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Behind the scenes: A look at how SGH keeps its surgical tools clean

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SINGAPORE: The constant clank, clank, clanking of metal on metal. 

It’s the sound you hear as you step into the Theatre Sterile Supplies Unit (TSSU). And it’s no wonder as the unit processes over 25,000 pieces of surgical equipment every month.

Located in the basement of the Singapore General Hospital (SGH) in Block 3, this little known unit is responsible for cleaning, sorting and sterilising all the surgical tools used by the hospital. This gruelling task lies with the team of 63 staff, whose main aim is to ensure the surgical tools are infection free, as this could make the crucial difference between life and death for patients. 

To cater to the surgical needs of SGH, the TSSU operates round the clock, with the staff rotated in eight-hour shifts across 24 hours.

With thousands of items under its care, the unit has a comprehensive inventory tracking system to ensure each and every piece is accounted for.

Seventy per cent of the washing and sterilisation processes are automated. The remaining 30 per cent of the work, however, still requires the human touch. This includes the manual checking, sorting and packing of instruments. 

TSSU staff checking surgical equipment post-surgery before they are sent for washing. (Photo: Cheryl Goh)

After surgery, the used tools are given an initial rinse, then transported to the TSSU via a specially designed lift that limits their exposure. They are then scanned, and checked for defects or if there are any missing items.

“When instruments don’t work, we’ve got to identify the problem. This is very important for patient safety. We need to get to the heart of the problem, so that we can rectify and take the necessary action,” said Koh Ka Cheong, a senior technician at TSSU.  

Senior technician Koh Ka Cheong reassembles a surgical power tool after it has been washed and cleaned. (Photo: Cheryl Goh)

The instruments are arranged in trays to ensure water can reach every nook and cranny before they are loaded into special washing machines. The water temperature in these machines can go up to 93 degrees Celsius. 

Washing machines where the surgical tools are washed with water heated up to 93 degrees Celsius. (Photo: Cheryl Goh)

After the tools are dried, the staff meticulously packs and wraps the items in sets. This process requires sharp eyes to ensure each set has the right tools. Each set can have up to 80 items.

The packed tools then go through part two of the cleaning ritual, where they are sterilised with steam at up to 134 degrees Celsius for about an hour to ensure all the germs are killed. They are cooled in storage before being delivered to the operating theatre when required. After each session of surgery, the whole cycle begins again.

The items are scanned at every step of the cleaning process to ensure they are accounted for. In the unlikely event something goes missing, stringent measures are in place.

“If the item cannot be located, we will inform the operating theatre nurses, who will inform the surgeon concerned. The surgeon will then decide whether to order an X-ray to exclude the possibility of the item being inside the patient,” said senior nurse manager Seah Soon Peng.

These back-end tasks at the TSSU are laborious and unglamorous, a far cry from the patient-facing work of doctors and nurses going on just one level above.

But the staff here takes great pride in what they do. “If there’s no problem and everything goes smoothly where patient safety is concerned, then I’m very happy,” said Mr Koh. 

“The greatest satisfaction would be when the surgery goes smoothly without any hiccup,” he said.

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5-car chain collision on PIE causes congestion

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SINGAPORE: Five cars were involved in a chain collision on the Pan-Island Expressway (PIE) on Thursday (Jan 18) afternoon, causing congestion for more than an hour.

Channel NewsAsia understands that there were no injuries.

Five vehicles were involved in the chain collision accident. (Photo: SG Road Vigilante/田晨夕) 

The Land Traffic Authority (LTA) alerted drivers to the accident slightly past 4pm. The authority also said there was congestion until the Toa Payoh exit, and warned drivers to avoid the first lane.

About 10 minutes later, the LTA sent out another tweet, saying that the congestion had extended until the CTE (City) exit. 

The congestion was cleared about one hour later, although there heavy traffic remained after the Thomson Road exit, according to another LTA tweet.

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Inside the Theatre Sterile Supplies Unit

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SINGAPORE: The constant clank, clank, clanking of metal on metal. 

It’s the sound you hear as you step into the Theatre Sterile Supplies Unit (TSSU). And it’s no wonder as the unit processes over 25,000 pieces of surgical equipment every month.

Located in the basement of the Singapore General Hospital (SGH) in Block 3, this little known unit is responsible for cleaning, sorting and sterilising all the surgical tools used by the hospital. This gruelling task lies with the team of 63 staff, whose main aim is to ensure the surgical tools are infection free, as this could make the crucial difference between life and death for patients. 

To cater to the surgical needs of SGH, the TSSU operates round the clock, with the staff rotated in eight-hour shifts across 24 hours.

With thousands of items under its care, the unit has a comprehensive inventory tracking system to ensure each and every piece is accounted for.

Seventy per cent of the washing and sterilisation processes are automated. The remaining 30 per cent of the work, however, still requires the human touch. This includes the manual checking, sorting and packing of instruments. 

