Lecture 3 8/22/24 Flashcards
What are antiseptics?
products or chemicals used to kill or inhibit microbes on living things
What are disinfectants?
products or chemicals used to kill or inhibit microbes on non-living things
What are the equipment classification levels for disinfection prior to use?
-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
What is sterilization?
process of eliminating pathogens from non-living tissue by destroying all forms of microbial life through physical or chemical methods
What are the available sterilization methods?
-steam
-ethylene oxide
-hydrogen peroxide
-radiation
-gludaraldehyde cold sterilization
How does steam sterilization work?
increased pressure increases temperature of steam to destroy microbes
When is ethylene oxide used for sterilization?
heat sensitive items
Why is plasma sterilization more ideal than ethylene oxide?
it is safer than EtO gas while still being ideal for heat sensitive items
Why can plasma sterilization not be used on items like endoscopes, linens, and gauze sponges?
the vapor is absorbed into the material
What are the characteristics of ionizing radiation?
-only used commercially due to expense, size, and regulations
-pre-packaged items from manufacturer may not be able to be re-sterilized
What are the key components of instrument care?
-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
What are the types of sterilization indicators?
-mechanical/physical
-chemical
-biological
What are the FDA standards for antiseptics?
-substantially reduce transient microorganisms
-possess broad-spectrum of antimicrobial properties
-fast-acting
-have persistent, cumulative activity
-be non-irritating to the skin
What are the general characteristics of chlorhexidine?
-cationic biguanide
-broad-spectrum
-not sporicidal, but can potentially prevent them
-must know concentration
What is the method of action of chlorhexidine?
disruption of the cell membrane
What are the physiologic characteristics of chlorhexidine?
-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
What are the adverse effects/disadvantages of chlorhexidine?
-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
What is the method of action of iodine?
effects protein synthesis and alters bacterial cell wall
What is the spectrum of iodine?
-bacteria
-viruses
-fungi
-protozoa
-spores
What are the general characteristics of povidone iodine/betadine?
-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
What are the physiologic characteristics of povidone iodine?
-broad spectrum
-residual activity for 4-6 hours
-contact time of 2 minutes
-stains skin
-scrub or solution
-dilutions will release more free iodine
What is the mode of action for alcohols?
denature proteins
What is the spectrum for alcohols?
-broad gram positive and negative bacteria
-multi-drug resistance pathogens
-fungi
-mycobacterium
What are the characteristics of 70% isopropyl alcohol?
-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
What are the disadvantages of using alcohols?
-corrosive to stainless steel
-can lead to hypothermia in smaller patients
-no residual activity; quick to evaporate
-flammable; caution needed with laser or electrocautery
When should surgical checklists be performed?
-before induction of anesthesia
-before skin incision
-before/during patient recovery
What precautions should be taken in regards to hair removal?
-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
What are the characteristics of aseptic surgical patient prep?
-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
What is the concept of clean hand and dirty hand when prepping patients?
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
What should be done whenever a male’s prepuce is in the prep field?
flush of the prepuce for at least two minutes with dilute antiseptic prior to skin prep
What are the characteristics of one step preps?
-need time to air dry
-contact time depends on product
-applied to clean and dried skin
-used as a final prep
