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Infection Control Yr1 > Instrument Identification + Sterilisation Methods > Flashcards

Instrument Identification + Sterilisation Methods Flashcards

1
Q

State the 7 instruments required for a basic suture kit

A

1 x Scalpel handle
1 x Treves forceps
2 x Mosquito forceps
1 x Mayo scissors
4 x Towel clips
1 x Gillies
2 x Needles

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2
Q

Define the term ‘sterilization of instruments’

A

The process by which instruments + drapes are rendered aseptic (or sterile) by the destruction or removal of all micro-organisms - including spores

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3
Q

State the 2 different categories of sterilization
+
Give an example of each

A
  1. Heat sterilization
    Hot-air oven + autoclave
  2. Cold sterilization
    Ethylene oxide + radiation
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4
Q

State the 4 different methods of sterilization

A
  1. High-pressure steam (autoclaves)
  2. Dry heat (ovens)
  3. Chemical sterilants (glutaraldehydes or formaldehyde solutions)
  4. Physical agents (radiation)
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5
Q

Why is boiling not considered an appropriate means of sterilization?

A

Because it does not reach a high-enough temperature to destory bacterial spores

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6
Q

CHECK - says different in pp

Name 2 chemical solutions, used for chemical sterilization

A
  1. Chlorhexidine
    +
  2. Glutaraldehyde

SHOULD ONLY BE CONSIDERED AS A MEANS OF DISINFECTION

They will kill bacteria = when instruments are soaked within them

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7
Q

In order to effectively kill micro-organisms, should dry heat occur for short or long periods of time?

A

Long periods of time

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8
Q

What 2 things should be considered when cooling metal instruments from dry-heat sterilization?

A
  1. Metal instruments are allowed a longer cooling periods, before use
    +
  2. Long periods of dry-heat can cause damage to surgical instruments
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9
Q

What instruments are hot-air ovens most useful for?

A

Items damaged by moist-heat, such as:
* Glassware
* Powders
* Oils
* Sharp-cutting instruments

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10
Q

What temperature + length of time is required for sterilizing glassware + non-cutting surgical instruments, in a hot-air oven?

A

Temp = 180 degrees celcius
Time = 60 mins (1hr)

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11
Q

What temperature + length of time is required for sterilizing powders + oils, in a hot-air oven?

A

Temp = 160 degrees celcius
Time = 120 mins (2hrs)

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12
Q

What temperature + length of time is required for sterilizing sharp-cutting instruments, in a hot-air oven?

A

Temp = 150 degrees celcius
Time = 180 mins (3hrs)

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13
Q

What is considered the most common form of equipment, used for sterilzation in the veterinary practice?

A

The Autoclave

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14
Q

How does an autoclave work?

A

1.Water is boiled (under pressure)
2.This generates steam
3.This generates heat
4.This penetrates the innermost layer of instrument packs

Remember - moisture increases the permeability to the heat

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15
Q

What time length is required for sterilizing items in the autoclave at a temperature of 150 degrees celsius?

A

180 minutes
(3 hrs)

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16
Q

What time length is required for sterilizing items in the autoclave at a temperature of 160 degrees celsius?

A

120 minutes
(2 hrs)

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17
Q

What time length is required for sterilizing items in the autoclave at a temperature of 180 degrees celsius?

A

60 minutes

(1 hr)

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18
Q

What should you avoid overloading + blocking in the autoclave?

A

Inlet + outlet
valves

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19
Q

What are the 3 main things all instruments should be free from, before entering the autoclave?
+
Why?

A

Free from:
1. Grease
2. Protein
3. Organic matter

+

Because the above will prevent effective penetration of steam

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20
Q

Briefly explain the drying cycle

A
  1. Steam is exhausted
  2. Steam is replaced by filtered air
  3. This dries the instrument packs
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21
Q

What are the 4 main/common items that are sterlised within the autoclave?

A
  1. Surgical instruments
  2. Drapes
  3. Gowns
  4. Swabs
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22
Q

What is Ethylene Oxide?

A

A chemical used for sterilisation

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23
Q

What colour is EO gas or liquid?

A

Colourless

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24
Q

What temperature is EO considered a gas?

A

UNDER 10.5 degrees celsius

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25
Q

What temperature is EO considered a liquid?

A

OVER 10.5 degrees celsius

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26
Q

Is Ethylene Oxide heavier than air?