TSSU staff checking surgical equipment post-surgery before they are sent for washing. (Photo: Cheryl Goh)

After surgery, the used tools are given an initial rinse, then transported to the TSSU via a specially designed lift that limits their exposure. They are then scanned, and checked for defects or if there are any missing items.

“When instruments don’t work, we’ve got to identify the problem. This is very important for patient safety. We need to get to the heart of the problem, so that we can rectify and take the necessary action,” said Koh Ka Cheong, a senior technician at TSSU.  

Senior technician Koh Ka Cheong reassembles a surgical power tool after it has been washed and cleaned. (Photo: Cheryl Goh)

The instruments are arranged in trays to ensure water can reach every nook and cranny before they are loaded into special washing machines. The water temperature in these machines can go up to 93 degrees Celsius. 

Washing machines where the surgical tools are washed with water heated up to 93 degrees Celsius. (Photo: Cheryl Goh)

After the tools are dried, the staff meticulously packs and wraps the items in sets. This process requires sharp eyes to ensure each set has the right tools. Each set can have up to 80 items.

The packed tools then go through part two of the cleaning ritual, where they are sterilised with steam at up to 134 degrees Celsius for about an hour to ensure all the germs are killed. They are cooled in storage before being delivered to the operating theatre when required. After each session of surgery, the whole cycle begins again.

The items are scanned at every step of the cleaning process to ensure they are accounted for. In the unlikely event something goes missing, stringent measures are in place.

“If the item cannot be located, we will inform the operating theatre nurses, who will inform the surgeon concerned. The surgeon will then decide whether to order an X-ray to exclude the possibility of the item being inside the patient,” said senior nurse manager Seah Soon Peng.

These back-end tasks at the TSSU are laborious and unglamorous, a far cry from the patient-facing work of doctors and nurses going on just one level above.

But the staff here takes great pride in what they do. “If there’s no problem and everything goes smoothly where patient safety is concerned, then I’m very happy,” said Mr Koh. 

“The greatest satisfaction would be when the surgery goes smoothly without any hiccup,” he said.

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Kidnap scares: One more international school flags incident involving a stranger offering lift to student

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Singapore

Thursday, January 18, 2018 – 17:28

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CNY shopping with Great Value & Savings at Harvey Norman

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Singapore

Friday, January 19, 2018 – 09:15

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Cabby injured after Sengkang lift plunges three storeys in a second

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An elderly cabby suffered injuries on his ankle and shoulder after he was thrown off his feet when the lift he was on descended three stories within a second.

The incident happened at Block 122, Sengkang East Way on Tuesday (Jan 16) at around 6pm.

This comes after a separate incident at around 5pm on Monday (Jan 15), in which the cabby tripped due to a misalignment between the lift floor and the lobby, reported Shin Min Daily News.

The cabby, Mr Chen Tianfu, 63, told the paper that he was about to step into the lift when he noticed that the floor of the lift was not aligned with the pavement of the lobby floor.

According to Mr Chen, there was about a 15cm height difference between the lobby and the lift floor.

He was not paying attention and tripped.

Said Mr Chen: “Lucky I held onto railings.

“The next day I boarded the lift on the 7th floor but ran into problems again.

“After the lift doors shut, within a second or sooner, the lift suddenly went from the 7th floor to somewhere between the 4th and 5th floor.

“I lost my balance and fell on the floor.

“I didn’t have time to regain balance before the lift started jerking up violently twice.

“I fell again.

“After a while, the lift returned to normal again.”

After alighting from the lift, Mr Chen felt pain on his right shoulder and suffered a swollen right ankle.

Passersby at the void deck realised that something was amiss and wanted to call an ambulance, but Mr Chen said he was badly hurt and chose to go back home to recuperate instead.

He added: “This lift often malfunctions and the doors can’t close properly.

“Not long ago, it underwent maintenance for almost two weeks, and only resumed operations on Jan 14. I never thought it’ll malfunction again after being repaired.

“This time, it seems even worse than before.”

Singapore

Thursday, January 18, 2018 – 16:36

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Cabby injured after Sengkang lift plunges three storeys in a second: 'Lucky I held onto railings'

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An elderly cabby suffered injuries on his ankle and shoulder after he was thrown off his feet when the lift he was on descended three stories within a second.

The incident happened at Block 122, Sengkang East Way on Tuesday (Jan 16) at around 6pm.

This comes after a separate incident at around 5pm on Monday (Jan 15), in which the cabby tripped due to a misalignment of the lift floor and the lobby, reported Shin Min Daily News.

The cabby, Mr Chen Tianfu, 63, told the paper that he was about to step into the lift when he noticed that the floor of the lift was not aligned with the pavement of the lobby floor.

According to Mr Chen, there was about a 15cm height difference between the lobby and the lift floor.

He was not paying attention and tripped.

Said Mr Chen: “Lucky I held onto railings.

“The next day I boarded the lift on the 7th floor but ran into problems again.

