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Principles of Surgery > Sterilization and Disinfection > Flashcards

Sterilization and Disinfection Flashcards

1
Q

Disinfection is defined as the reduction or destruction of ______ pathogenic microorganisms on ______ (nonliving) objects.

A

most, inanimate

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2
Q

Disinfectant is defined as chemical agents that reduce ______ _____ on ______ objects.

A

microbial load, inanimate
is a chemical agent

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3
Q

Sterilization is defined as the elimination of ____ microbes on an inanimate object

A

all

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4
Q

Antiseptic is defined as the chemical agents that ______ microbial load or inhibit ______ of microbes on _____/_____ objects.

A

reduce, growth, living, animate
e.g. what we use to clean a patient during surgery

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5
Q

Sterility is defined as the absence of _____ forms of microbial life only _____ objects

A

all, inanimate

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6
Q

Which words should be paired together?

A
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7
Q

Examples of low level contamination
Don’t require disinfection unless they are really dirty

A

• Reception desks
• Offices
• Walls
• Doors

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8
Q

Examples of high level contamination
Minimum thorough cleaning
Drying agent followed by a low level disinfectant

A

• Kennels/housing
• Exam tables
• Operating tables/floors

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9
Q

When selecting a disinfectant, what should you consider?

A
  1. What level of disinfection is required?
    • critical
    • semi-critical
    • non-critical
  2. Is it compatible to the item you want to disinfect?
  3. Is it user friendly?
  4. Is it cost effective?
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10
Q

“Critical” level of sterility and disinfection applies to equipment or implants entering ____, ____ tissue, ____, or ______. This includes (4).

A

body, sterile, cavity, bloodstream

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11
Q

“Semicritical” level of sterility and disinfection applies to equipment that comes in contact with _____ or _______ ______ _______ penetrating body or cavity. This includes (6).

A

skin, mucous, membranes, without

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12
Q

In terms of semicritical sterility and disinfection, items must be _____ and ______ to reduce microorganisms but since sterility is ___ maintained during procedure sterility isn’t _____. _____
sterilization is common though.

A

cleaned, disinfected, not, required, Terminal

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13
Q

“Non-critical” level of sterility and disinfection applies to equipment that comes in contact with _____ skin or mucous membranes but not _____ associated with surgery. This includes (7).

A

intact, directly

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14
Q

In terms of non-critical sterility and disinfection, equipment should be _______ but do not require
specific handling ________ patients. Should be _______ cleaned when done for the day.

A

disinfected, between, terminally

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15
Q

Common disinfectants

A

Do not memorize this slide
Just know the compounds

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16
Q

What microbes does Isopropyl Alcohol (IPA) kill?

A

Bacteria, fungi, viruses, NOT spore.

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17
Q

What microbes does Povidone-iodine (PVI) kill?

A

Bacteria (fast), fungi, viruses, spores

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18
Q

What microbes does Chlorhexidine Gluconate
(CHG) kill?

A

Bacteria (fast), fungi (poor), viruses (poor), NOT spores

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19
Q

What microbes does Alcohol-based solutions kill?

A

Bacteria, +/- = fungi, viruses, spores

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20
Q

Isoprpyl Alcohol is considered to be both a _______ and an _______.

A

disinfectant, antiseptic

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21
Q

IPA is _________ ( _________ at lower
concentrations) and kills many _____ and _____

A

bactericidal, bacteriostatic, fungi, viruses

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22
Q

Describe IPA’s residual activity?

A

Minimal (evaporates)

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23
Q

IPA is less effective than ?

A

PVI or CHG

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24
Q

IPA is not typically used as a ______ _______ agent.

A

cold sterilization

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25
Q

IPA is helpful in removing excess ____ on the ____ prior to surgery

A

lipids, skin

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26
Q

Povidone-iodine (PVI) is considered to be both a _______ and ______.

A

disinfectant, antiseptic

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27
Q

Describe the activity of PVI?

A

• Bactericidal
• Fungicidal
• Effective against viruses
• Sporocidal (15 min contact time)

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28
Q

Describe the residual activity of PVI.

A

Minimal; Effectiveness decreased in presence of organic material

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29
Q

The concentration of PVI varies in accordance to its ____.
• For wound management: ___ to ___% solution
• For surgical prep: ___% scrub/solution

A

use, 0.1, 1, 10

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30
Q

Chlorhexidine Gluconate (CHG) is an ______.

A

Antiseptic

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31
Q

Describe Chlorhexidine Gluconate (CHG) activity.