A

Yes

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27
Q

What are the 4 hazards which EO causes on a cellular level?

A

It’s:
1. Carcinogenic
1. Neurotoxic
1. Mutagenic
1. Can cause reproductive issues

Long time exposure = chronic exposure

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28
Q

What 4 pathogens are rendered ineffective, when sterilized with the chemical sterilization method?

A
  1. Viruses
  2. Bacteria
  3. Spores
  4. Fungi
29
Q

What happens when the temperature is increased, when using EO?
+
What happens to the duration of the cycle?

A

The ability of the EO to penetrate materials increases
+
the duration of cycle shortens

30
Q

What type of bag + type of seal is requried for EO sterilizing?

A

A disposable bag
+
velcro seal tie

31
Q

What type of container does EO come in?

A

An ampule

32
Q

Where should an ampule be put
+
when should it be broken?

A

Ampule should be placed within a bag
+
broken only once within the bag

NEVER remove from bag ONCE BROKEN

33
Q

What type of chip should be placed within the bag with the ampule?

A

Humidity chip

34
Q

What is the minimum % of humidity required to kill the pathogenic micro-organisms, during Ethylene Oxide sterilization?

A

35%

35
Q

State the 4 hazardous issues that inhalation of EO can cause.

A
  1. Respiratory irritation
  2. Nausea
  3. Headache
  4. Neurological dysfunction
36
Q

What can skin exposure to Ethylene Oxide cause?

A
  1. Burns
  2. Skin irritation
  3. Allergic contact dermatitis
  4. Frost bite
37
Q

What 3 affects can eye exposure to EO cause?

A
  1. Severe irritation
  2. Cataracts
  3. Corneal burns
38
Q

How can exposure occur with EO?

A
  1. Direct contact with ampule
  2. Inadequate ventiliation
  3. Insufficent ventilation times
39
Q

How does Ethylene oxide gas sterilse instruments, in regards to pathogenic micro-organisms?

(In basic terms)

A
  1. The gas inactivates the DNA + RNA within the cell of the pathogenic micro-organism
  2. Preventing replication (inhibiting)
40
Q
A
41
Q

What are the 3 main dangers that Ethylene oxide poses to humans?

A
  1. Toxic to health
  2. Irritant to tissues
  3. Highly inflammable
  4. Highly explosive
42
Q

What piece of legislation governs the chemicals used for chemical sterilization?

A

The Control of Substances Hazardous to Health 2002
(COSSH)

43
Q

When considering dilution rates + contact times of chemicals, what must you follow?

A

The dilution rates + contact times are utilised, as dictated by the chemical’s manafactures guidelines

44
Q

What method of sterilization should be kept in fume cupboard, in a well ventilated room + away from all working areas?

A

Ethylene Oxide

45
Q

During an Ethylene Oxide cycle, what room is the minimum temperature required?

A

20 degrees celsius

46
Q

State the basic method of using a Ethylene Oxide sterilizer

A

Loading
1. Place indivdually packed items into the polythene liner bag (PLB)
1. Place scored ampoule containg the EO liquid inside the PLB
1. Seal the bag with a metal twist tie
1. Put PLB into sterilizer unit
1. Snap ampoule from outside of the bag, releasing the gas
1. Quickly close + lock the door of the unit
1. Turn the ventilator on + wait 12 hrs

Unloading
1. After 12 hrs, turn on the pump

  1. 2 hours after aerating, remove sterilized items
  2. Store items for further 24hrs in a well ventilated room
  3. Ready for use!

  1. linear bags are supplied with the sterilzer
  2. Bags mut be sealed to keep gas circulating around the contents
  3. This minimizes the exposure to the gas
  4. Accidental opening = can be prevented if the door is locked
  5. Pump = allows contents to aerate, before it’s safe for the ‘operator’ to open
  6. Ensuring any toxic gas has been removede
  7. Make sure all EO has dissipated
47
Q

Name as many items + materials that are suitable for EO sterlization?

A
  • Anaesthetic tubing
  • Endotracheal tubes
  • Fibreoptic equipment
  • Optical instruments
  • Plastic items - syringes, catheters
  • High-speed drills
  • Battery operated drills

These can also be considered - BUT - the length of the cycle restricts their everyday use!
* Surgical instruments
* Gowns
* Drapes

48
Q

How is sterilization achieved using radiation?

