Chapter 14 - High Temperature Sterilization

4 FACTORS THAT IMPACT STERILIZATION

-The type of microorganisms present. -The design of the medical device. -The number of microorganisms (bioburden) present. -The amount and type of soil present.

Peel pouches should be placed ___ while being sterilized and should be aligned from ___

on the edge/paper to plastic.

Allow for proper steam penetration and avoid ____.

overloading

Position textile packs so the layers within them are ____ to the shelf.

perpendicular

Dynamic air removal sterilizers use 2 different types of preconditioning methods for air removal. These include variations of ____ and above-atmospheric-pressure processes, such as the ____

prevacuum air removal/steam-flush pressure-pulse process (SFPP).

The higher the bioburden on an object

the more difficult it will be to sterilize

The portion of the steam sterilizer that measures steam temperature and automatically controls the flow of air and condensate from the steam sterilizer chamber is the ____

thermostatic trap

True or false? After sterilization the load contents may take 2 hours or more to cool?

true

True or false? Items with a standard steam sterilization cycle recommended by the manufacturer can be damaged if run on an extended cycle?

true

The cooling time may be only 30 minutes for small sets or peel pouches, but can take ____ for larger sets.

two hours or longer

Gravity sterilization has temperatures of ____

250°F

Dynamic Air Removal has temperatures of ____

270°F 275°F

To ensure air removal in these sterilizers, the integrity of the sterilizers should be checked daily by processing called a ____

Bowie Dick test.

Terminal Sterilization is often performed in the ____.

CS department

True or false. Extended Sterilization Cycles can be placed in with the regular cycles

False

True or false. Recording devices sure as the Gauge and Monitor controls can be checked ____, to include the paper charts and printer paper.

False

True or false? Immediate use steam sterilization is the process to sterilize trays for future use?

False

True or false? Steam flush pressure pulse sterilizers are a type of gravity sterilizer?

False

True or false? When water is seen on the outside of a pack after sterilization the pack is considered safe to use if all other packs the load are dry?

False

True or false? Wood Products should be sterilized in an extended steam cycle?

False, wood cannot be sterilized in a steam cycle at all

When sterilization is complete, follow the sterilizer ____ for opening the door.

IFU

The ____ cycles through 3 cycles when using saturated steam.

IUSS

CS technicians should be familiar with two basic sterilization cycles: ____

IUSS sterilization and terminal sterilization.

IUSS

Immediate Use Steam Sterilizers

IUSS Sterilization is often performed in the ____.

OR department

Exposure

Once the temperature is reached the sterilizers control system will begin running a time cycle for the exposure phase

Exhaust

The drain is open and the steam is removed through the discharge line right after the exposure phase.

Bioburden

The number of microorganisms on a contaminated object; also called "bioload" or "microbial load".

Dynamic Air Removal Sterilizers

There is a vacuum pump or water ejector that removes air from the chamber more effectively during the preconditioning phase, prior to the reaching of the exposure temperature.

Cleaning is the first step of sterilization.

True

True or false. When cleaning and maintaining sterilizers you must allow it to cool down before any cleaning or maintenance procedure can be down.

True

True or false? The steam sterilization process can be affected by the design of the medical device being sterilized?

True

Steam Flush Pressure Pulse Process

Uses a repeated sequence of a steam flush and pressure pulse to remove air from the sterilizer chamber and processed materials, that occurs in atmospheric pressure with no vacuum required.

Dynamic Air Removal Sterilizers Temperature

Usually operate at higher temperatures (270°F to 275°F) than gravity sterilizers.

A CS technician must know the ___ of a sterilizer to better understand how it operates.

anatomy

When combining loads, hard goods should be placed on what shelf?

bottom shelf

This insulation also provides a safety feature because it reduces the likelihood that personnel working behind the sterilizer will be ___.

burned

Is located in the floor of the steam sterilizer.

chamber drain

It has a safety locking mechanism that automatically activates when ____ and it can only be unlocked when ----.

chamber pressure is applied/pressure is exhausted

Packages must not touch ____.

chamber walls

Items processed using IUSS must undergo the same ____ as items that are terminally sterilized.

cleaning and preparation

Placing warm sterilized packages on cool surfaces will cause ____ to form.

condensation

The outside of the jacket is covered with insulation to help prevent ____ from forming on the jacket's outer and inner walls.

condensation

The three main phases of a terminal steam sterilizer cycle are ___

conditioning, exposure, and exhaust.

