Name the 3 recommended types of chemical disinfectants
GlutaraldehydesChlorine compoundsIodophors
What must the label state on a chemical disinfection solution container in order for us to use it?
shelf lifeuse lifereuse lifedirections for activationtype of container for storagetoxic effects
What chemicals must be included in a chemical disinfection solution for us to use it?
tuberculocidalbacteriocidalvirucidalfungicidal
What is the criteria for selecting a chemical disinfectant agent?
EPA approvedChemicals includedLabels
Can chemical disinfectant solutions be altered by foreign materials?
Yes
How is disinfection achieved by use of chemical disinfectants?
by coagulation, precipitation, or oxidation of protein, or denaturation of enzymes of cells
What are chemical disinfectants used for?
treatment area after appointmentimpressionsdentures/partials
Low level disinfectant
incactivates vegetative bacteria and certain lipid-type viruses, but does not destroy spores, tubercle bacilli, or non-lipid viruses
Intermediate level disinfectant
inactivates all forms of microorganisms, but does not destroy spores
High level disinfectant
inactivates spores, fungi, bacteria, and viruses, is a disinfectant, or a sterilizer
What are chemical disinfectants used for?
surface disinfectantsimmersion disinfectantsimmersion sterilantshand antimicrobials
Why isn't chemical sterilization effective?
Can't verify effectiveness with spore testingcan't package instrumentsmust rinse with sterile watermust be completely immersed in solution (immersion)
How long does chemical sterilization take?
10-12 hours
What are chemical sterilants used for?
items that can't be sterilized with heat
environmental
no contact with pt. surfaces-low level disinfection
non-critical
doesn't touch mucous membrane (light, some x-ray materials)-low level disinfection
semicritical
touch intact mucous membrane (mirror)-sterilize or high level disinfection
Critical
Penetrates soft tissue or bone (needle, explorer, etc)
Critical
penetrates soft tissue or bone. (needle, explorer, etc)-sterilize or dispose
What are the limitations of using gluteraldehydes?
irritates skin and eyescorrosive to some instrumentsbad to inhale
How do you prepare Gluteraldehyde solutions?
mix 2 components to activate
How do gluteraldehydes disinfect?
high level disinfectants (used in immersion disinfection)damage proteins and nucleic acids
What are the types of gluteraldehydes used?
2% nuetral2% alkaline2% acidic
How do chlorine compounds disinfect?
oxidation of enzymes, and cell wall components
What are chlorine compounds used for?
water purificationdenture cleaning
what are chlorine compounds made up of?
sodium hypochloride 5.25% (household bleach)
What are the limitations of chloride compounds? And why are they so widely used?
a. you must change it every day harmful and corrosive bad smellb. It's cheap and breaks things down easily
How do idophors disinfect?
Iodine is released slowly
What are idophors used for?
surgical antisepsisliquid soapsmouth rinsessurface antiseptics
what are idophors made up of?
1% 0-benzyl-pehlorophenol9% 0-phenylphenyldiluted with distilled water
High concentration idophor
protoplasmic poison- destroys cell wall and precipitates protein
Low concentration idophor
surface disinfectant- inactivates enzymesdilluted with distilled water
Describe typical care of sterile instruments
store in package/wrapperput package in clean cabinet or drawer and make sure it's datedresterilize instruments after 3 months
How do chemical vapor sterilizers sterilize?
combination of alcolhols, formaldehydes, keytone water, and acetone heated under pressure produce gases that sterilize
what are chemical vapor sterilizers used for?
low melting plasticsliquidsheat sensitive hand pieces
What temperature is used for chemical vapor sterilization?
127-132 C (260-270 F)
What pressure is used for Chemical vapor sterilization?
20-40 lbs
Do instruments need to dry and cool after use of chemical vapor sterilizer?
Need to cool, but not dry
How often must you clean/ refill chemical vapor sterilizer?
once a week
What are the advantages of using a chemical vapor sterilizer?
easy to useshort amount of timecorrosion and rust free
What are the disadvantages of using the chemical vapor sterilizer?
you need a lot of ventilation, the fumes are very dangerous
How does Dry Heat sterilizer sterilize?
Oxidation-from heat conducted from the outside to inside
What is the dry heat sterilizer used for?
materials that can't be steam autoclavedoilspowderssmall instruments that might be corroded or rusted
Does oil, debris, or grease protect microorganisms from sterilization in using Dry Heat sterilizer?
yes
What temperature is used for Dry Heat sterilizer?
160 C (320 F) for 2 hrs170 C (340 F) for 1 hr -sterilization/timing doesn't start til after machine preheated
What happens if the tempurater exceeds 160 C using Dry heat sterilizer?
it can ruin/destroy sharp edges
What are the advantages of using Dry Heat sterilization?
useful for materials that can't be autoclavedif at right tempurature, good for sharp instrumentsno rust or corrosion
What are the disadvantages of using Dry heat sterilization?
it takes a LONG timemust maintain very high tempuratures
How does Moist Heat Steam under pressure (steam autoclave) sterilize?
Heat destroys by inactivating cell proteins or enzymesmoist heat coagulates proteins
What are steam autoclaves used for?
materials except: oils powders waxes or items that can't get too hot
What purpose does pressure serve in steam autoclave?
to increase temperature
Steriliztion in steam autoclave depends on what?
penetrating ability of steam
What are the conditions for packing and preparing instruments and steam autoclave?
no airleave space between objectsinstruments are cleaned and air dried
What is the tempurature used for steam autoclave?
121 C (250 F)
What amount of pressure is used for steam autoclave?
15 lbs pressure
How long do you run steam autoclave?
15 min30 min if load is heavy
What are the advantages of the steam autoclave?
quick and efficientmost economic method
What are disadvantages of using steam autoclave?
corrosionno oils, liquids, powders, waxes, or materials that can't handle heat
what are the three tests for adequate sterilization?
external chemical indicaterinternal chemical indicatorbiologic monitor
external chemical indicator
seals package and changes color if correct temperature of autoclave was reached (external on package)
internal chemical indicator
color change shows instruments exosed to heat and steam for the right time
Biologic monitor
tests that autoclave functions right-run organisms through machine then culture them
What microorganism is used for the biologic monitor test in the steam autoclave?
geobacillus stearothermophilus strips
How often must you perform the biologic monitor test?
once a week
sterilization
all forms of life are destroyed
3 methods for sterilization
dry heatchemical vaporsteam autoclave
What are the causes for incomplete sterilization?
inadequate preperationmisuse of equipmentinadequate maintenance
Describe the seal on the package for instruments
indicator tapeindicator strip changes color during sterilization indicating that auclave reached right tempurature for penetration, but it does not indicate in sterilizedblack strip should appear when done
When do you unwrap your instruments
Not until you are infront of your patient
What materials do you need to prepare for instrument packaging?
sturdy wrapping to preven tearswrapping that permits steam or chemical vapor to pass through contents
what are the indications for thourgough drying?
when sterilizing by dry heat, chemical heat, chemical vapor, or ethylene oxidenonstainless steal must predip in rust inhibitor before steam autoclavingpackaging in paper wrap
How do you arrange you instruments when packaging?
preplan and preload cassette for specific appointmentdate and mark tray or packageuse clear see through package
How long do you run the ultrasonic?
15 minutes
is the ultrasonic a substitute for sterilization?
No
How do instrument wahsers disinfect
high velocity, and hot water
How do instrument washers/thermal disinfectants and ultrasonics disinfect?
higher degree of temp and high velocity