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120 Cards in this Set
- Front
- Back
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Sterile technique is defined as any procedure in which_____________?
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added precautions are used to avoid contamination of animal, objects and area
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2 factors that prevented development of surgery are:
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*Lack of anesthesia and pain managment
*Inability of OR team to prevent infections |
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Antwon VonLeewenhoek is known for what scientific contribution?
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Developed the first magnification lens
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Ignaz Semmelweis is known as____ because____ ?
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Father of MEDICAL asepsis
he noticed that when midwives washed their hands between patients, deaths decreased |
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Louis Pasteur is known as _______
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the father of Bacteriology.
*Developed vaccine for anthrax, rabies treatment and pasteurization of milk |
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Joseph Lister is known as _______, was the first to soak instruments in ________ and this resulted in the decrease of ____________
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Father of SURGICAL ascepsis
carbolic acid nosocomial infections |
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Robert Koch is also known as _____ , he worked with Pasteur, isolated microorganisms and developed _____
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Father of bacteriology
laboratory procedures |
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Medical asepsis is a technique used to maintain _________
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an aseptic environment on TISSUE
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Aseptic technique is any technique used to prevent________
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sepsis and possible resulting infections
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Asepsis is the complete absence of ________
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living PATHOGENIC organisms
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Sepsis is defined as the presence of
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pathogenic microbes
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Sterile is defined as
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complete asepsis
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living tissue can never be ____
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STERILE
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Sterilization is the procedure which results in
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complete absence of microbes
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Contaminated refers to any item that
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*any item that has not been through the sterilization process
*Or something sterile has come in contact w/ a non-sterile field or object |
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Sanitized refers to any cleaning procedure that prevents ___________
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disease and ensures a clean environment
*from moping and cleaning cages to medical and surgical asepsis |
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A disinfectant is an agent applied to ___________
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non-living surfaces to significantly reduce number of microbes.
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An antiseptic is an agent applied to ___________
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LIVING tissue to significantly reduce number of microbes
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Instruments should be cleaned ______
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IMMEDIATELY after surgery
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When cleaning instruments, you should separate out ____________
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Used versus unused instruments because instruments that have not been used do not need to be cleaned/scrubbed which prolongs their life. DO need to be re-sterilized.
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When cleaning instruments, what 2 types should never be cleaned together?
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bulky and delicate
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Instruments should always be cleaned
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with ratchets OPEN
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What are the 2 main types of cleaning?
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Manual
Mechanical |
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Manual cleaning involves ________
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scrubbing and rinsing ALL surfaces
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Manual instrument cleaning is the most common type of instrument cleaning and involves scrubbing with ________ and then rinsing with_______.
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enzymatic cleaner
distilled H2O |
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Mechanical instrument cleaning is the most effective way to clean and involves removing dirt and debris with _________ that requires a special solution diluted with distilled H2O.
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Soundwaves
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The basic method for mechanical instrument cleaning is:
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Rinse instruments
put in ultrasonic cleaner for 5 minutes rinse with distilled H2O |
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Soaking instruments in instrument milk (sodium benzoate) is done to :
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lubricate the instrument and puts a protective film on it to protect it from heat and rust
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What is the basic process of applying Instrument Milk?
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Soak, spray on instruments
Let it dry on instruments **Do not wipe off** |
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Instruments should be allowed to air dry on______________
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lint free cloth with box locks completely open
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Instruments should be checked for rust or stains. There is nothing that can be done for rust but some stains can be taken care of by:
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Minor stains can be removed with a pencil eraser
Deeper stains may be removed using a special stain remover (Miltex, Schein) |
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After cleaning and drying process, instruments should be checked for cracks and defects as well as sharpness. What are some of the guidelines for checking sharpness?
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Fine Scissors-should easily cut a glove
Medium Scissors-(metz)easily cut single layer of stockinette Large scissors-(mayo) should easily cut a double layer of bandage |
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Forceps should be checked for
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Proper alignment, no gaps and ratchets securely lock
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When packaging for sterilization, items in the pack should be packed _______
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In reverse order of use
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When packaging for sterilization, what are some basic items that need to be done?
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*Heavy items on bottom
*Use a base towel *open ratchets, but towel clamps should be closed *Always double wrap *towels and drapes should be on top |
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In regards to packing materials, what are 4 qualities to look for?
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Selective permeability
resistant to damage flexible-conforms to shape of pack Memory-ability to return to normal position |
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Selective permeability with packing materials refers to the materials ability to _____________
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keep microbes, dust and dirt out AND allow Gas & steam to go in and out
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What are 4 basic types of packing material?
