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132 Cards in this Set
- Front
- Back
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centers for disease control recomendations for infection control focused on risk of transfer of blood borne pathogens, recognizing that other body fluids carry infectious agents
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standard precautions
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what is not a body fluid that can spread disease
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sweat
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when is the oral cavity sterile?
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in utero
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many salivary bacteria come from where?
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the dorsum of the tongue, the top
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high counts of total microorganisms are found where?
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in dental biolfilm(plaque), periodontal pockets, and carious lesions
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what can cause inadvertant transmission to pathogens?
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careless handwashing,
nonhygenic personal habits, inadequate sterilization dirty hands handling sterile instruments |
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the spread of mo from one source to another
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cross contamination
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how can cross contamination occur
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person to person,
person to inanimate object, inanimate object to another person |
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mode of escape from resevoir , exit from the respiratiory tract, skin lesions
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port of exit
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person to person is what kind of transmission?
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direct transmission
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transmission by way of a vehicle such as contaminated hands or instrument
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indirect transmission
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one who does not have immunity to the invading infectious agent
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susceptible host
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what are the essential features for disease transmission
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infectios agent, resevoir, prot of exit, mode of transmission, entry to new host, susceptible host
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what contributes to control of dust borne pathogens?
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surface disinfection
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ability of mo to survive interim exposures
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virulence
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what are some abnormal physical conditions that influence development of infection?
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defective heart valve, or systemic diseases
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T/F : steroids and chemotherapeutic agents are immunosuppressive
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TRUE
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do prostheses and implants alter normal defenses?
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YES
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classified by particle size and are constantly being produced
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aerosols
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what are the size of TRUE aerosols?
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less than 50 um in diameter, all are less than 5 um
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biologic contaminates occuring in solid or liquid form, invisible, an remain in air for long times,
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aerosols
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heavier larger particles that may remain air borne for a short time becuase of their size and weight. may be visible when landed
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spatter
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how big is spatter?
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any particles greater than 50 um
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where are aerosols and spatter originated from?
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breathing, speaking, coughing, intraorla procedures
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what are the 4 pathogens transmissible by the oral cavity?
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TB
hepatitis aids herpetic infections |
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which infection is caused by bacteria?
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TB
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how is tb transmitted?
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inhalation
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what are some clinical findings of tb?
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lymphadenopathy, and oral lesions
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which hep can be most resistant to sterilization?
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hep G
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which hep is the most commonly occuring strain of hep?
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A
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inflammation of the liver
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hepatitis
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with who does hepatitis most commonly occur in?
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children and young adults
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wht are the transmission routes of hep a
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fecal, water/food borne, and blood`
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transmission routes for hep b?
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blood and other bodily fluids, percutaneous exposure
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which is the most serious of the hep viruses?
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hep c
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how is hep c transmitted
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percutaneous exposure to contaminated blood and plasma derivatives, and contaminated needles
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hep e is transmitted by what?
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waterborne, fecal/oral route
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hhv2
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genital herpes
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hhv3
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chicken pox, shingles
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hhv4
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epstein barr virus: infectious mononucleosis, hairy luekoplakia, and lymphatic cancers
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hhv1
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herpes simplex virus: herpetic gingivostomatis, labializ, whitlow, conjuctivitis
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type of herpes, tongue lesions associated with subsequent development aids tongue lesions appear white linear lesions along lateral borders
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hairy leukoplakia
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HIV
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transmitted by sexual contact, and blood and blood products
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what do you always ask an HIV patient?
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what is your cd4 count?
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what cd4 count is the minimum in order to treat patients?
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anything over 200 cd4 lymphocytes
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what is the minimum viral load in order to treat a patient?
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over 100,000
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what is the standard filtration of a mask?
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95% blocked
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what should you do before washing your hands?
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always apply/adjust mask and eyewear
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when should you put on gloves?
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after you have put on your mask and eyewear AND washed your hands
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does handwashing disinfect or sterilize?
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disinfect
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what are indications to wash hands?
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soiled, torn, before gloves, after gloves, after touching objects that may be contaminated w saliva
BEFORE LEAVING THE TREATMENT ROOM |
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what must you do before hand washing?
