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Chapter 8 Sterilization > Chapter 8 Sterilization > Flashcards

Chapter 8 Sterilization Flashcards

1
Q

Class 1 indicator?

A

External CI= Tape, turns black..

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2
Q

Class 2 indicator?

A

Used in certain test procedures such as Bowie dick tests for the pre vacuum sterilizers

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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)

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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

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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.
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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)

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6
Q

ALL ABOUT STEAM

A

……

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7
Q

Kill action?

A

Denature, Coagulation

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8
Q

Sterilant?

A

Steam under pressure (Ideal steam quality 97% dry saturated steam, 3% estrained water

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9
Q

Paratmeters?

A
  1. Steam under pressure
  2. Time
  3. Tempature
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10
Q

Indications?

A

Heat & Moisture tolerant/resistant

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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

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12
Q

BI?

A

Geobacillus stearothermophilus

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13
Q

ALL ABOUT EO

A

…..

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14
Q

Chemical indicator (color changes)

A

Clear to black

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15
Q

Cycles?

A

Pre-vac & gravity displacement

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16
Q

Issues

A

Drying time & Wet packs

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17
Q

Kill action

A

Alkalynation

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18
Q

Sterilant

A

100% EO (mixed with HCFH and CO2)

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19
Q

4 Parameters

A
  1. EO concentration
  2. Time
  3. Temp
  4. Humidity
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20
Q

Indications

A

Heat, pressure and moisture SENSITIVE items

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21
Q

Wrapping

A

Textiles, Non-woven, paper-plastic pouches, certain Rigid containers, Polyethylene, Polyolefin, Tyvek (all plastic)

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22
Q

BI?

A

Bacillus Atraphaes

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23
Q

Chemical indicator?

A

N/A

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24
Q

Cycles

A

100% EO-Vacuum

mixtures-pressure

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25
Q

Issues?

A

Aeration time

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26
Q

ALL ABOUT LTGP

A

….

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27
Q

Kill action?

A

Oxidation

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28
Q

Sterilant

A

59% Hydrogen Peroxide plasma

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29
Q

3 Parameters

A
  1. Hydrogen Peroxide GP
  2. Time
  3. Tempature
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30
Q

Indications

A

ALL items except for LUMENED ITEMS!

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31
Q

Wrapping

A

polyolefin wraps, Tyvek pouches (all plastics) Certain Rigid containers

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32
Q

BI?

A

Geobacillus stearothermophilus

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33
Q

Chemical Indicator (Color changes)

A

RED-YELLOW

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34
Q

Cycle

A

NX- standard/advanced and 100NX-standard/flex/express

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35
Q

Issues

A

Limits on lumens, length and depth on endoscopes

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36
Q

ALL about LTHP

A

….

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37
Q

Kill action

A

Oxidation

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38
Q

Sterilant

A

59% LIQUID hydrogen Peroxide Concentration (vaporized)

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39
Q

Parameters

A
  1. Hydrogen Peroxide concentration
  2. Time
  3. Tempature
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40
Q

Indications

A

Heat, Pressure & Moisture SENSITIVE items (Like EO)

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41
Q

wrapping

A

Polyolefin wraps, tyvek pouches (all plastic)

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42
Q

BI

A

Geobacillus sterathermophilus

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43
Q

Chemical indicator (color changes)

A

N/A

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44
Q

Cycles

A

Lumens, non lumens and combo of both

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45
Q

Issues

A

Oxidizing agent can be corrosive to device surfaces

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46
Q

ALL ABOUT OZONE

A

…….

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47
Q

Kill action

A

Oxidation

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48
Q

Sterilant

A

Ozone (O3)

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49
Q

Parameters

A
  1. Ozone concentration
  2. Time
  3. Tempature
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50
Q

Indications

A

Stainless steel instruments

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51
Q

Wrapping

A

Certain rigid containers, non-woven cellulosic (paper)

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52
Q

BI

A

Geobacillus sterathermophilus

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53
Q

Chemical Indicators (color changes)

A

N/A

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54
Q

Cycles

A

N/A

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55
Q

Issues

A

very corrosive to stainless steel instruments

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56
Q

All about DRY HEAT

A

…..

