Lecture 3 8/22/24

Question 1

What are antiseptics?

Answer 1

products or chemicals used to kill or inhibit microbes on living things

Question 2

What are disinfectants?

Answer 2

products or chemicals used to kill or inhibit microbes on non-living things

Question 3

What are the equipment classification levels for disinfection prior to use?

Answer 3

-critical: must be sterile prior to use
-semi-critical: must have high-level disinfection prior to use
-non-critical: must have low-level disinfection prior to use

Question 4

What is sterilization?

Answer 4

process of eliminating pathogens from non-living tissue by destroying all forms of microbial life through physical or chemical methods

Question 5

What are the available sterilization methods?

Answer 5

-steam
-ethylene oxide
-hydrogen peroxide
-radiation
-gludaraldehyde cold sterilization

Question 6

How does steam sterilization work?

Answer 6

increased pressure increases temperature of steam to destroy microbes

Question 7

When is ethylene oxide used for sterilization?

Answer 7

heat sensitive items

Question 8

Why is plasma sterilization more ideal than ethylene oxide?

Answer 8

it is safer than EtO gas while still being ideal for heat sensitive items

Question 9

Why can plasma sterilization not be used on items like endoscopes, linens, and gauze sponges?

Answer 9

the vapor is absorbed into the material

Question 10

What are the characteristics of ionizing radiation?

Answer 10

-only used commercially due to expense, size, and regulations
-pre-packaged items from manufacturer may not be able to be re-sterilized

Question 11

What are the key components of instrument care?

Answer 11

-use of enzymatic cleaners to remove organic debris prior to sterilization
-using ultrasonic and manual cleaning
-lubrication
-clean lumens
-routine maintenance and sharpening
-proper pack prep., including having instruments unassembled and unengaged

Question 12

What are the types of sterilization indicators?

Answer 12

-mechanical/physical
-chemical
-biological

Question 13

What are the FDA standards for antiseptics?

Answer 13

-substantially reduce transient microorganisms
-possess broad-spectrum of antimicrobial properties
-fast-acting
-have persistent, cumulative activity
-be non-irritating to the skin

Question 14

What are the general characteristics of chlorhexidine?

Answer 14

-cationic biguanide
-broad-spectrum
-not sporicidal, but can potentially prevent them
-must know concentration

Question 15

What is the method of action of chlorhexidine?

Answer 15

disruption of the cell membrane

Question 16

What are the physiologic characteristics of chlorhexidine?

Answer 16

-broad spectrum with rapid onset
-residual activity for up to 2 days
-2-5 minute contact time; high end for surgical prep.
-binds to stratum corneum
-scrub or solution

Question 17

What are the adverse effects/disadvantages of chlorhexidine?

Answer 17

-ototoxic if in contact with middle or inner ear
-neurotoxic
-toxic to the eye at conc. above 2%
-may be inactivated by organic debris
-may cause oral irritation in felines

Question 18

What is the method of action of iodine?

Answer 18

effects protein synthesis and alters bacterial cell wall

Question 19

What is the spectrum of iodine?

Answer 19

-bacteria
-viruses
-fungi
-protozoa
-spores

Question 20

What are the general characteristics of povidone iodine/betadine?

Answer 20

-povidone is a carrier polymer that allows for slow release of iodine
-should not be used in open wounds due to risk of iodine absorption and retardation of fibroblasts
-skin reactions are common; especially avoid in people with shellfish allergies

Question 21

What are the physiologic characteristics of povidone iodine?

Answer 21

-broad spectrum
-residual activity for 4-6 hours
-contact time of 2 minutes
-stains skin
-scrub or solution
-dilutions will release more free iodine

Question 22

What is the mode of action for alcohols?

Answer 22

denature proteins

Question 23

What is the spectrum for alcohols?

Answer 23

-broad gram positive and negative bacteria
-multi-drug resistance pathogens
-fungi
-mycobacterium

Question 24

What are the characteristics of 70% isopropyl alcohol?

Answer 24

-fast killing of bacteria, but not effective against spores
-most effective and rapid single-acting agent
-harsh to mucous membranes
-dries out skin
-denatures fats and proteins

Question 25

What are the disadvantages of using alcohols?

Answer 25

-corrosive to stainless steel -can lead to hypothermia in smaller patients -no residual activity; quick to evaporate -flammable; caution needed with laser or electrocautery

Question 26

When should surgical checklists be performed?

Answer 26

-before induction of anesthesia -before skin incision -before/during patient recovery

Question 27

What precautions should be taken in regards to hair removal?

Answer 27

-do not clip hair the day before surgery -be cautious of razor burn and micro-lacerations that could lead to infection -avoid hair on leg wraps -avoid warm blades -do not clip hair in the OR

Question 28

What are the characteristics of aseptic surgical patient prep?

Answer 28

-use cotton or gauze to apply -use water or alcohol to rinse -use target pattern and go from clean to dirty -finish with a sterile prep in OR with antiseptic solution

Question 29

What is the concept of clean hand and dirty hand when prepping patients?

Answer 29

cotton/gauze with cleaning solution should be taken from the container with the clean hand, and then transferred to the dirty hand that will interact with the patient

Question 30

What should be done whenever a male's prepuce is in the prep field?

Answer 30

flush of the prepuce for at least two minutes with dilute antiseptic prior to skin prep

Question 31

What are the characteristics of one step preps?

Answer 31

-need time to air dry -contact time depends on product -applied to clean and dried skin -used as a final prep