sterlization Flashcards
best way to remove blood from surgical instruments
§ Alcaline, low sudsing detergent or enzymatic solution and cold water is best to remove blood
§ Ultrasonic cleaning is good for removing blood that has been set by exposure to heat or in the box-lock of instruments (open box- lock)
are lubricant baths good for preparing instruments? why? what about lubricant sprays?
§ Lubricant baths are no longer recommended due to contamination issue with repeated use (bacterial contamination)
§ Surgical lubricant sprays are recommended (not industrial or household oils) to lubricate instruments and minimize corrosion
how to use autoclave to kill microbes
§Minimum of 30 minutes at 121°C is the standard minimum exposure to kill most infective organisms using a gravity displacement autoclave
what does autoclave kill?
§Kills bacteria, viruses, fungi and spores
how to flash sterilize with autoclave
§Flash sterilizing is done on an unwrapped instrument
§Must be in an open, perforated tray (with a towel at bottom)
§Minimum 132°C for 4 minutes (actual cycle takes longer)
§Need a special type of autoclave (prevacuum autoclave*) for this to be done
why do packs need to cool slowly after autoclaving
prevent condensation
what can prolong shelf-life of sterile packs?
plastic sleeves
what factors can lead to failed sterilization?
§Improper instrument cleaning
§Harbor bacteria
§Mechanical failure
§Poor function / maintenance
§Improper use of equipment
§Read / follow the instructions
§Improper wrapping
§ Contamination
§Poor loading
§Does not contact all surfaces
sterility indicator types, and how they work
§ Chemical indicators: strip that changes colour /checkmark if exposed to a set temperature, pressure or humidity
ØDoes not indicate for how long or that sterilization actually occurred
§ Biological indicators: Sealed tubes containing bacterial spores to be destroyed by sterilization
ØMust culture to see if spores are dead…
> Biological indicators are more reliable but less useful given the delay to culture the indicator
§ Rapid-action indicators with colored reaction (1-2 h) are more useful but only if you have enough packs to wait to use…
options for chemical sterilization for instruments? disadvantages?
§Ethylene oxide:
> Most common gas sterilizer
> Capable of killing all microorganisms
§ Disadvantages:
§ Absorption by rubber, plastic etc.
§ Requires long aeration times (12 hours to 7 days)
§ Many are illegal in US and and Canada (CFC 12)
how does plasma sterilization for instruments work? advantages and disadvantages?
§Plasma sterilization: (Sterad®)
§ Vapour phase hydrogen peroxide
§ Rapid with no aeration period required
§ No toxic residue
§ Disadvantages:
§ Some materials cannot be sterilized using this method e.g. gauze sponges, some plastics, liquids etc.
§ $$$
what is cold sterilization? what is it good for and how do we do it?
§ Soaking instruments in disinfectant solutions
§ Gluteraldehyde is most commonly used
§ Effective against many bacteria, viruses & spores
§ Usually used for instruments that are used in “dirty” surgeries or endoscopic equipment
§ Must rinse very well before use