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57
Q

Kill action

A

Oxidation

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58
Q

Sterilant

A

High heat

59
Q

2 Parameters

A
  1. Time

2. Tempature

60
Q

Indications

A

Powder/Oils

Petroleum-based products

61
Q

Wrapping

A

Aluminum foil, metals, glass containers, gassing envelopes

62
Q

BI

A

Bacillus atrophaeus

63
Q

Chemical Indicator (Color changes)

A

N/A

64
Q

Cycles

A

Gravity convention

65
Q

Issues

A

Long sterilization process

66
Q

Environmental conditions in sterilization?

A

68F-73F, humidity 35-60% (ideally 50%) 10x per hr at positive air pressure

67
Q

Sterilizer “access” area

A

Loaction: behind the sterilizer Access for: Service reps (repair)

68
Q

Sterility?

A

The absence of all microbial life including “BACTERIAL SPORES”

69
Q

What’s required in order for sterilization to do it’s job

A

That PARAMETERS are met.

70
Q

How many spores is sterilization designed to kill?

A

1 Million

71
Q

How is it measured?

A

10-6th

72
Q

What is SAL

A

Sterility Assurance Level

73
Q

For sterile to remain sterile?

A

Only touched by sterile objects or used by aseptic presentation

74
Q

3 cycle parameters needed in steam sterilization?

A
  1. Saturated steam under pressure
  2. Time
  3. Temp
75
Q

Steam sterilization occurs by?

A

Condensation

76
Q

Kill process for steam?

A

Denature/coagulation

77
Q

True or False? Is steam the most cost efficient and non-toxic?

A

TRUE

78
Q

what types of items used in steam

A

Heat and moisture tolerant

79
Q

There is sufficient steam pressure and it enters the…

A

Steam jacket

80
Q

What is the recommended range of pressure found in the steam lines/steam supply???

A

60-80 psig

81
Q

Chamber is surrounded by a jacket and steam is keep jacket?

A

warm

82
Q

Pressure range within the jacket?

A

60-80 psig

83
Q

Where does steam exit?

A

Drain line

84
Q

Coldest part of sterilizer?

A

Drain line

85
Q

What device is kept in coldest part of sterilizer?

A

Heat sensing thermometer

86
Q

PCD

A

Process challenge device (Biological Indicators)

87
Q

Where is PCDs and Bowie dick (CI) placed?

A

bottom shelf above drain line (coldest part) and checked daily

88
Q

How is it measured

A

by the relative dryness of the steam

89
Q

% of dry saturated steam?

A

97%-100%

90
Q

% of estranged water?

A

3%

91
Q

Term used when saturated steam is subjected to a higher temp? and there is an absence of water?

A

Super heating

92
Q

What should not be in the chamber?

A

AIR

93
Q

2 BASIC steam cycles?

A

DAR aka PREVAC (mechanical)

94
Q

Prevac

A

Air is removed from chamber and load by means or pressure and vacuum excursions

95
Q

Minimun exposure time for PREVAC?

A

3-@275*F (28-30psig)

4-@270*F (28-30psig)

96
Q

Gravity-displacement?

A

residual air through an open vent and air sucked out immediately

97
Q

On rare occasions what type of substances can only be processed in gravity displacement

A

LIQUIDS, gravity due to slow exhaustion

98
Q

(L-H) Minimum exposure time for Gravity displacement steam?

A

10 mins-275F and 30 psi steam pressure
15-25 mins @270 and 27 psi steam pressure
30 mins @250F and 15 psi steam pressure

99
Q

10 mins?

A

275*F at 30 psi

100
Q

15-25?

A

270*F at 27 psi

101
Q

30?

A

250*F at 15 psi

102
Q

4 phases of steam?