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Textile
Paper Dennison Paper/plastic combo |
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Textile is cloth made of cotton with a thread count of 140 to 288, and sometimes other synthetic materials. It comes in different sizes and colors and one large disadvantage is that it is more costly initially than other types. Its advantages are:
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Less likely to tear
reusable |
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Paper packing materials comes in rolls or sheets and is one of the cheapest materials. It is FRAGILE and therefore you should always
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wrap twice
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Dennison wrapping material is a textile/paper combo that is water resistant that comes in sheets or rolls and although expensive, is excellent for _______________
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patient drapes
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Paper plastic combo packing material is also known as ______________, comes in rolls or premade patches, can be used for gas, steam or gas plasma sterilization methods. It is a single use wrap that has the indicator strip right on it.
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Chex-all, Visu-all, Steri-shur
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Steam indicator strips indicate that ___________ and go in EVERY pack.
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STERILITY has been achieved
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Bacillus stearothermophilus is a bacteria that is found on indicator strips and they are responsible for ______?
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The color change that indicates sterility
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Steam sterilization tape goes from tan to tan with black stripes when exposed to _______ but this does NOT indicate ___________
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heat
sterility |
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Preparation of sterile packs should be done in a separate room and all instruments should be _________ before packing.
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clean, dry and inspected
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They are packed in a stainless steel pan with a towel to collect
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moisture
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NEVER wrap an ___________ pack
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incomplete
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What should be placed in all surgical packs?
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an indicator strip
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Always make sure packs that you have one of are always wrapped and __________ before you leave for the day.
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ready to be autoclaved and cooled before use
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Towels should be folded in a __________
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folded in a pleated according fashion
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Three things that should be on every pack:
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Contents of pack
Date of sterilization Initials of person who sterilized |
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Shelf life of most surgical packs will be 6-8 weeks depending on __________
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material, storage and sterilization method
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Packs should be stored in a ___________
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dry dust free enviro in a closed cabinet and stock should be rotated appropriately. (FIFO)
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Bulky soft items are usually wrapped
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alone
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Gauze sponges are typically packed in standard amounts of
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10 per pack
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Towels are typically packed in sets of ____________
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2-6 towels
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There are many types of steam sterilization that use pressurized steam along with the increased temp ______________ microbes
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kill
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The high pressure of stream sterilization ensures _________
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total saturation of the packs
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Items are loaded in a _____________ when put in a autoclave to allow steam to freely circulate within the unit.
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single layer
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If you use an autoclave with multiple racks, make sure the layers are not
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touching
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When filling the chamber of an autoclave, use only
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distilled water
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The instrument milk put into the chamber of an autoclave serves the purpose of _____________
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lubricate instruments , prevent dulling and rust
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For an autoclave, with a full load, you use _____ temperature and leave in for _________ minutes
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121.5 C
30 minutes |
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If only one pack and this is NOT a full load for your autoclave, the _____temp and _____ minutes
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121.5 C
15 minutes |
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If you are putting in half a load in the autoclave, then the temp should be ____ for ____ minutes.
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121.5 degrees Celsius
15 minutes |
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Flash sterilization involves placing an unwrapped instrument in a tray with a towel at ______ for ____ minutes
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134 degrees Celsius
3 minutes |
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Before opening chamber door of autoclave make sure
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PSI and temp are both at zero
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If a proper autoclave cycle has been run the pack should come out ________
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dry and autoclave indicator tape should indicate the appropriate change.
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Shelf life of steamed packs is
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30 days
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When autoclaving, during the drying cycle, heat sterilized air
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replaces steam, which allows packs to dry.
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Removing packs from the autoclave before they are dry will allow
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microbes to be wicked in and decreases integrity of paper and textiles.
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The flash cycle is used only when necessary for unwrapped instruments and we use a
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flash pan with a quarter drape
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Gravity displacement autoclaves are also called Downward displacement autoclaves and these force
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air downward and out of chamber which allows the air to escape to the outside as the temp rises.
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Vacuum displacement is another type of autoclave in which the autoclave vacuums the air out of the chamber and a couple advantages of this type are:
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Faster than gravity alone
Can begin sterilizing sooner Draws the moisture out so drying can begin sooner Lower overall expense |
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What are some disadvantages of vacuum autoclaves?
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* May dull sharp edges and corrode instruments
*cannot be used on anything that is heat or water sensitive |
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Steam integrators should be run in an empty cycle for quality control every ___ and have a shelf life of ____
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month
30 days |
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Gas sterilization chambers use ampuoules of Ethylene Oxide gas which is also known as
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ETO gas & brand name is Anprolene
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Gas sterilization autoclave cycles are run at a temperature of ______ for _______ hours
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50 to 60 degrees Celsius
18-24 hours |
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What are some disadvantages of vacuum autoclaves?
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* May dull sharp edges and corrode instruments
*cannot be used on anything that is heat or water sensitive |
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Steam integrators measure steam, heat and sterility of the autoclave. Before use, it is _______, after cycle it should be blue to accept line.
