Chapter 8 Sterilization Flashcards
(146 cards)
1
Q
Class 1 indicator?
A
External CI= Tape, turns black..
2
Q
Class 2 indicator?
A
Used in certain test procedures such as Bowie dick tests for the pre vacuum sterilizers
3
Q
Class 3 indicators? Single-variable
A
Designed to only 1 variable (example;glass ampule that contains a chemical that contains a chemical that melts when sterilized)
4
Q
Class 4 indicators? Multi-variable indicators
A
designed to react to two or more of the variable of the sterilization process that they are designed to monitor. Most class 4 indicators show a successful endpoint by color change
4
Q
Class 5 indicators
A
designed to reach their endpoint response when exposed to critical variables -- time, temperature and the presence of steam. This class of chemical indicator provides the most thorough information about the effectiveness of steam sterilization cycles. Class 5 CIs must have three stated values* – at 121°C, 135°C and one temperature in between – a Class 5 CI and the BI indicates a sterilization failure, the Class 5 CI will also indicate a sterilization failure.
5
Q
Class 6 indicators?
A
Designed to react to all of the official variables of the specific sterilization process that they are designed to monitor. Class 6 does not contain spores… labeled for pre vacuum, express at 270*F at 4 min cycle. (non-implant loads)
6
Q
ALL ABOUT STEAM
A
……
7
Q
Kill action?
A
Denature, Coagulation
8
Q
Sterilant?
A
Steam under pressure (Ideal steam quality 97% dry saturated steam, 3% estrained water
9
Q
Paratmeters?
A
- Steam under pressure
- Time
- Tempature
10
Q
Indications?
A
Heat & Moisture tolerant/resistant
11
Q
Wrapping?
A
Textiles(thread,yarn), Non wovens (single use only, made up of cellulose, plastic) Paper-plastic pouches, Polyolefin wraps(thermal plastics), Rigid sterilization containers
12
Q
BI?
A
Geobacillus stearothermophilus
13
Q
ALL ABOUT EO
A
…..
14
Q
Chemical indicator (color changes)
A
Clear to black
15
Q
Cycles?
A
Pre-vac & gravity displacement
16
Q
Issues
A
Drying time & Wet packs
17
Q
Kill action
A
Alkalynation
18
Q
Sterilant
A
100% EO (mixed with HCFH and CO2)
19
Q
4 Parameters
A
- EO concentration
- Time
- Temp
- Humidity
20
Q
Indications
A
Heat, pressure and moisture SENSITIVE items
21
Q
Wrapping
A
Textiles, Non-woven, paper-plastic pouches, certain Rigid containers, Polyethylene, Polyolefin, Tyvek (all plastic)
22
Q
BI?
A
Bacillus Atraphaes
23
Q
Chemical indicator?
A
N/A
24
Cycles
100% EO-Vacuum
| mixtures-pressure
25
Issues?
Aeration time
26
ALL ABOUT LTGP
....
27
Kill action?
Oxidation
28
Sterilant
59% Hydrogen Peroxide plasma
29
3 Parameters
1. Hydrogen Peroxide GP
2. Time
3. Tempature
30
Indications
ALL items except for LUMENED ITEMS!
31
Wrapping
polyolefin wraps, Tyvek pouches (all plastics) Certain Rigid containers
32
BI?
Geobacillus stearothermophilus
33
Chemical Indicator (Color changes)
RED-YELLOW
34
Cycle
NX- standard/advanced and 100NX-standard/flex/express
35
Issues
Limits on lumens, length and depth on endoscopes
36
ALL about LTHP
....
37
Kill action
Oxidation
38
Sterilant
59% LIQUID hydrogen Peroxide Concentration (vaporized)
39
Parameters
1. Hydrogen Peroxide concentration
2. Time
3. Tempature
40
Indications
Heat, Pressure & Moisture SENSITIVE items (Like EO)
41
wrapping
Polyolefin wraps, tyvek pouches (all plastic)
42
BI
Geobacillus sterathermophilus
43
Chemical indicator (color changes)
N/A
44
Cycles
Lumens, non lumens and combo of both
45
Issues
Oxidizing agent can be corrosive to device surfaces
46
ALL ABOUT OZONE
.......
47
Kill action
Oxidation
48
Sterilant
Ozone (O3)
49
Parameters
1. Ozone concentration
2. Time
3. Tempature
50
Indications
Stainless steel instruments
51
Wrapping
Certain rigid containers, non-woven cellulosic (paper)
52
BI
Geobacillus sterathermophilus
53
Chemical Indicators (color changes)
N/A
54
Cycles
N/A
55
Issues
very corrosive to stainless steel instruments
56
All about DRY HEAT
.....
57
Kill action
Oxidation
58
Sterilant
High heat
59
2 Parameters
1. Time
| 2. Tempature
60
Indications
Powder/Oils
| Petroleum-based products
61
Wrapping
Aluminum foil, metals, glass containers, gassing envelopes
62
BI
Bacillus atrophaeus
63
Chemical Indicator (Color changes)
N/A
64
Cycles
Gravity convention
65
Issues
Long sterilization process
66
Environmental conditions in sterilization?
68*F-73*F, humidity 35-60% (ideally 50%) 10x per hr at positive air pressure
67
Sterilizer "access" area
Loaction: behind the sterilizer Access for: Service reps (repair)
68
Sterility?
The absence of all microbial life including "BACTERIAL SPORES"
69
What's required in order for sterilization to do it's job
That PARAMETERS are met.
70
How many spores is sterilization designed to kill?
1 Million
71
How is it measured?
10-6th
72
What is SAL
Sterility Assurance Level
73
For sterile to remain sterile?
Only touched by sterile objects or used by aseptic presentation
74
3 cycle parameters needed in steam sterilization?