“After the lift doors shut, within a second or sooner, the lift suddenly went from the 7th floor to somewhere between the 4th and 5th floor.

“I lost my balance and fell on the floor.

“I didn’t have time to regain balance before the lift started jerking up violently twice.

“I fell again.

“After a while, the lift returned to normal again.”

After alighting from the lift, Mr Chen felt pain on his right shoulder and suffered a swollen right ankle.

Passersby at the void deck realised that something was amiss and wanted to call an ambulance, but Mr Chen said he was badly hurt and chose to go back home to recuperate instead.

He added: “This lift often malfunctions and the doors can’t close properly.

“Not long ago, it underwent maintenance for almost two weeks, and only resumed operations on Jan 14. I never thought it’ll malfunction again after being repaired.

“This time, it seems even worse than before.”

Singapore

Thursday, January 18, 2018 – 16:36

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Elevators/Lifts

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Man dies from critical kidney failure after visiting unlicensed TCM practitioner for 15 months

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An ill man attended weekly sessions with an unlicensed traditional Chinese medicine (TCM) practitioner operating from his Marsiling flat but died from a critical kidney failure 15 months into treatment.

The unlicensed practitioner has been charged with the illegal practice and advertising of his services.

Wong Choo Kum, 69, had pleaded not guilty to the charges during the trial on Monday (Jan 15).

In the second round of trials on Wednesday morning (Jan 16), Wong did not have a lawyer.

According to the charges read out, Wong had operated his makeshift clinic in his flat at Block 16, Marsiling Lane, between November 2013 and January 2015.

He checked the deceased’s pulse and tongue during each session and told him that he was susceptible to a stroke or major illness.

He then prescribed him medicine to prevent and treat diabetes and other illness.

The court understands that Wong’s girlfriend and daughter also stayed in the same flat in which Wong practised TCM.

Wong is also accused of distributing illegal flyers promoting his services to residents at Block 19, Marsiling Lane in September 2013.

It was revealed in court that the deceased, who cannot be named due to a gag order, had suffered from a myriad of ailments, including diabetes, high blood pressure and high cholesterol.

He was already on western medication, reported Lianhe Wanbao.

However, his widow said that after Wong promised to ‘cure her husband completely’ in 13 sessions, he decided to forgo the medication and ‘focus’ on getting treated by Wong.

Wong has denied the charges, citing that he is not a TCM practitioner and does not use TCM methods to treat patients.

However, the deceased’s wife said:

“My late husband told me that the accused (Wong) promised to cure him in 13 sessions.

“The accused also told him even if he continued with his western medical procedures, he would still eventually go blind.”

She added that in the initial stages, her husband seemed more energetic after taking the medication and herbs prescribed by Wong.

However, as the sessions continued, he started becoming dizzy.

Medicines and herbs retrieved from Wong’s inventory were revealed to contain sildenafil, a substance used to treat erectile dysfunction, and improve male potency.

By February 2015, Wong claimed that he had already ‘cured’ the deceased, but the latter’s condition continued to deteriorate.

He lost sight in his left eye, while both his legs became swollen.

He later sought treatment at a clinic and had an operation for his eye at a hospital.

The widow added that when during the sessions when she accompanied her husband, she witnessed Wong providing chiropractic massage.

As her hands were aching at that time, she accepted Wong’s offer to treat her.

After the massage, Wong gave her a few medical patches, similar to the ones he had pasted on her husband’s back.

He then told her it would cost her $1,200 if she wanted to continue her treatments.

She said: “It was just my hands hurting, but he wanted to charge me so much.

“At that time, I was so shocked… I never returned to his house again after that.”

Singapore

Thursday, January 18, 2018 – 15:32

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Celine Dion's Jakarta concert ticket price reaches $2,300

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The ticket prices for Celine Dion’s upcoming concert in Jakarta have reportedly reached Rp 25 million (S$2,316) excluding tax and administration fees.

Previously it was announced that the Emerald category, which is supposedly the most prominent category in the concert, would cost “only” Rp 12.5 million.

The Rp 25 million ticket appears on the ticket seller’s website as a reservation-only Diamond category, which was not listed on the concert’s poster.

Other categories available for fans seeking to watch Dion’s live performance are Sapphire, Ruby, Gold, Silver, Bronze and Green. Several of these were reportedly already fully booked when this article was being written, such as Ruby A1, A3 as well as B1, Bronze A1, Green A2 and Green B2. The pre-sales tickets for Green A1 and B1 are said to have already sold out.

Despite the extraordinary high price of the tickets, netizens were nonetheless excited to have the opportunity to watch the songstress of “My Heart Will Go On”.

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Celine Dion is slated to perform in Indonesia for the very first time on July 7 at Sentul International Convention Center, Bogor, West Java.

Tickets for the show are available from Jan. 19 at 11 a.m., while members of Team Celine will be able to purchase them between Jan. 17 at 10 a.m. and Jan. 19 at 10 a.m. (kes)

Thursday, January 18, 2018 – 14:51

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