Cold Chain Handling

Department of Pharmaceutical Services

Ministry of Health

Presented by :
Daniel Wee Vui Teck
Pharmacist
Outline of presentation
Cold Chain Handling
Storing cold chain products
Types of fridges
Use of thermometers
Transporting cold chain products
Receiving and documentation
Cold Chain Handling
Cold chain products are temperature sensitive (too
hot, too cold)
Any exposure will reduce it’s efficacy ( 1 min, 5 min, 10
min)
Care must be taken when:
Storing
Transporting
Using / administering
Storing cold chain products

Pharmaceutical Refrigerators vs Domestic Fridge

• Regulated temperature, minimum fluctuation

Temperature at +2°C to +8°C

Freezer : less than -10°C (preferably -15°C to -25°C)

Storing cold chain products
Thermometers – monitor temperature.
Twice daily – morning and evening.

Max-min thermometer – to know the upper and

lower most temperature.

Standard Operating Procedures should be attached

to the fridge for easy and quick referencing.
Standard Operating Procedure
SOP
Fridge
Large space to hold maximum stock required
Well maintained/serviced
Equipped with alarm and sensors
Adding ice packs
Bottom of fridge
Small amount to be loaded at a time
Thermometer (sensor probe)
Middle part of fridge
Do not put medicine blocking or near air inlet
Maintain air circulation
Small Pharmaceutical Fridge
Large Pharmaceutical Fridge
Thermometer and record sheet
Picture example (correct storage)
Picture (lining of icepacks)
Air Inlet

Incorrect storage:
Blocking air inlet
Wrong storage
Overloaded.
Air cannot circulate
around the boxes.
Quarantine stock
Domestic Fridge and Freezer
Use in smaller clinics / MCH
Temperature should be maintained and recorded
using thermometer – twice daily
Freezer to keep ice packs and Polio vaccine
Avoid ice build-up
Never keep items in shelves of fridge door
Never keep items near the freezer compartment
Do not put medicine blocking or near air inlet
Domestic Fridge with Freezer
Cold Room
Warehouses, State Medical Store, Hospital Store
Freezer Room or Cold Room
Fitted with alarms (external) and continuous
temperature monitoring
Temperature mapping – mark hot and cold spots to
determine storage for certain products
Free circulation of air between boxes
Space for packing, unpacking of medicines
Standby Generator
Recommended to have at each health
establishment / supplier

UPS, voltage regulator is recommended to avoid

fluctuations that damage electronic equipment

Have written procedures, contacts, in case of

break.
Transporting CCP
Sturdy and appropriate container for transport
(Cool boxes, cartons, Styrofoam boxes)

Set up written procedures – nature of products,

local conditions (weather), special precautions

Packing is done to maintain temperature

Transporting CCP
Refrigerated vehicles or containers should be mapped and
monitored

Monitoring devices such as Vaccine Vial Monitor or Cold

Chain Monitor card can be used together with the
container

Review and audit to personnel, equipment and process

should be done regularly. Record should be maintained
Cold Boxes
Containers and labelling
Special handling requirements must be clearly stated
on the container
Choosing the right container
Maintain temperature during transit
Space available
Shield from outside elements e.g. temperature, rain
Length of time of transit
Maintenance of container
Clean the inner surface and left to dry
Inspect for cracks or leaks
Cold/Ice Packs
The type, size and number of cold packs should
correspond to transport duration, required
temperature and amount of medicine
Packing done to maintain temperature
Conditioning the pack – allow to warm for few
minutes before putting in
Avoid direct contact – ensure barrier existed between
ice packs and medicine to avoid freezing
Ice packs
Receiving and documentation
Recipient should examine the shipment
upon reception – checklist or SOP

Products should be promptly transferred

into suitable storage area.

Icepacks should not be put in the fridge.

Receiving and documentation
Documentation should be done and
include time, recorded temperature range

Record action taken if temperature is not

maintained

Records should be kept for future

reference
Vaccines
Use a vaccine vial monitor to check the validity of the vaccine
Take home messages
Refer to Cold Chain Guideline
Develop and update S.O.P.
Proper arrangements in the fridge
Proper arrangements during transport
Proper documentations
Educate other staff
 The End
Thank you for listening