Week 2 Flashcards
sterilization
eliminates or kills all forms of life including transmissable agents (fungi, bacteria, viruses, spore forms, etc).
acheived by:
- moist heat and pressure (autoclave)
- ionizing radiation
- UV radiation
- chemicals
- filtration
disinfection
destroy microorganisms found on non-living objects by destroying cell wall or interfering with cell metabolism.
- not endospores and viruses
antisepsis
process of killing most or nearly all microorganisms on skin, in wounds, on mucous membranes, clothing, and hard surfaces using heat, chemicals, or ultraviolet rays.
60-90% ethyl and isopropyl alcohol pros and cons
Pro: excellent antiseptic, commonly available, inexpensive
Con: not good cleaning agent, easily inactivated by dirt, blood, foreign bodies, flammable, damage latex over time
types of antiseptics
60-90% alcohols
3% iodine
7.5-10% iodophors (betadine)
2-4% chlorhexidine (hibiclens, hibiscrub, hibitane)
0.2-2% triclosan
H2O2
nonionic surfactants (Shur-Clens and Pharmaclens)
Iodine and Iodophor solutions as antiseptics pros and cons
pros: inexpensive, effective, available, kills broad spectrum, non-irritating
* best pre-surgical
cons: at least 2 minutes of contact time to release free iodine, little residual antimicrobial effect, rapidly inactivated by organic materials, absorptions through skin can cause hypothyroidism in newborns!, allergic reaction can occur.
chlorhexidine Gluconate (CHG) Hibiclens Pros and COns
Pros: Good alternative to iodophors, broad spectrum antimicrobial, safe for newborns, persistent action on skin, increased inhibition of microbes with repeated use, minimally effected by organic materials.
Cons: Expensive, neutralized by natural soaps, hand creams, not effective against tubercle bacillus, decomposes if used above pH 8, can cause conjunctivities if contacts eyes.
hydrogen peroxide pros and cons
Pros: dislodges bacteria, debris, contaminants, best on intact skin or very dirty wounds.
Cons: don’s use on freshly sutured wounds, wound damaging agent, don’t use for forceful irrigation, can cause ulceration of newly formed tissue
non-ionic surfactants pros and cons
pros: no adverse effects on wounds and lacerations
cons: no antibacterial activity
What characteristics should be considered when choosing an antiseptic
- can it physically remove dirt and other materials as well as some transient microorganisms from the skin?
- Does it have a residual effect/killing action that continues after antiseptic has been applied
- is there evidence of product safety?
- cost
Which is considered the best pre-surgical antiseptic
Povidone-iodine (Betadine)
Post-operative infection is determined by what risk factors
- number of organisms entering wound
- type of virulence of bacteria
- strength of pt defense mechanisms (immune system)
- external factors (surgery over 4 hours, length of hospital stay, etc)
Pros and cons of shaving skin before prepping for surgery
Pros: easier to see area you are cutting/suturing?
Cons: causes multiple areas of nicking of skin which provides a portal of entry for secondary infections
Know basics of how to establish sterile fields for patient
Patient: cut hair back with scissors rather than shave area, wash skin with soap or alcohol, dry, apply antiseptic, simple fenestrated drape and secure, allow antiseptic to dry
Know pros and cons of using alcohol for skin prep injections
Pros: none
Cons: does not reduce chance of infection
Know basics of how to establish sterile fields for doctor
cover hair, use mask (both optional), hand scrubbing (at least 3 times for up to 5 minutes), sterile gloves (most important technique to master), hold hands above waste
Know basics of how to establish sterile fields for instrument field
Sterilize all instruments with autoclave
Keep in sterile package until dumped into sterile field, not touching outside of packagine.
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