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put on eye wear and mask
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what must be in hand rub?
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alcohol
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what gloves do you wear when handling sharps or during disinfection?
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utility
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includes uriticaria, dermatitis, sneezing, itchy/runny nose, breathing difficulties, watery/ itchy eyes, drop in BP, and anaphylaxis
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hypersensitivty type I
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contact dermatitis develops 6 to 72 hrs after contact
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hypersensitivity type IV
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who are at risk of a latex allergy?
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frequent exposure to latex, medical treatment req placement of rubber tubes or drains, allergies to AVOCADOS, BANANA, KIWI FRUIT, CHESTNUTS AND PAPAYA
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if an item will penetrate bone or tissuewhat classification is it?
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critical
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forceps, scalpels, bone chisels, scalers, curets, burs, and instument put into the mouth that can penetrate tissue
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critical instruments
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items that touch mucous mb or nonintact skin and have a lower risk of transmission, WONT CUT TISSUE
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semicritical instruments
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contact only intact skin,
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noncritical instruments
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what type of instruments must be sterilized?
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critical
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what kind of instruments can be high-level disinfected or should be sterilized
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semicritical instruments
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impression trays and x ray holders are examples of what classification of instruments?
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semicritical instruments
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these items should be cleaned with an EPA-registered intermediate or low level disinfectant after each use
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noncritical instruments
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position indicator device, of x ray unit tube head, lead apron, and curing light are examples of what kind of instruments
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noncritical instruments
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what is the routine for instrument processing?
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instrument cleaning>package>Sterilize> clinical use
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increased efficiency in cleaning bioburden from instruments is a benefit of what cleaner?
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the ultrasonic cleaner
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reduced danger to clinicial from direct contact w potential pathogens and improved effectiveness for sterilization are advantages for what ?
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ultrasonic cleaner
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is the ltrasonic processer a substitute for sterilization?
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NO
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what must you do after using an ultrasonic processor?
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let the instuments dry
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what is used before using ultrasonic if you cant disinfect shortly after use?
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the holding tank
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what is the least desirable way of handling instruments
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manual handling of them
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to prevent contamination of newly sterilized instruments when removed from sterilizer by providing a means of storage for the instruments
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instruent packaging
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what does chemical indicator tape indicate?
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that the correct temperature has been reached, does not indicate sterilization
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what are the objectives of infection control
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reduce pathogenic mo's to a safe level, eliminate cross contamination, application of standard precautions
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what do we do to reduce aerosols?
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pre operative rinsing, HVE, postpone treatment if patient is infective, use barriers
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what are the approved methods of sterilization?
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moist heat, steam under pressure, dry heat, chemical vapor
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what must the method of sterilization do?
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it must provide complete destruction of all mo's, viruses, and spores, but cannot damage instruments and materials
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what are the incidences in which incomplete sterilization usually occurs?
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inadequate prep( packaging), misuse of equipment ( overloading, timing, temp), or inadequate maintenance
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monitors selected test mo's that are put thru the sterilization cycle, if no growth sterizer has performed
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biologic monitor
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biologic monitors should be used how often?
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weekly
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what does heat do to mo's?
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inactivation of proteins and enzymes & coagulation of protein
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what cant steam under pressure (moist heat) be used?
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oils, waxes, and powders, or materials that cant handle high temps
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sterilization achieved by action of heat and moisture, pressure is only to attain high temp. air must be excluded
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moist heat: steam under pressure
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what is essential for mosit heat to operate properly
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space between objects
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what is the temp for a moist heat, steam under pressure autoclave?,
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temp must remain at 121C at 15 pounds pressure for 15 min
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what are disadvantages of moist heat?
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canc orrode carbon instruments not good for oils, powders,and waxes that cant handle heat
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advantages of moist heat?
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all life forms killed quickly and efficiently, broad spectrum, most economical
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sterilization is achieved by heat that is conducted from the exterior surface to the INTERIOR of the object
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dry heat
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temp for dry heat?
