Protein Coagulation

Question 1

what is the best course of action for dealing with instruments with blood or biological matter

Answer 1

the best course of action is to have the shortest amount of time between use and processing

Any blood or biological matter still present can start to dry in and adhere to the surface of the instrument

Question 2

what are major factors to consider in decontamination

Answer 2

• Time
• Temperature
• Water
• Chemicals
• Energy

Question 3

what is the sinner circle

Answer 3

It shows the 4 key elements that are required for a successful cleaning process
- chemicals
- energy
- time
- temperature
If we decrease or increase any of the quarters we will impact what percentage they play within the process

Question 4

what water is recommended for the disinfection stage

Answer 4

for disinfection stage water of less than 30µs is recommended in reference to conductivity

Question 5

what can water pick up as it travels in rivers etc

Answer 5

• Minerals
○ Calcium
○ Potassium

• Silicates
○ Sand
○ Glass
○ Rock

• Organics
○ Vegetation
○ Colloidal particle

• Metals 
		○ Iron
		○ Zinc
		○ Tin
Mercury

Question 6

what is the measure of the stuff in the water called

Answer 6

The measure of this is called conductivity

Also referred to as TDS (total dissolved solids)

Question 7

what is the unit for conductivity

Answer 7

The unit of measurement is µs (micro-siemens)

Question 8

can we use tap water for sterilisation

Answer 8

no
we must use pure water

We cannot use standard tap water because of the particulate within the water as this can have a detrimental impact and leave residue on the surface of the instruments

Question 9

what is pure water

Answer 9

Pure water refers to:
distilled 
De-ionised
 Reverse osmosis
Sterile

Pure water has had nearly all of the particulate filtered out or removed and has very low levels of bacterial and fungal presence

Gives a lower measurement on the conductivity meter eg 4.3µs / micro-siemens

Question 10

what does enzymatic detergents do

Answer 10

breaks protein down into smaller particles

Question 11

how is the chemical molecuule within detergents designed

Answer 11

• The chemical molecule within detergents is designed to have hydrophilic and hydrophobic ends
○ One end repels water and the other is attracted to it
The hydrophobic end never contacts water because of the repulsion ~ this is where the contamination is drawn to and then flushed away as the hydrophilic end attaches to water molecules

Question 12

what is the energy in manual cleaning

Answer 12

scrubbing brush

Question 13

where does the energy come from in the utlrasonic bath

Answer 13

In the ultrasonic bath the force comes from high frequency sound waves causing cavitation

Question 14

where does the energy come from in the washer-disinfector

Answer 14

The WD use a high pressure (1-1.5 bar) water jet or spray

○ Note: the WD is generally the least ferocious so we supplement the process with stronger chemicals

Question 15

what is the best method for highest energy

Answer 15

So because the force we can generate within the WD is less than we would be able to exert using a scrubbing brush or with the ultrasonic process that is when we tend to use the more powerful chemicals (the high alkalines) as it in an enclosed process as well meaning that the chamber is shut and generally the operator won’t have to come into contact with the water and the chemicals

Question 16

what temperature is needed to prevent protein coagulating

Answer 16

<35 degrees C

Question 17

what is the time and temperature for steam sterilisation

Answer 17

134-137○C for 3 mins minimum

Question 18

what is the time and temperature for thermal disinfection

Answer 18

90-95˚ for 1 minute, minimum

Question 19

what water is used, what temperature, for how long, with what chemicals, using what energy for manual cleaning

Answer 19

water: tap water
temperature: less than 35
time: dependent on operator allocation
chemicals: pH neutral or enzymatic detergent
energy: scrubbing with brush

Question 20

what water is used, what temperature, for how long, with what chemicals, using what energy for ultrasonic

Answer 20

water: tap water used to fill the bath
temperature: less than 35
time: dependent on validated cycle time (20 mins)
chemicals: pH neutral or enzymatic detergent
energy: ultrasonic sound waves

Question 21

what water is used, what temperature, for how long, with what chemicals, using what energy for washer-disinfector

Answer 21

water: cleaning stage can use standard tap water
temperature: dependent on chemical validated with process (<65)
time: dependent on validated cycle time (55 mins)
chemicals: low alkaline or high alkaline detergent
energy: water jet / spray

Question 22

what water is used, what temperature, for how long, with what chemicals, using what energy for thermal disinfection

Answer 22

water: to be at conductivity lower than <30us
temperature: between 90-95
time: minimum hold time of 1minute
chemicals: must be free from all chemicals
energy: water jet / spray

Question 23

what water is used, what temperature, for how long, with what chemicals, using what energy for steam sterilisation

Answer 23

water: pure water
temperature: between 134-137
time: minimum hold time of 3 mins
chemicals: free from all chemicals
energy: steam heat energy