1. Temperature Monitoring and Excursions
Tennessee Immunization Program

2. What Is A Temperature Excursion (TE)?
When the temperature in a vaccine refrigerator is:
above 8⁰C (46⁰F)
below 2⁰C (36⁰F)
When the temperature in a vaccine freezer is:
above -15⁰C (+5⁰F)
below -58⁰C (-50⁰F)

3. Read and Record Twice a Day
Upon arrival to
clinic
Current temperature
Minimum/Maximum temperature
Check for alarms
1 hour before leaving
clinic
Current temperature
Check for alarms

4. Digital Data Logger For Temperature Monitoring
Records current, minimum and maximum temperatures
Records that user checked temperatures AM and PM
Visual and/or audible alarms for out-of-range temps
Low battery indicator
Data are easily downloadable to computer for review

5. Checking Temperatures Twice a Day when Clinic is Open
Presentation examples use a common Berlinger Fridge Tag 2™ model data logger; other types of loggers are acceptable and may have different instructions. Use of this example should not be construed as an endorsement or preferential recommendation.
Checking Temperatures Twice a Day when Clinic is Open

6. Be Familiar With Your Data Logger
Read the data logger manual.
Know how to:
locate and read the CURRENT, MINIMUM, & MAXIMUM temperature
download the temperature data files and read the report
recognize that a temperature alarm is indicated
audible sound?
alarm symbols on main digital display?
or text message alerts?
how to clear an alarm once addressed

7. Indicates Temperatures Within Range
Example of Fridge Tag2 (FT2)Digital Data Logger

8. 1ST Press of READ – READ the Display
Today’s MAXIMUM temperature is displayed in the lower right corner of the display.
TRIANGLE POINTING UP WILL FLASH

9. 2nd Press of READ – READ the Display
Today’s MINIMUM temperature is displayed
in the lower right corner.
TRIANGLE
POINTING
DOWN
WILL FLASH
3.2ºC

10. 3rd Press of READ – RECORD
Records (in the memory of the data logger), when the temperatures were checked.
Recorded on data logger report as “am” or “pm”.
If using a FT2L, the exact time the temperature was checked will be recorded in the Events Column.

11. Know Your Alarm Symbols

12. Example FT2 - The Giant “X” Alarm Symbol
Temperature has been or is OUT-OF-RANGE DO NOT USE VACCINE CALL TIP

13. Multiple OUT-OF-RANGE temperatures.
The Alarm Symbol
Multiple OUT-OF-RANGE temperatures.
DO NOT USE VACCINE
CALL TIP

14. Triangle (Pointing UP or DOWN) Alarm Symbol
OUT-OF-RANGE temperature alarm occurred on this day. The triangle will stay for 30 days.

15. Example – Fridge Tag2 (FT2)
Yellow & Black “Piano Keys”
A visual “picture” of alarms that occurred within past 30 days
TODAY = far right
YESTERDAY = next key
-2d = 2 days ago, etc
UP & DOWN Triangles
Up = too warm alarm occurred
Down = too cold alarm occurred
Place = day the alarm occurred

16. Know How To Handle An Alarm
Presentation examples use a common Berlinger Fridge Tag 2™ model data logger; other types of loggers are acceptable and may have different instructions. Use of this example should not be construed as an endorsement or preferential recommendation.
Know How To Handle An Alarm

17. 1 2 3 Follow These Steps DO NOT USE THE VACCINE
Unit failures cannot always be prevented.
Revaccination is 100% preventable. 2
Restore proper storage conditions (if current temperature is out of range)
Label “Do Not Use until approved by TIP” 3
CALL TIP IMMEDIATELY during business hours (8-430 Central Time) at
Answer questions from TIP
or fax data logger report to
Note edits to steps on this slide - klm

18. Standard TIP Questions for Excursion
What is the current temperature?
Is the MMR kept in the refrigerator or freezer?
Have any vaccines been given since the excursion?
Have the vaccines been involved in any previous excursions?
Do you have any open multi-dose vials (e.g., IPOL)?
Is this a stand-alone or combination R/F storage unit?
How high or low did the temperature go outside of the recommended range and for how long?
Are privately-purchased vaccines also in this unit?

