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Ice Pack

Write its two uses in public health.
1. Maintaining cold chain by using frozen ice packs in vaccine carriers and cold boxes.
2. For keeping reconstituted BCG, measles containing vaccines, rotavirus, JE and OPV during the immunization session if no other option is available. Reconstituted vaccines must be discarded after 4 hours of reconstitution.

How is an ice pack prepared for use?
Steps of preparing a frozen ice pack:
1. Fill the ice pack up to the mark.
2. Screw the lid tightly and check for any leaks.
3. Wipe dry the outer surface.
4. Place the ice packs in the freezer with the broad surface upright and parallel to each other (one can stack a larger number of ice packs this way).
5. Keep a gap or breathing space between ice packs for the freezing to be faster and uniform
6. Leave in the freezer for 24 hours.
7. The packs will be completely frozen
8. Condition the ice pack before use

What are the precautions to be taken while preparing and using the ice packs?
• Check for cracks before filling
• Do not add salt to the water.
• Do not fill water level higher than the mark on the bottle.
• Do not refill an ice pack every time before use; the same water can be used repeatedly
• Condition the ice packs before putting them into the carrier or cold box.

What is the need to condition the ice pack?
Conditioning is done to ensure that the ice pack is at 0°C only and not lesser, before it is put into the vaccine carrier.
When the ice pack is freshly taken out of a deep freezer, the temperature of the ice pack may be much below 0°C. If used immediately in the vaccine carrier, there is a risk of freeze- sensitive vaccine getting frozen and damaged.
How is an ice pack "conditioned"?
Conditioning is done by keeping the ice pack at the room temperature till condensation of water is seen on the outer surface. It can be confirmed by shaking the ice pack and ensuring that the ice moves and splashing of water can be heard.

Where various vaccines should be kept at the immunization site?
Inside the holes on the ice pack:
 BCG and
 Measles
On the surface of the ice pack:
 OPV
 JE and
 Rotavirus vaccine
Never to be kept on the ice pack:
 IPV
 Hepatitis-B
 TT
 DPT and
 Pentavalent vaccines

Reference:
GOI. Immunization Handbook for Medical Officers. New Delhi: Department of Health and Family Welfare; 2016.
GOI 2015. Introduction of Rotavirus Vaccine in the UIP, FAQs for Medical Officers. Immunization Division, Ministry of Health & Family Welfare, New Delhi, IndiaIndia