A

• Bactericidal (rapid; quicker with GM + > GM-)
• Minimal activity against viruses and fungi
• Not sporicidal

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32
Q

Describe CHG’s residual activity
• Residual activity due to _____ binding
• Not inactivated by organic _____, _______, or _____ (so even if you have a dirty patient, it will still be actively working)

A

keratin, debris, alcohol, or soaps

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33
Q

For CHG, concentration varies according to its use:
• For wound management: _____% solution
• For surgical prep: ___% scrub/solution

A

0.05, 4

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34
Q

Alcohol based solutions are considered to be _______.

A

antiseptics

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35
Q

Alcohol based solutions have a superior ________ activity than PVI, CHG, or IPA alone

A

antimicrobial

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36
Q

The residual activity of alcohol based solutions is ?

A

More than alcohol alone

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37
Q

The usage of alcohol based solutions is a ____-step process (“_____”, single application and let dry)
• ChloraPrep (2% CHG + 70% IPA)
• ACTIPREP (83% Ethanol + Zinc Pyrithione)
• DuraPrep (PVI + 74% IPA

A

one, scrubless

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38
Q

Sterilization is an ______ state, there is no such thing as almost or sort of sterile. It either is or isn’t.

A

absolute

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39
Q

What are the different types of sterilization?

A

• Steam Sterilization
• Chemical (Gas) Sterilization
• Ethylene oxide
• Plasma sterilization (hydrogen peroxide gas)
• Gas plasma
• Peracetic acid sterilization
• Ionizing radiation (gamma)
• Cold chemical sterilization

40
Q

Steam Sterilization is when ______ steam destroys microorganisms by ______ and cellular protein _______

A

saturated, coagulation, denaturation

41
Q

What machine is used for steam sterilization?

A

Cylindrical machine

42
Q

Is steam sterilization common?

A

It is very common

43
Q

What are the pros of steam sterilization?

A

It is cheap, non-toxic, safe, and simple to use. It is effective, can be used for wrapped and unwrapped items, and has a quick turnaround time.

44
Q

What are the cons of steam sterilization?

A

Not suitable for heat sensitive items, potential for injury if not maintained or used correctly, requires care and maintenance.

45
Q

A gravity displacement sterilizer works on principle that air is ______ than steam. The machine uses ________ steam that goes from the _____ to _____ chamber.

A

heavier, pressurized, outer, inner

46
Q

With steam sterilizer machines, microbial death is dependent on, _______ time (minimum __-__ mins based on _____ is being sterilized), _______ (____° F- ____° F), ______ __- ___PSI

A

exposure, 10-30, what, temperature, 250, 275, Pressure, 15, 18

47
Q

Steam sterilizers are

A

• Dependable, simple design, affordable

48
Q

Notes from this slide

A

Creates steam, works its way up untilthe ambietn gas is being pushed out.

49
Q

A prevaccum sterilizer allows sterilization in ______ items with ______ to reach spaces through a _______ mechanism. Usually runs for about ___-___ minutes at _____ °F to ___°F

A

porous, harder, vacuum, 3, 4, 270, 275

50
Q

A flash sterilizer should only be used in _______ when no alternative is available.

A

emergencies

51
Q

Flash sterilizers use a gravity _______ sterilizer with a _____ tray.

A

displacement, metal

52
Q

Flash sterilizers should be used on metal nonporous items (items ______ lumen) for __ minutes at ____° F to ____° F and metal items _____ lumen and ______ items (3) for ____ minutes at ___° F to ____° F

A

without, 3, 270, 275, with, porous, rubber, plastic, autoclavable power tools, 10, 270, 275

53
Q

Notes on this slide
don’t need to know this

A
54
Q

When would a steam sterilizer fail?

A

• Inappropriate packing or loading
• Poor steam quality (not enough water, etc.).
• Vacuum failure
• Inadequate temperature

55
Q

________ ______ is used for chemical (gas) sterilization (gas __________), which is a _______ gas.

A

Ethylene Oxide, diffusion (through instrument packs), flammable.

56
Q

What are the pros of chemical (gas) sterilization?

A

Sterilizes heat sensitive equipment, sterilizes moisture sensitive equipment.

57
Q

What are the cons of chemical (gas) sterilization?

A

Expensive, lengthy time cycle, hazardous

58
Q

Efficacy of chemical (gas) sterilization depends on

A

Gas used, temperature, humidity, exposure time.

59
Q

_______ _______ (____) is used for plasma sterilization.
It is a ____ temp sterilization, is completed in ______ time because no _______ is needed

A

Hydrogen Peroxide (H2O2), low, rapid, drying.

60
Q

Plasma sterilization uses _____ photons and _______ to kill _________ by ________.

A

UV, radicals, microorganisms, oxidation.

61
Q

What are the pros of plasma sterilization?