19. What’s next? TIP contacts vaccine manufacturers for guidance
If private vaccines were inside the unit, TIP also will obtain manufacturer recommendations for them
Provide a list of private vaccine by brand
Merck vaccines require lot numbers & expiration dates
TIP calls the clinic and shares recommendations
Vaccine usability
Storage and handling recommendations to prevent future problems

20. Vaccine Transport (if required)
Use Emergency Vaccine Storage and Handling Plan.
Follow emergency “pack out” instructions found at
Any back-up unit used to store vaccines must meet VFC requirements
Remember, do not use the freezer portion of a combination refrigerator/freezer unit to store frozen vaccine.
You must monitor any back-up units used to store vaccine a minimum of twice a day with a VFC-approved thermometer with a current certificate of calibration, just as with the primary storage unit. No out of range temperatures.

21. Power Outage
Contact your utility company; ask an approximate time the power may be restored.
2. If power is expected to be restored in <4 hours:
DO NOT MOVE THE VACCINE.
Keep the doors shut.
Monitor the temperature inside the units
Prepared to transport vaccine to Emergency Vaccine Storage location, or hold in a properly packed temporary transport box if necessary.
If a temperature alarm occurs, notify TIP IMMEDIATELY during business hours:

22. Power Outage continued
If the utility is unsure when power will be restored and the clinic is closing:
Use Emergency Vaccine Storage & Handling Plan.
Notify TIP immediately (if after hours, call next business morning)
If restoration of power will be more than 4 hours:
Notify TIP immediately (if after hours, call next business morning) at
Why notify TIP immediately? The emergency plan is to be followed after hours: immediate notification is ONLY during business hours.

23. Presentation examples use a common Berlinger Fridge Tag 2™ model data logger; other types of loggers are acceptable and may have different instructions. Use of this example should not be construed as an endorsement or preferential recommendation.
Reviewing the Alarm

24. Indicates “too warm” alarm
1st Press of READ
If “too warm alarm” (triangle points UP), it will show the MAXIMUM temperature reached.
If “too cold alarm” (triangle points DOWN), it will show the MINIMUM temperature reached.
Indicates “too warm” alarm
10.2 C
Warmest
Temperature
Reached was
10.2C

25. 2nd Press of READ-date & time alarm occurred.
Alarm occurred on September 16, 2012 at 1:47PM

26. 3RD Press of READ - duration of alarm
Alarm lasted 3 hours and 47 minutes

27. 4th Press of READ Clears the Alarms
To clear the X, press read 4 times on EACH day a triangle
is pointing either up or down until a √ appears.

28. Reading The Data Logger Report
Presentation examples use a common Berlinger Fridge Tag 2™ model data logger; other types of loggers are acceptable and may have different instructions. Use of this example should not be construed as an endorsement or preferential recommendation.
Reading The Data Logger Report

29. Example of a FT2 Data Logger Report

30. Reading the Report
Indicates temperature has been checked once in the morning (am) & once in the afternoon (pm).
Target is 5⁰C or 40⁰F

31. Reading the Report – Lower Alarm Limit
The coldest temperature reached in a 24 hour period was 0⁰C .
The alarm lasted
3 hours 17 min.
The alarm
occurred at
12:22PM.

32. Reading the Report – Upper Alarm Limit
“In Progress” indicates a temperature reading is still occurring at this time.
*The temperature
reached 11.3⁰C for
36 minutes within
a 24 hour period.
*The time above
recommended range
was not long enough
to trigger an alarm.

33. Reading the Report – External Sensor Connection
“OK” = secure connection; temperature is being measured.
“In progress” = disconnected ; hasn’t
reached 10 min or >.
“ALARM!” = not connected for > 10 min.