A

Sterilzation is achieved by the use of gamma radiation

49
Q

Why is radiation sterilzation not used commonly within the veterinary practice?

A

Because it can only be carried out under controlled conditions, required by at an industrial level
+
Dangerous + harmful

50
Q

Name 3 types of items which are suitable to be used for radiation sterilization?

A
  1. Needles
  2. Syringes
  3. Catheters
51
Q

State the dilution rate required for G9 Instrument cleaner

A

1:100

1ml G9 : 100ml water

52
Q

State the dilution rate required for G9 Instrument disinfectant

A

1:50

1ml G9 : 50ml water

53
Q

How long does G9 Instrument cleaners + disinfectants affects last for?

A

Up to 7 days

54
Q

What is the contact time for soaking instruments in a G9 Instrument cleaners + disinfectant solution?

A

15 mins

55
Q

What can Instrument cleaners + disinfectant be used for?

A

Manual + ultrasonic use

56
Q

What specific surgical piece of equipment is ideal for using G9 instrument cleaner?

A

Fibreoptic endoscopes

57
Q

What is the function of Instrument cleaner?

A

To remove proteinaceous + organic material from the suface of instruments + endoscopes

58
Q

What are the 6 types of organic matter does Instrument cleaner digest and dissolve on surgical instruments?

A

It’s digests + dissolves:
1. Blood
2. Mucus
3. Fecal matter
4. Vomital matter
5. Organic contaminants
6. Proteinaceous soils

59
Q

What are the 2 other alternative names for purified water?

A
  1. Demineralised water
  2. Deionised water
60
Q

State the 4 step process to using instrument cleaner to manually clean surgical instruments

A
  1. Add 50ml (1:100) of Instrument cleaner to 5L water
  2. Rinse surgical instruments in cold water to rinse off visable organic matter off
  3. Submerge instruments ASAP in the solution
  4. Soak for a contact time of 15 mins
  5. Rinse throughly with purified water

According to G9 Instrument cleaner..

61
Q

State the 3 step process to using instrument cleaner in the Ultrasonic cleaning machine to clean surgical instruments

A
  1. Add 50ml (1:100) Instrument cleaner to 5L water, in the ultrasonic cleaning tank
  2. Rinse surgical Instruments in cold water to remove visable organic matter
  3. Submerge instruments into the ultrasonic cleaning tank, for a contact time of approx 15 mins
  4. Remove the instruments from the UCT
  5. Rinse throughly with purfied water

UCT = Ultrasonic Cleaner Tank

62
Q

What 4 chemicals does G9 Instrument disinfectant not contain?

A
  1. Gluteraidhyde
  2. Phenols
  3. Chlorine
  4. Peracetic Acid
63
Q

State the 6 types of micro-organisms that the G9 instrument disinfectant is effective against

A
  1. Bacteria
  2. Fungi
  3. Yeast
  4. Viruses
  5. Spores
  6. Mycobacteria
64
Q

How do ‘Mycobacteria’ differ from bacteria?

A

Mycobacteria differ in metabolisim, as well as structurally from other bacteria as they have:

  • An outer membrane
  • They do not have capsules
  • Most do not form endospores
  • Thicker cell wall

Their cell wall is hydrophobic, waxy + rich in mycolic acids/mycolates

65
Q

State 6 structures which can be used to define a Mycobacterium

A
  1. Gram-positive
  2. Catalase positive
  3. Non-motile
  4. Non-spore forming
  5. Rod-shaped
  6. 0.2–0.6 μm wide and 1.0–10 μm long
66
Q

State the 6 step process to using instrument disinfectant to manually or ultrasonically disinfect surgical instruments

A
  1. Add 100ml (1:50) Instrument disinfectant to 5 litres water into the sterilisation trough
  2. Rinse surgical instruments with cold water to remove any visable organic matter
  3. Submerge surgical instruments in the sterilisation troughs for an approx contact time of 15 mins
  4. Remove the instruments from the trough
  5. Rinse the surgical instruments in purified water
  6. Dry + package the disinfected instruments
67
Q

State 4 areas of the body you should refrain from contacting, with disinfectant

A
  1. Skin
  2. Eyes
  3. Mouth
  4. Nose (Inhalation)
68
Q

What 2 factors should you always be aware of before using disinfectants?

A
  1. It is used in a well ventilated area
  2. Using the appropriate PPE
69
Q
A

Infection Control Yr1 (21 decks)

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