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white
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Steam integrators should be run in an empty cycle for quality control every ___ and have a shelf life of ____
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month
30 days |
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Gas sterilization chambers use ampuoules of Ethylene Oxide gas which is also known as
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ETO gas & brand name is Anprolene
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Gas sterilization autoclave cycles are run at a temperature of ______ for _______ hours
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50 to 60 degrees Celsius
18-24 hours |
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Traits of Ethylene Oxide/ETO/Anprolene are:
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*Odorless/tasteless
*Carcinogenic & Poisonous *Flammable & Explosive *irritating to to mucous membranes *expensive |
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What are some factors that increase ETO's ability to destroy microbes?
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*Temperature of 50 to 60 degrees Celsius
*breaking ampule increases pressure as it inflates bag *Humidity 40 to 80% *Amount of time 12-36 hours Concentration of ETO in mg/L of air |
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When using gas sterilization with ETO, the right amount of moisture is needed. To little results in______ and too much results in _______________
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ETO does not penetrate pack
ETO turns into ethylene glycol--antifreeze |
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Gas sterilization is very effective and works by
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inhibiting cell reproduction by inactivating the DNA
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Gas sterilization can sterilization can sterilize everything, especially
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the heat or water sensitive items
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When loading items into a gas sterilization autoclave, they should be clean and dry, wrapped the same as steam and the one major difference is that
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all plugs and stylets should be removed to allow the gas to flow freely through the whole instrument.
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The ETO ampuoles turn from liguid to gas when exposed to air and when loading the ETO bag, you need to put in a ________to absorb excess moisture because too much moisture will create antifreeze.
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Humidichip
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When prepping the pack for a gas sterilization autoclave, you need to:
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*Put all wrapped items in an ETO bag
*Place ampoule, humidichip, and dosimeter in the bag *Seal bag *Break ampuole Close door, run cycle |
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Shelf life of gas items is
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90 days
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The OSHA Permissible Exposure Level (PEL) of ETO/Anprolene is
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1part ETO to 1000 parts of room air
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OSHA regulations mandate that the ETO must be used with an appropriate unit and _____should be worn when handling.
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gloves
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Per OSHA, if you are exposed to ETO, rinse and
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seek medical attention
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A gas sterilization unit must be
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in a separate room and at least 25 feet away from air intakes, doors, windows and vents.
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Advantages of Gas ETO/Anprolene sterilization are:
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Prolongs shelf life of heat and water sensitive items
Helps keep instruments sharp |
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Disadvantages of Gas ETO/Anprolene sterilization are
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Expensive
Safety hazards Amount of time to run |
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ETO dosimeter badges change color in
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proportion to the dose of gas that they come in contact with.
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ETO dosimeter badges indicate, amount of time, temp
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and that ETO concentration was achieved by bar going from Orange/yellow color to black.
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Ionizing radiation sterilization is used primarily in manufacturing companies and the microbes are destroyed by
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electrodes---generated by beta and cathode rays. Is typically used for large batches of needles, syringes, gloves, suture, plastic tubing, food, bedding for lab animals and lasts for years.
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Gas plasma is rarely used but is also known as Sterrad Units, These create a gas plasma with
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40 to 50% peroxide being mixed with radiowaves.
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The gas plasma cycle runs for ____mins at a temp of _____
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45 mins
40-55 degrees Celsius |
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Advantages of gas plasma sterilization are:
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*It is nontoxic
*It is quicker than some types-74 minutes total cycle time **can be used on water and heat sensitive items |
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Disadvantages of gas plasma sterilization are
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Requires special packaging
Cannot put items with cellulose (paper) in this type tends to leave a residue on linens and cottons. |
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When loading a gas plasma/sterrad unit, the packs are wrapped in paper or
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a special chex-all made by Tyvek
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Liquid sterilization is also known as
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cold sterilization
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Liquid/Cold sterilization uses ______ solution
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dialdehyde
----Cidex, benzol, Amerse, Nolvasan which are corrosive to tissue |
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Liquid/cold sterilization is used to
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highly disinfect in immersion after 20 minutes, which decreases contamination level and it will not kill spores.
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Liquid/Cold sterilization is _____ and should only be used on instruments that are used for_____.
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not a true sterilization method
contaminated wounds |
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Liquid/cold sterilization solution should be changed
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DAILY
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Items sterilized through Liquid/cold sterilization, though not sterile should be
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handled as if they were sterile.
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In the tray for Liquid, Cold sterilization, mix solution with
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distilled water
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name some items commonly seen in a Liquid/Cold sterilization tray:
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wound care, declaw instruments, suture scissors, needle drivers, thumb forceps
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What are some of the non-acceptable sterilization methods:
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*Moist heat/boiling results in sanitized but not sterile items if done for 20 - 30 minutes but does not kill spores
*Dry heat/Baking only removes moisture from bacteria wall |
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The shelf Life of packs is ____ in hot humid climates
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decreased
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Frequent handling of packs will
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decrease shelf life
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Packs are considered contaminated when:
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wet
tape is broken or torn pack has punctures or tears |
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Packs should be stored
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in a separate, well ventilated area
Watch for brittle paper in arid high altitude areas -In a closed cabinets or with dust covers -in a method that uses stock rotation |