A

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
Q

IUSS- Immediate use steam sterilization aka FLASH are used in?

A

OR, Ambulatory surgery centers and labor and delivery

104
Q

Used when…

A

a one of a kind item is dropped

105
Q

Wrapped or unwrapped?

A

UN wrapped

106
Q

Steriizer express cycle?

A

in which devices to be sterilized are packaged in single ply

107
Q

what items CANNOT be processed in IUSS-FLASH?

A

Porous and lumens cannot be processed in an express cycle

108
Q

ALL items should be?

A

Documented on IUSS form

109
Q

IUSS cycles

A

PRE-VAC and High speed Gravity?

110
Q

Pre-vac in IUSS

A

270*F metal non-porous, no lumens @ 3 mins

270*F metal w/lumens, porous @ 4 mins

111
Q

HS gravity?

A

270*F metal non-porous, no lumens @ 3 mins

270*F metal w/ lumens. porous item @ 10 mins

112
Q

Can items contaminated with prions be used in IUSS?

A

NO

113
Q

Prion, CJD or TSE’s?

A

Extended sterilization

114
Q

Minimun parameters needed to destroy Prions as recommended by AAMI?

A

PreVAC and GRavity displacement?

115
Q

Prion PreVAC (Higher temp, shorter time)

A

273*F 28-30 @ 18 mins

116
Q

Prion Gravity (lower temp, longer time)

A

250*F 15-17 @ 60mins

117
Q

% in Mechanical erros in steam

A

15%

118
Q

% in Human errors?

A

85%

119
Q

Gases that enters chamber that can cause failures?

A

Non condensable gases also one of the causes of Bowie dick tests (CI)failures…

120
Q

Bowie dick tests are for?

A

Test for air in chamber and the only steam process this test is used on is the PREVAC aka DAR.

121
Q

It air removal tests required for gravity displacement and steam flush sterilization?

A

NO

122
Q

When is BOWIE DICK (CI) performed?

A

1st shift of day (same time and day) in an empty cycle, no drying required.

123
Q

After cycle is done what should one do once the CI Bowie dick pack is allowed to cool?

A

Uniform change should be verified

124
Q

Bowie dick dry time?

A

3-4 mins after DOCUMENT after every use

125
Q

BOWIE DICK IS A?

A

CLASS 2

126
Q

What happens inside if drying doesn’t take effect?

A

Wet packs or wicking

127
Q

what is used when drying with PREVAC?

A

Hepa air filter

128
Q

how are packs dried in Gravity-displacement?

A

Evaporation

129
Q

Drying depends on several factors

A

Weight and configuration of sets and how you load sterilizers

130
Q

how does air and steam exit chambers?

A

Drain

131
Q

This Class chemical indicator is used steam sterilization only

A

CLASS 1 autoclave tape

132
Q

BI test incubation procedure

A

…..

133
Q

How long does it take for the BI or BI viral for LARGER units using steam take to incubate (after sterilization)

A

48 hours

134
Q

How long does an enzyme-based rapid readout for a (BI or larger readout take to incubate (after sterilization)

A

3 hours

135
Q

IUSS incubation for (bi ir bi viral)

A

24-48 hours

136
Q

IUSS enzyme based rapid readout

A

1-3 hours

137
Q

Incubation positive in BI is

A

BAD

138
Q

IUSS incubator temp?

A

131F to 140F

139
Q

how many spores does 1 BI have?

A

i million

140
Q

When is Test BI needed?

A

First full load, every load “implants” after a positive BI test, qualification testing, complex instruments and testing uses

141
Q

CONTROL BI should it be sterilized?

A

NO

142
Q

CONTROL BI incubate only?

A

YES

143
Q

Should it come with same lot as BI?

A

YES

144
Q

Should we identify it with a “C” and date?

A

YES

145
Q

what are CONTROL BI’s used for

A

to verify spores are viable. support media (promote growth) and the CONTROL should always turn POSITVE (yellow)

Chapter 8 Sterilization (1 decks)

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