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Sterile Techniques > Instrument Care and Sterilization > Flashcards

Instrument Care and Sterilization Flashcards

1
Q

Principles of Instrument Cleaning

A
  1. Instruments are expensive
  2. Should clean after sx
  3. Separate used vs. unused instruments
  4. Separate bulky from delicate instruments
  5. Clean with ratchets open or on first notch
  6. Always remove sharps before washing
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2
Q

Two Methods of Cleaning

A
  1. Manuel cleaning
    - Most common
    - Basic instructions:
    • Rinse with distilled water
    • Use instrument cleaner
  2. Mechanical: Ultrasonic cleaning
    - Most effective
    - Removes dirt and debris with sound waves
    - Requires special solution, should be distilled
    - Debulk
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3
Q

Cleaning Process

A
  1. Soak in instrument milk
  2. Dry
  3. Check instruments (rust, stains, cracks)
  4. Check sharpness and ratchets
  5. Package materials
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4
Q

Soak in Instrument Milk

A

Sodium bonzoate
Lubricates
Protects from heat, dulling edges and rust
Never rinse
Dilute instrument milk with distilled water
Let instruments soak for minimum of 5 minutes

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5
Q

Dry

A

Let instruments air dry or wipe dry with clean cloth
DO NOT RINSE OFF INSTRUMENT MILK
DO NOT WRAP WET INSTRUMENTS

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6
Q

Check Instruments

A

Minor stains can be removed with pencil remover

Deeper stains can be removed using Miltex or Schein

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7
Q

Packaging for Sterilization

A 
Heavy instruments on bottom
Open ratchets
Use base towel
Towel clamps closed
Towels and drapes on top
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8
Q

Qualities of an Ideal Wrapping Material

A

Selective permeability
Flexible
Resistant to damage
Has memory (return to original shape)

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9
Q

Textile (Cloth) Drapes

A

Linen
Cloth
Different color/sizes (W/in same color group)
Expensive

  • Easy to handle and resist tearing
  • Expensive and laundered after every use and if not rinsed properly they can leave a residue on instruments
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10
Q

Paper Drapes

A

Rolls or sheets
Very cheap
Very fragile- always wrap twice
Crepe vs. non-crepe

  • Good barrier against microbes and inexpensive
  • One use only and difficult to handle
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11
Q

Dennison

A

Textile/paper combo
Water resistant
Sheets/rolls
Excellent for pt. drapes

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12
Q

Paper and Plastic Combo

A 
"Chex-all", "Visu-all", "Steri-shur"
Rolls/pouches
Used for gas/steam or gas plasma
May have indicators on pack
One time use only
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13
Q

Steam Indicator Strips

A

Indicate that sterility has been reached
Go inside the pack
Change color or shape

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14
Q

Steam Sterilization Tape

A

Only indicates exposure to heat
Doesn’t ensure sterility
Tan w/ white stripes
Stripes turn black after heat exposure

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15
Q

Gas Sterilization Tape

A

Tape is green w/ yellow stripes

Stripes turn red

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16
Q

Three Things That Need to be on Every Wrapped Pack

A

Contents of pack
Initials of person who wrapped pack
Date of sterilization

17
Q

Shelf Life

A

Decreases in humid climates and frequent handling

6-8 weeks

18
Q

A Pack in Contaminated When….

A 
Tape torn
Date missing/illegible 
Holes in wrapping material
Pack is dropped
Pack is wet
19
Q

Storing Packs

A

Store in dry, dust free area
Closed cabinets
Rotate stock (oldest pack 1st)

20
Q

Steam Sterilization (Autoclave)

A
  • Pressurized steam allows heat to kill microbes and high temp. to saturate the packet
  • Sea level: 15 psi
  • Above sea level: 17 psi
  • Need distilled water, heat, and pressure
  • Load items in single layer to allow steam to freely circulate within unit
21
Q

Autoclave Cycle

A

Full load- 250 degrees fahrenheit for 30 min

1 pack- 250 degrees fahrenheit for 15 min

22
Q

Ventilation Cycle

A

Before opening chamber door, make sure psi is at zero

Packs should be dry when they come out

23
Q

Types of Autoclave

A

Gravity Displaced

  • Gravity forces the air down and out
  • Slower

Vacuum Displaced

  • Used to remove air from chamber
  • Faster
24
Q

Advantages and Disadvantages of Steam Sterilization

A

Advantages
-Quick (~1 hour)

Disadvantages

  • Dulls sharp objects and corrodes instruments
  • Cannot use on heat or H20 sensitive objects

*Shelf life = 30 days
Flash cycle- 275 degrees fahrenheit for 3 min

25
Q

Gas Sterilization Types

A

Anprolene= Brand name
ETO= Brand name
Ethylene Oxide= Chemical name

26
Q

Gas Sterilization

A

Effective means of sterilization by disrupting the DNA of microorganisms, which prevents them from reproducing
Different size chambers
Prices vary ($$$)

27
Q

Traits of ETO

A 
Odorless
Tasteless
Flammable
Explosive
Carcinogenic
Poisonous 
Irritating to MM
28
Q

Criteria of ETO

A 
Temperature: 50-60 degrees fahrenheit 
Time: 18-24 hours
Humidity: 40-80%
Concentration: 500-1000 mg/L
Pressure: Occurs as ampule blows up in bag
29
Q

Advantages and Disadvantages of Ethylene Oxide

A

Advantages:

  • Prolongs life of heat/H20 sensitive instruments
  • Keeps instruments sharp
  • Shelf life is dependent on circumstances

Disadvantages:

  • Expensive
  • Slow: entire cycle takes between 16-24 hours
30
Q

ETO Gas Dosimeter

A
  • Change color in proportion to dose sterilant that they come in contact with
  • Indication if time, temp, and EO concentration were adequate
  • Pre bar: Orange
  • Post bar: Black (reach to arrow)
31
Q

Humidity Control

A

Humid chip

If there is too much moisture in bag or chamber- ethylene oxide= ethylene glycol

32
Q

Air Scan Monitoring Badge

A

Checks on airborne concentration of EO gas

Place in room where gas sterilizer is being used

33
Q

Ionizing Radiation

A
  • Large number of x-rays are scanned through packs to destroy microbes
  • Done in large facilities
  • For needles, syringes, gloves, sutures, etc.
  • Shelf life –> can be many years
34
Q

Gas Plasma

A
  • Uses 40-50% hydrogen peroxide
  • Cycle: 40-55 degrees celsius for 45 minutes
  • For instruments only

Advantages

  • Non-toxic
  • 74 minute for 1 load
  • Heat/H20 sensitive items

Disadvantages

  • Special packaging (plastic trays)
  • Doesn’t work on cellulose (paper)
35
Q

Gas Plasma Liquid Sterilization/Chemical Immerison

A
  • Glutaraldehyde (CIDEX)- most common solution- 10 hour soak
  • Must rinse instruments with sterile water/saline before using on pt.
  • Instruments may be considered “highly sanitized” after soaking for 20 minutes in CIDEX
36
Q

Gas Plasma Cold Sterile Tray

A
  • Solution should be diluted using sterile or distilled water (not tap water)
  • Change solution daily or when solution looks cloudy (change weekly)
  • Common solutions:
    • Amerse
    • Benzall
    • Nolvasan
37
Q

Gas Plasma Biologics

A

Bacillusstearothermophilus-Steam

Bacillus subtilis- Gas

Sterile Techniques (3 decks)

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