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surgical technology-sterilization
sterilization
33
Medical
Undergraduate 2
03/15/2010

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Term
who and what was the first chemical to disinfect (used by who)?
Definition
homer
Term
what did aristotle understand
Definition
for soldiers to avoid disease
Term
what did hippocraties and galen do with inst.?
Definition
boil them
Term
ernest von bergman introduced what and what year?
Definition
steam sterilizer; year 1886
Term
what happend 1929 as far as anti bacterial agents go?
Definition
ethalyne oxide was discoverd
Term
what year was Glutaraldhyde introduced?
Definition
1963
Term
what is Used for items that can not be heat sterilized
Definition
Glutaraldhyde
Term
what are the 2 reliability parameters
Definition
Two types of parameters
Product associated
Process associate
Term
what are teh product associated parameters? (list them)
Definition
Bioburden
Bioresistance
Biostate
Bioshielding
Density
Term
define bioburden
Definition
degree of contamination with microorganisms and organic debris
Term
define bioresistance
Definition
– factors such as heat and/or moisture sensitivities and product stability
Term
define biostate
Definition
– Nutritional, physical and/or reproductive phase of microorganisms
Term
define bioshielding
Definition
Characteristics or the packaging materials
Term
define density
Definition
– factors affecting penetration and evacuation of the agent
Term
list process associated parameters
Definition
Temperature
Humidity/moisture/hydration
Time
Agent/air purity, residues
Saturation/penetration
Sterilizer capacity
Term
what are the 3 methods of sterilization?
Definition
Thermal
Chemical
Radiation
Term
list 2 thermal methods:
Definition
Steam under pressure/moist heat
Hot air/ dry heat
Term
list chemical methods
Definition
Ethylene Oxide gas
Formaldehyde gas and solution
Hydrogen peroxide plasma vapor
Ozone gas
Acetic acid solution
Glutaraldehyde solution
Peracetic acid 0.2% solution
Hypochlorous acid (electrochemical conversion process)
Term
describe steam under pressure:process, requisites, kill times, temperature
Definition
Ethylene Oxide gas
Formaldehyde gas and solution
Hydrogen peroxide plasma vapor
Ozone gas
Acetic acid solution
Glutaraldehyde solution
Peracetic acid 0.2% solution
Hypochlorous acid (electrochemical conversion process)
Steam enters chamber under pressure
Condenses on contact with cold items
Condensation liberates heat,
Simultaneously heating and wetting items
Providing two requisites
Moisture
Heat
Process spoken of in terms of degrees of temperature and time of exposure
Exposure time
Dependent on the
Size of load
Contents of load
Temperature within the sterilizer
End of cycle
Revaporation of water condensate must effectively dry the load
Kill times
Vegetative forms of most organisms are killed in a few minutes
Temperature ranging from 130º to 150º F (54º - 65º C)
Certain bacteria spores will withstand temp of 240ºF (115º C) for more than 3 hours
No living thing can survive direct exposure to saturated steam @ 250º F (132º C) for longer than 15 minutes
Term
list advantege of steam sterilization
Definition
Advantages of steam sterilization
Easiest
Safest
Surest method of onsite sterilization
Least expensive
Most easily supplied agent
Piped in from facility’s boiler room
Term
list disadvantages of steam sterilizer
Definition
Disadvantages of steam sterilization
Precautions must be used in preparing and packaging items, loading and operating the sterilizer and drying the load
Items need to be clean, free of grease and oil, and not sensitive to heat
Direct contact of steam with all areas of the item
Timing of cycle adjusted for differences in materials, sizes of loads, variables subject to human error
Steam may not be pure
Amount of solid, liquid or vapor contamination in the steam
Impurities cause wet or stained packs or instruments
Term
list types of steam sterilizers
Definition
gravity displacment
Prevacuum
flash
Term
give gravity displacement sterilizer temperature and times and PSI
Definition
Operate on standard cycle
250º -254ºF (121º-123º C)
Presure 25 –18 pounds per square inch (psi)
Size and contents of the chamber determine the exposure period
Minimum exposure time is 15minutes
May vary if closed container system is used
Some air powered instruments require longer exposure
Term
give times operation and temp of Prevacuum and PSI
Definition
Degree of vacuum is achieved by means of a pump and a steam injector system
Prevacuum period of 8-10 minutes effectively removes the air to minimize steam penetration time
Preconditions the load and help eliminate air from packages
Post vacuum cycle draws moisture from the load to shorten the drying time
Bowie-Dick test is performed daily to ensure that the vacuum pump is functioning properly
Temperatures are controlled at 270º - 276º F (132º-135.5º C) at a pressure of 27 psi
All items are exposed to temperature of at least 270ºF (132º C) for a minimum of 4 minutes
Complete cycle takes approximately 15 – 30 minutes
Term
what is the purpose of a bowie dick test?
Definition
to ensure the vacum in a prevacum is running correctly
Term
flash sterilization : operation ,PSI, temperature, time
Definition
Gravity displacement is most common
Operates at 27psi at sea level
Or at 22 psi at 5000 ft above sea level
To increase chamber temperature to between 270º-275º F (132º-135ºC)
Minimum exposure time is 3 minutes for unwrapped, nonporous, uncomplicated stainless steel items without lumens
Porous items or instruments with instrument marking tape or lumens time is increased to 4 minutes or longer in prevacuum or 10 minutes or longer in gravity displacement sterilizer
Entire time for starting, sterilizing and opening the sterilizer is a minimum of 6-7 minutes
Process should be documented
Should not be used for routine sterilization of complete instrument sets
Used only in urgent, unplanned, emergency situations
Individual items inadvertently dropped or forgotten for which no alternative method exists
Instruments should be thoroughly washed and dried before processing
Term
who can use flash sterilizer during procedure and how?
Definition
ST- only touch sterile surfaces
Circulator- has special handles
Term
how long should packages remain untouched and at what temperature after sterilization ?
Definition
15- 1 hour ; 68-75 f
Term
process cycle for sterilization
Definition
Heat up and/or penetration of the agent
Kill time – exposure to the agent
Safety factor for bioburden
Evacuation or dissipation of the agent
Term
list the protocol for sterilization cycle
Definition
Administrative monitoring
Mechanical indicators
Chemical indicators
Biologic indicators
Term
list the process of administrative monitoring
Definition
Written policies and procedures
Decontaminating, terminally sterilizing, cleaning all reusable items. Disposing of disposable items
Packaging and labeling items
Loading and unloading the sterilizer
Operating the sterilizer
Monitoring and maintaining records
Transport of items
Storing sterile items
Handling sterile items ready for use
Sterile transfer to sterile field
Tracking and recall of items for unsafe load
Term
what are the mechinical indicators
Definition
Mechanical indicators
Gauges
Thermometers
Timers
Recorders
Other devices that monitor function
Routine maintenance
Preventive maintenance
Term
wat are chemical indicators
Definition
Help monitor the physical conditions within the sterilizer
Alert personnel to
Malfunctions
Human errors in packaging
Improper loading of sterilizer
Placed inside package, position most likely for sterilant to reach
Expected results not shown, Do Not Use the Item
Does not establish sterility of the item, only that process parameters have been met
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