DH theory

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