A

Sterilizes heat and moisture intolerant items (#1 option), quick turnaround, no harmful emissions

62
Q

What are the cons of plasma sterilization?

A

Gas cannot penetrate linen, gauze, wood products,
endoscopes, and some plastics
Requires specific synthetic packaging
Sterilization chamber is relatively smaller than that of an EtO sterilizer.

63
Q

Ionizing Gamma Radiation is a ____ temperature sterilization process and is useful for ___ sensitive
equipment. Only used ________ since its so
expensive. Uses _______ __ gamma rays

A

low, heat, commercially, cobalt 60

64
Q

What are the pros of ionizing gamma radiation?

A

high penetrating power, rapidity of action, low temperature, flexibility

65
Q

What are the cons of ionizing radiation?

A

expensive, dangerous, can cause breakdown of packing material or product

66
Q

Peracetic acid sterilization uses ____ temperature ______ immersion sterilization on _____ sensitive items. This is used on items that will be used _______, not ____ term.

A

low, liquid, heat, immediately, long

67
Q

What are the pros of peracetic acid sterilization?

A

Sterilizes heat intolerant items, rapid sterilization cycle, low temperature, safe.

68
Q

What are the cons of peracetic acid sterilization?

A

Only applicable for immersible instruments, can be expensive, no sterile storage.

69
Q

Cold sterilization uses _____, _______ chemicals to sterilize instruments. The effect depends on _______ (______) time
• Disinfection = ____ ____
• Sterilization = ____ ______

A

liquid, noncorrosive, contact, immersion, 10, minutes, 10 hrs

70
Q

What chemicals can be used for cold sterilization?

A

• Glutaraldehyde 2%
• Ortho-phthalaldehyde (OPA) (Cidex OPA)
• Hydrogen peroxide 7.5% (Sporox II)

71
Q

When using cold sterilization, instruments should be rinsed with sterile _____ and dried with sterile _____.

A

water, towels

72
Q

Components needed for surgery in one sterile pack include:

A

• Gown + towel
• Instruments + gauze
• Miscellaneous items

73
Q

Wrapping material for surgical packs depends on
the ?

A

method of sterilization

74
Q

Paper bags are used to wrap?

A

Small light, non- sharp items such as Cotton balls and Gauze

75
Q

What are the pros of wrapping material?

A

Cheap, easily obtained

76
Q

What are the cons of wrapping material

A

easily perforated when wet, items can’t be visualized, heavy items can break through

77
Q

What type of linen material can be used for surgical packs?

A

Linen material = Usually cotton blend (muslin or
linen) OR Synthetic material

78
Q

Laminated sleeves/packs/pouches are a combination of _______, _____ stable _____ film laminated to ________ paper

A

transparent, heat, plastic, treated

79
Q

What are the pros of laminated sleeves/packs/pouches?

A

Cheap and easily obtained, pre-cut sizes or rolls in various widths, several small items can fit, instruments can be identified.

80
Q

What are the cons of using laminated sleeves/packs/pouches?

A

Easily perforated when wet, heavy items can break through.

81
Q

Instrument containers are made up of?

A

Aluminum and stainless steel

82
Q

Instrument containers store ?

A

a wide range of surgical instruments

83
Q

List the steps of the surgical pack procedure

A

Cleaning and sonicating instruments
• Pre clean rinse
• Instrument soak
• Cleaning
• Manually
• Ultrasonic cleaning equipment
• Post clean rinse
• Instrument drying

84
Q

How do you prep the surgical pack?

A

Place and organize instruments
Add drape and gauze
Add sterile indicator
Wrap (2x)
Secure with autoclave tape
Sign and initial

85
Q

What are the purpose of sterilization indicators?

A

Monitors effectiveness of the sterilization process

86
Q

Chemical indicators: chemical change occurs in response to _____, _____ and/or _______ but NOT _______ ______.
• Does not confirm ______

A

heat, pressure, humidity, exposure time, sterility

87
Q

Biological indicators:
• Only means of ensuring ______ following sterilization
• Sterility is assessed using ______ maintained in a _____ or on a ____

A

sterility, bacteria, broth, strip

88
Q

How should all surgical items be wrapped?

A

All surgical items should be wrapped so they can be easily unwrapped without breaking sterile technique

89
Q

Wrapped Surgical Packs

A

??

90
Q

Folding and wrapping gown

A

??

91
Q

Folding Surgical Gown

A

??

92
Q

When folding the huck towel, you should use _____ hands. This towel is used as a ___.

A

dry, drape

93
Q

Folding and wrapping drapes

A

??

94
Q

Opening wrapped pack

A

??

95
Q

Opening sterile instruments and equipment

A

??

Principles of Surgery (13 decks)

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