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160C maintained for 2 hours; 170C for 1 hour
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what must you do for dry heat?
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"preheat"
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advantages of dry heat?
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good for what cant be used in the steam under pressure autoclave, no corrosion
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disadvantages to dry heat?
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long exposure time, penetration slow and uneven,
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microbial and virla destruction from permeation of the heated formaldehyde and alcohol. tightly wrapped packages would not permit penetration
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chemical vapor sterilizer
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temp for chemical vapor sterilizer?
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127C-132C w/ 20-40 pounds of pressure for a min of 20 min
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advantages of chemical vapor sterilizer?
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corrosion and rust free, sterilization in a short cycle
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disadvantages of the chemical vapor sterilizor?
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adequate ventilation is needed, cant be used in sml room, odor,
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what type of sterilization is most commonly used in hospitals?
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ethylene oxide
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what sterlizers dont need pressure?
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ethylene oxide, dry heat
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sterilizes in 10-16 hours depeding on temp and concentration
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ethylene oxide
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what is the temp for ethylene oxide
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75F, 25C
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what must you have for ethylene oxide?
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well ventilated room, overnight processing time, must air plastic and rubber items
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advantages of ethylene oxide
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many types of materials can be sterilized, low temp
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disadvantages of ethylene oxide
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expensive, ventilation needed, long time, airing of plastic,rubber, and cloth for several hrs
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refers to the ability of a chemical disinfectant ti destroy or inactivate living orgs.
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biocidal activity
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inactivates spores, and all forms of bateria,fungi,and viruses, can be a disinfectant or sterilant
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high level disinfectant
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inactivate all forms of mo's but dont distroy spores
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intermediate level disinfectants
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inactivate vegetative bacteria nad lipid type viruses, but not spores, tb, or non lipid viruses
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low level disinfectants
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low level disinfectants do not kill what?
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spores, tb, nonlipid viruses
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what are criteria for epa approval of disinfectants?
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tuberculcidal, bacteriocidal, virucidal, fungicidal, effectiveness and stability expressed by shelf life, use life, and reuse life
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warnings, toxic effects, and directions for emergency care are contained on what?
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material safety data sheet
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why are instruments stored without sealed wrappers only momentarily sterile?
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due to air-borne contamination
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what shelf life do packages and sterilized instruments have
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several months to a year, plastic and nylon last longer
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what does the cleanliness and neatness of hte treatment room reflect
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the dhcps character and conscientiousness
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bacillus stearothemophilus vials, ampules, or strips
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steam autoclave
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bacillus subtillus strips
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dry heat oven, ethylen oxide
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bacillus stearothemophilus strips
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chemical vapor
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at designated time exposure, they are high level disinfectants and act to kill mo's by damaging proteins and nucleic acids
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glutaraldehydes
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what are advantages and disadvantages of glutaraldehydes?
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adv: mix of 2 containers, have a shelf life, high level disinfectant
dis: toxic, caustic to skin, must have gloves, |
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use life is one day only, corrosive, skin irritant, odor,
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Chlorine compunds/ sodium hypochlorite
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hard water inactivates pores, use distilled or soft water, and can discolor surfaces
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iodophors
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can be water based or alcohol based ,
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phenolics
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ACT AS PROPLSMIC POISONS THAT DESTROY THE CELL WALL AND PRECIPITATE THE PROTEIN
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HIGH CONcentrations of phenols
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used as surface disinfectants and inactivate enzyme systems
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lower concentrations of phenols
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what are approved effective agents?
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iodophors, sodium hypochlorite, or complex phenols
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what does the effectveness of the disinfectant result from?
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the pyhsical rubbing and removal of contaminated material and the chemical inactivation of the living mo's
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what do you wear when cleaning and disinfecting surfaces?
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heavy duty household gloves and mask
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howlong must the disinfectant dry?
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3 min
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how long do we flush water lines?
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2 min at start of day, 30 sec between patients
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invasive objects and instruments used to directly inject or cut into hard or soft tissue of oral cavityq
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sharps
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biohazardous waste consists of items that?
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release blood if compressed, dried blood on gauze
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