1. Saturated steam under pressure
2. Time
3. Temp
75
Steam sterilization occurs by?
Condensation
76
Kill process for steam?
Denature/coagulation
77
True or False? Is steam the most cost efficient and non-toxic?
TRUE
78
what types of items used in steam
Heat and moisture tolerant
79
There is sufficient steam pressure and it enters the...
Steam jacket
80
What is the recommended range of pressure found in the steam lines/steam supply???
60-80 psig
81
Chamber is surrounded by a jacket and steam is keep jacket?
warm
82
Pressure range within the jacket?
60-80 psig
83
Where does steam exit?
Drain line
84
Coldest part of sterilizer?
Drain line
85
What device is kept in coldest part of sterilizer?
Heat sensing thermometer
86
PCD
Process challenge device (Biological Indicators)
87
Where is PCDs and Bowie dick (CI) placed?
bottom shelf above drain line (coldest part) and checked daily
88
How is it measured
by the relative dryness of the steam
89
% of dry saturated steam?
97%-100%
90
% of estranged water?
3%
91
Term used when saturated steam is subjected to a higher temp? and there is an absence of water?
Super heating
92
What should not be in the chamber?
AIR
93
2 BASIC steam cycles?
DAR aka PREVAC (mechanical)
94
Prevac
Air is removed from chamber and load by means or pressure and vacuum excursions
95
Minimun exposure time for PREVAC?
3-@275*F (28-30psig)
| 4-@270*F (28-30psig)
96
Gravity-displacement?
residual air through an open vent and air sucked out immediately
97
On rare occasions what type of substances can only be processed in gravity displacement
LIQUIDS, gravity due to slow exhaustion
98
(L-H) Minimum exposure time for Gravity displacement steam?
10 mins-275*F and 30 psi steam pressure
15-25 mins @270 and 27 psi steam pressure
30 mins @250*F and 15 psi steam pressure
99
10 mins?
275*F at 30 psi
100
15-25?
270*F at 27 psi
101
30?
250*F at 15 psi
102
4 phases of steam?
Conditioning-air is removed from chamber and steam injected
Packs are gradually heated- to reduce amount of condensation
Sterilization/exposure phase-tempature maintained for the prescribed amount of time
Exhaust phase-Steam is exhausted
Drying phase-lasts about 30 mins (in DAR filtered air is drawn into chamber)
and drying in (gravity displacement - heat in chamber evaporates moisture)
103
IUSS- Immediate use steam sterilization aka FLASH are used in?
OR, Ambulatory surgery centers and labor and delivery
104
Used when...
a one of a kind item is dropped
105
Wrapped or unwrapped?
UN wrapped
106
Steriizer express cycle?
in which devices to be sterilized are packaged in single ply
107
what items CANNOT be processed in IUSS-FLASH?
Porous and lumens cannot be processed in an express cycle
108
ALL items should be?
Documented on IUSS form
109
IUSS cycles
PRE-VAC and High speed Gravity?
110
Pre-vac in IUSS
270*F metal non-porous, no lumens @ 3 mins
| 270*F metal w/lumens, porous @ 4 mins
111
HS gravity?
270*F metal non-porous, no lumens @ 3 mins
| 270*F metal w/ lumens. porous item @ 10 mins
112
Can items contaminated with prions be used in IUSS?
NO
113
Prion, CJD or TSE's?
Extended sterilization
114
Minimun parameters needed to destroy Prions as recommended by AAMI?
PreVAC and GRavity displacement?
115
Prion PreVAC (Higher temp, shorter time)
273*F 28-30 @ 18 mins
116
Prion Gravity (lower temp, longer time)
250*F 15-17 @ 60mins
117
% in Mechanical erros in steam
15%
118
% in Human errors?
85%
119
Gases that enters chamber that can cause failures?
Non condensable gases also one of the causes of Bowie dick tests (CI)failures...
120
Bowie dick tests are for?
Test for air in chamber and the only steam process this test is used on is the PREVAC aka DAR.
121
It air removal tests required for gravity displacement and steam flush sterilization?
NO
122
When is BOWIE DICK (CI) performed?
1st shift of day (same time and day) in an empty cycle, no drying required.
123
After cycle is done what should one do once the CI Bowie dick pack is allowed to cool?
Uniform change should be verified
124
Bowie dick dry time?
3-4 mins after DOCUMENT after every use
125
BOWIE DICK IS A?
CLASS 2
126
What happens inside if drying doesn't take effect?
Wet packs or wicking
127
what is used when drying with PREVAC?
Hepa air filter
128
how are packs dried in Gravity-displacement?
Evaporation
129
Drying depends on several factors
Weight and configuration of sets and how you load sterilizers
130
how does air and steam exit chambers?
Drain
131
This Class chemical indicator is used steam sterilization only
CLASS 1 autoclave tape
132
BI test incubation procedure
.....
133
How long does it take for the BI or BI viral for LARGER units using steam take to incubate (after sterilization)
48 hours
134
How long does an enzyme-based rapid readout for a (BI or larger readout take to incubate (after sterilization)
3 hours
135
IUSS incubation for (bi ir bi viral)
24-48 hours
136
IUSS enzyme based rapid readout
1-3 hours
137
Incubation positive in BI is
BAD
138
IUSS incubator temp?
131*F to 140*F
139
how many spores does 1 BI have?
i million
140
When is Test BI needed?
First full load, every load "implants" after a positive BI test, qualification testing, complex instruments and testing uses
141
CONTROL BI should it be sterilized?
NO
142
CONTROL BI incubate only?
YES
143
Should it come with same lot as BI?
YES
144
Should we identify it with a "C" and date?
YES
145
what are CONTROL BI's used for
to verify spores are viable. support media (promote growth) and the CONTROL should always turn POSITVE (yellow)