Saturated steam sterilization cycle phases

conditioning, exposure, exhaust, drying

The most frequent cause for sterilization failure is lack of steam ____.

contact

Regardless of the type of steam sterilization method used, the same four conditions _____ must be met.

contact, temperature, time and moisture

The most common reason for sterilization failure is lack of ____

contact.

A wet pack is considered ____ and must be completely repackaged and reprocessed.

contaminated

Factors that can cause sterilant contact failure with the instrument are

crowded loads, clogged drain strainer

How frequently should a sterilizer strainer be removed and cleaned?

daily

The chamber drain strainer should be removed at cleaned ____.

daily

The ____ is the weakest part of a steam sterilizer.

door

The ____ and the area surrounding it are the coolest

drain

The thermostatic trap is located in the ____.

drain line

Another name for superheated steam is...

dry steam

While using the steam sterilizer cycle for terminal sterilization items are expected to be ____

dry upon completion of the sterilization process.

The SFPP uses ___

ejectors.

Inadequate ____ time at the correct elevated temperature is a reason for sterilization failure

exposure

Is designed to maintain a tight seal that prevents steam from escaping the Chamber of the sterilizer.

gasket

The sterilizers ____ provide a visual and written record of sterilization conditions.

gauges and controls monitors

The two most commonly-encountered temperatures for steam sterilization are:

gravity sterilization and dynamic air removal

The ____ remove air from the chamber by Steam for seen the cooler air and the Chamber out through the drain

gravity sterilizers

While using the steam sterilizer cycles for IUSS items sterilized should be used ____.

immediately

Central Service Technicians need to understand the anatomy of a steam sterilizer to

understand how the sterilizer operates

The prevacuum uses a ____

vacuum.

SFPP

Steam Flush Pressure Pulse Process

Conditioning

Steam enters back portion of sterilizer and is displaced through the drain. As steam enters the sterilizer chamber, pressure begins to rise and so does the steam temperature.

Gravity Air Displacement Sterilizers

Steam enters the chamber and because air is heavier than steam the steam forces the cooler air to the bottom of the chamber and out the drain.

____ are frequently used in clinics and dental offices.

Tabletop Sterilizers

A Steam Sterilization Cycle has at least three and possibly four phases:

-Conditioning -Exposure -Exhaust -Drying (in most instances)

Steam is the sterilant of choice for several reasons.

-Low cost -Rapid sterilization cycles -Relatively simple technology -Leaves no chemical residues or byproducts

Drying

Drive times are based on the IFU. this happens after the exhaust phase

Bowie Dick test is only performed or needed for ___

Prevacuum Steam Sterilizers.

-Failure to adequately clean the object being sterilized. -Sets that are too dense or instruments positioned in a way that does not allow steam contact. -Packages wrapped too tightly. -Loads that are too crowded. -Containers that are positioned incorrectly.

Reasons for sterilization failure

____ must be positioned so air can exit and steam can enter.

Solid containers

The ___ surrounds the sides, top and bottom of the vessel, and steam circulates in this space to pre-heat the interior chamber walls.

jacket

The interior chamber walls of the sterilizer are heated by steam in the ___ of the sterilizer

jacket

The most common reason for sterilization failure is the ____ of the device being sterilized.

lack of contact between steam and the entire surface

The most common reason for steam sterilization failure is

lack of steam contact with the instrument

Thermostatic trap is ____

located in the drain line and measures the steam temperature and automatically controls the flow of air and condensate from the sterilizing chamber.

When the cart is removed, it should be placed in a ____ in close proximity.

low-traffic area where there are no air conditioning or other cold air vents

To ensure full steam contact and removal of air, the sterilizer ____ allow adequate air circulation and drainage of the condensate.

must be properly loaded to

Steam is the most frequently-used sterilant for devices not adversely affected by moisture or heat because of its successful record of ___

safety, efficacy, reliability and low cost.

When loading a steam sterilizer, basins should ___

stand on edge

There should be visible space between packs to allow ____

steam circulation and drying.

Wet packs may occur when a ____ process is used.

steam sterilization

Saturated Steam

steam that contains the maximum amount of water vapor.

Saturated Steam is required for effective ____.

sterilization

For sterilizers without carts, items should remain in the ____

sterilizer chamber until properly cooled.

One of the most frequent causes of a clogged drain screen is ___

tape.

To be effective, steam sterilization must occur at specific ____.

temperatures

The ____ cycles through all 4 cycles when using saturated steam which includes the drying.

terminal sterilization