes with said titles.  Eventually, being looked upon as the leader can have its trying moments.  I have explained in previous posts about representation of a laboratory facility in an inspection or audit role.  In a less stressful situation such as interaction amongst staff of your own facility things can still get dicey.  Decorum, tact, and Witt will always prevail in every situation or interaction.  As the leader you are relied upon to give sound judgement, smart opinion, astute evaluation, and complete answers to questions.  As the leader, sometimes it is hard not to get "Fed-Up" with ridiculous questions or challenges that sometimes challenge not only reasoning skills but also patience.  Working in a large facility with hundreds to thousands of fellow staff members it is only a matter of time before one of those staff members really tries your patience.  Here is one such observation that although I gave a good observation and astute answer to a ridiculous question I ran the risk of running myself under hot water.  Every situation is different.  Whenever patient care is involved you always have to give 100% attention and serious response.  When the same issue is bantered about over and over again sometimes it is best to stop the BS and say it straight - Straight Talk From The Hematech.

Dry ice is nothing more than solidified carbon dioxide with some impurities mixed in.  As such, this substance is very efficient at keeping materials in close proximity in a frozen state.  Dry ice maintains a constant temperature of -80ºC which is very, very cold.  Laboratorians know that in order to keep blood specimens stable for long periods of time -80ºC is the temp required inside a frost-less freezer or dedicated laboratory grade freezer.  If specimens are going to be shipped across the state, overnight, or across the globe the only way to do that is with a well insulated cooler box full of dry ice to keep the specimens in a frozen stable state.  Well everything works great when there is enough dry ice packed in the box, the box is sealed properly, and the shipping is prompt and on time.  A small cooler box with 1-2 lbs of dry ice sealed appropriately will keep contents frozen for up to 5 days.  Add more dry ice such as 2+ lbs and you can insure stability of contained specimens for up to 7 days.  

This is the story of a physician office that would just not follow directions for shipping frozen specimens.  If you put a couple of pebbles of dry ice in a box you can't expect to have stability for very long.  That will not last more than an hour or two.  Well, delivery after delivery, specimens from this one physician office arrived devoid of dry ice and warm as the ambient temperature.  After several failed attempts to ship specimens to the core lab something was just plain wrong and the responsible people for packing and shipping were failing in their duties.  Project management type staff members are responsible for well managing the project and the customer.  I had had it by now.  After many emails back and forth, phone calls, disputed state of arriving cooler boxes it was time to educate the project manager.  One such day, a cooler box was expected from said physician office with supposed frozen specimens.  I notified the project manager to come to the lab to visually inspect the cooler box as it was opened.  The project manager ran right over.  As several of us, me the lab manager, several technical staff members, the project manager who was in a new position, and an assistant we all observed the opening of the box.  What would we find?  A box full of dry ice and specimens or another failed attempt at shipping specimens.  Well, after anticipation of the physician staff finally getting it right - No, just a box of warm specimens and no sign of dry ice.  What could possibly be wrong?  Why is this happening?  "Something is terribly wrong" said the project manager.  I said, "yes something is wrong - if they placed the required amount of dry ice in the box we would have frozen specimens today?"  Some banter went back and forth with the project manager; yes they were putting in dry ice, yes it was the right amount, then the ridiculous started.  Assertions flew about the cooler box and how faulty it was.  That was hog wash; it is a styrofoam box used for hundreds of shipments each day to that facility.  Then the "Piece de resistance" came out of the mouth of the intrepid project manager.  She asked, "So- how cold is the dry ice is those boxes over there?"  I replied, "they are full of dry ice and dry ice is -80ºC."  Then she asked, "Well how do you know that dry ice is cold?"  I looked at her dumb founded.  Devoid of an astute smart complete response I said the following; "Well,... stick your hand in a box of dry ice for 30 minutes, take your hand out, then smash your hand on that table over there."  "If your had shatters into a million pieces you know that dry ice is cold."  Of course that elicited a dumb chuckle from the assistant and some smiles from my staff in attendance. Blank stare from the project manager was followed by more dumb inquisitive banter.  Now the morale of the story is I might have felt better after I said what I said and it really needed to be said at that point in the situation - but that banter would come back to bite the lab.  As it turns out that project manager started dating the medical director of the laboratory.  Over head pages from the project manager emanating from the sound system through out the facility complex were heard beckoning the medical director by his pet name which we all promptly heard for the first time and only time.  I guess she got the smack-down because she never over-head paged the man again.  Anyway, might I digress?  She suggested to the medical director probably over sultry pillow talk that the cooler boxes used for transporting frozen specimens were faulty.  It could not be the staff of the physician office not placing enough dry ice in the boxes; No it had to be the cooler boxes.  Well that prompted a very scientific, thorough, and painstaking review of so said boxes.  The result of that validation found that not only were the boxes doing their job the specimens were perfectly safe for a very long travel.  

Here is the validation overview:
A handful of specimens were packed in a standard styrofoam cooler box ( approx 8" x 8" by 12") with 2.2 lbs of dry ice. In with the specimens was a very expensive temperature recording device that was capable of recording the environment temperature for over a weeks time.  The box was packed and shipped exactly as instructions were given to all physician offices shipping samples to the core lab.  The package was shipped over 1200 miles to an office then without opening the box it was return shipped back to the lab.  Well, low and behold, the temperature inside the box never wavered, dry ice was still in the box upon its return to the core lab, and specimens maintained frozen state the whole way.

Yes, dry ice is cold, very cold.  It makes for an efficient medium to pack and keep frozen all sorts of items such as foods, chemicals, and blood.  The validation was a success.  Eventually, the physician office caught on and thawed specimens were seen no more.  Good for patient care - good for my sanity.

So, think about that wise crack before you let it fly.  You never know if the receiving person is going to sleep with your boss and cause you grief.

Take care my laboratory friends.  Be careful what you overhead page.  
Another tip! Be careful of the email you send.  How embarrassing it is to be in a room observing a presentation from a managers laptop, projected on the wall for all to see.  Then in the lower right hand corner MS-Outlook flashes the subject line of an incoming email and the senders name.  Whoops, there flies another pet name!  From another Medical Director to the underling.  How true, how sad, how true.

Scott R. Mayorga A.A.S., BS MT(ASCP)H CLS

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