CH. 21 Instrument Processing and Sterilization

Critical

1) Critical instruments are those used to penetrate soft tissue or bone, or enter into or contact the bloodstream or other normally sterile tissue. They should be sterilized after each use. Sterilization is achieved by steam under pressure (autoclaving), dry heat, or heat/chemical vapor. Critical instruments include forceps, scalpels, bone chisels, scalers and surgical burs.

At a temperature of 160º C (320º F), dry heat sterilization requires ___ minutes.

120mins/2hrs

Steam temperatures in sterilizing cycles are

121.11º C (250º F) for 30 minutes or 133.88º C (273º F) for 15 minutes.

When sterilizing instruments in the autoclave, the timing is __ minutes after the controls show the pressure at 15 psi and the temperature at 121º C (249.8º F).

15mins

Semi critical

2) Semi-critical instruments are those that do not penetrate soft tissues or bone but contact mucous membranes or non-intact skin, such as mirrors, reusable impression trays and amalgam condensers. These devices also should be sterilized after each use. In some cases, however, sterilization is not feasible and, therefore, high-level disinfection is appropriate. A high-level disinfectant is registered with the U.S. Environmental Protection Agency (EPA) as a "sterilant/disinfectant" and must be labeled as such.

Non critical

3) Non-critical instruments are those that come into contact only with intact skin such as external components of x-ray heads, blood pressure cuffs and pulse oximeters. Such devices have a relatively low risk of transmitting infection; and, therefore, may be reprocessed between patients by intermediate-level or low-level disinfection. An intermediate-level disinfectant is EPA-registered as a "hospital disinfectant" and will be labeled for "tuberculocidal" activity (e.g., phenolics, iodophors, and chlorine-containing compounds). A low-level disinfectant is EPA- registered as a "hospital disinfectant" but is not labeled for "tuberculocidal" activity (e.g., quaternary ammonium compounds). The tuberculocidal claim is used as a benchmark to measure germicidal potency. Germicides labeled as "hospital disinfectant" without a tuberculocidal claim pass potency tests for activity against three representative microorganisms: Pseudomonas aeruginosa, Staphylococcus aureus, and Salmonella choleraesuis

why is adequate spacing between packs important

Because steam must circulate around the packs for sterilization to happen

Which of the following verifies sterilization by confirming that all spore-forming microorganisms have been destroyed?

Biological monitor

Which of the following is considered a noncritical instrument?

X-ray Head

Examples of semicritical items include

amalgam condensers and burs

The ultrasonic solution should be cleaned frequently, -----------, and more frequently if it becomes cloudy.

at a minimum of once a day

An ultrasonic cleaner should be labeled with a

biohazard label and a chemical warning label

When returning soiled instruments to the sterilization center, the tray is placed in the __________ area.

contaminated

------ is preferred for steam autoclaves

distilled water

Before instruments are wrapped for dry heat sterilization, they must be clean and

dry

The least desirable method of precleaning instruments is

hand scrubbing

_____ is an ineffective means of cleaning an instrument and not recommended by OSHA.

hand scrubbing

A ______ is used following an ultrasonic bath prior to bagging the instruments for sterilization.

holding solution

Chemical sterilants are not an excellent method of

sterilization