Presentation on the topic of sterilization of individual instruments. Presentation on the topic "sterilization"
slide 2
Thermal: steam and air (dry heat). Chemical: gas or chemical solutions Radiation sterilization - used in industrial version Membrane filter method - used to obtain a small amount of sterile solutions, the quality of which can deteriorate dramatically under the action of other sterilization methods
slide 3
Sterilization methods approved for use in healthcare facilities.
slide 4
Thermal sterilization
Roasting and boiling Roasting is not currently used to sterilize instruments. The method can be used at home when it is impossible to use others. The firing of metal instruments is carried out with an open flame. Usually, a tool is placed on a metal tray, a small amount of ethyl alcohol is poured and set on fire. Boiling has long been the main method of sterilizing instruments, but has rarely been used recently, since this method achieves a temperature of only 100 ° C, which is not enough to kill spore-bearing bacteria. Tools are boiled in special electric sterilizers of various capacities. Opened instruments (disassembled syringes) are placed on a mesh and immersed in distilled water (sodium bicarbonate can be added - up to 2% solution). The usual sterilization time is 30 minutes from the moment of boiling.
slide 5
Thermal sterilization (steam method)
An autoclave is used to reach temperatures above the boiling point of water. An autoclave is a device for steam sterilization under pressure. The temperature of saturated steam depends on the pressure. Autoclave operating modes: 132 °C - 2 atmospheres (2 kgf/cm2) - 20 minutes - basic mode. Sterilize all products (glass, metal, textiles, EXCEPT RUBBER). 120 ° C - 1.1 atmospheres (1.1 kgf / cm2) - 45 minutes - gentle mode. (glass, metal, rubber products, polymer products - according to the passport, textiles) 110 ° C - 0.5 atmospheres (0.5 kgf / cm2) - 180 min - especially gentle mode (unstable preparations, nutrient media) Compact portable autoclave
slide 6
Thermal sterilization
It is often possible to achieve the same effect by fractional sterilization in fluid steam at 100°C (tyndalization). The liquid is sterilized in this case at 100°C for three consecutive days for 30 minutes daily; between heatings, it is kept in a thermostat so that the spores germinate, and then the vegetative cells are destroyed during the next heating. For many purposes, one is content with partial sterilization, i.e. destruction of vegetative forms of microorganisms. This effect is usually achieved by pasteurization - holding for 5-10 minutes at 75 or 80°C. Pasteurization partially sterilizes, in particular, milk, wines. Two methods of pasteurization are used: short-term heating (20 s at 71.5-74°C) and strong heating (2-5 s at 85-87°C).
Slide 7
Thermal sterilization (air method)
Dry heat. Sterilization is carried out in special devices - dry-heat cabinets-sterilizers. Sterilization in a dry-heat cabinet occurs by means of circulation of hot air inside it. With dry heat sterilization, bacterial spores tolerate higher temperatures and longer than with moist heat sterilization. Therefore, heat-resistant glassware, powders, oils, etc. are sterilized for 1 hour at a temperature of 180°C. Sterilization in an autoclave and a dry oven is currently the main, most reliable way to sterilize surgical instruments, glassware
Slide 8
Thermal sterilization (glasperlen method)
The principle of operation of the glasperlene sterilizer is based on bringing sterilized surgical instruments into contact with small glass spheres having a temperature of 250C. The sterilizer is designed for rapid sterilization of all-metal, without cavities, channels and locking parts, dental and other medical instruments and devices in an environment of glass beads heated to a temperature of 190-290ºС with full immersion of small products in them, as well as working parts of larger products. Sterilization of the instrument is carried out within a very short time - no more than 20 seconds. Due to such a short period and the non-destructive effect of sterilization (glassperlene) balls on the instrument, the negative effect of high temperature is practically absent. Sterilizes in just 5 seconds: forceps, pliers, scalpel holders, probes, spatulas, chisels, chisels, diamonds, files, burs, root elevators, retractors, contra-angles, needle holders, tweezers, gingival scissors, etc.
Slide 9
Thermal sterilization (infrared method)
The small-sized sterilizer is intended for sterilization of dental and microsurgical instruments made of metals in hospitals, clinics, hospitals and other medical and cosmetology institutions. Sterilization is carried out by infrared powerful short-term thermal effect.
Slide 10
Chemical sterilization (gas method)
In world practice, there are 3 main methods of low-temperature sterilization: gas ethylene oxide, gas formaldehyde and plasma. Gas sterilization is carried out in special sealed chambers. The sterilizing agent is usually formalin vapor (formaldehyde tablets are placed at the bottom of the chamber) or ethylene oxide. Instruments laid on the grid are considered sterile after 6-48 hours (depending on the components of the gas mixture and the temperature in the chamber). A distinctive feature of the method is its minimal negative impact on the quality of instruments, and therefore the method is used primarily for the sterilization of optical, highly accurate and expensive instruments.
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When sterilizing foodstuffs, medicines and various kinds of devices, as well as in laboratory practice, the use of ethylene oxide has justified itself, which kills both vegetative cells and spores, but only works if the materials to be sterilized contain a certain amount (5-15 %) water. Ethylene oxide is used in the form of a gas mixture (with N2 or CO2), in which its share is from 2 to 50%. The ethylene oxide method provides the most gentle sterilization temperature regime.
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Chemical sterilization (plasma method)
The plasma method allows you to create a biocidal environment based on an aqueous solution of hydrogen peroxide, as well as low-temperature plasma (ionized gas formed at low pressure). This is the most modern sterilization method known today. It allows you to sterilize any medical products, from hollow instruments to cables, electrical appliances, to which in some cases none of the known sterilization methods can be applied at all. With this method, after injecting a solution of hydrogen peroxide into the sterilization chamber, a source of electromagnetic radiation with a frequency of 13.56 MHz is turned on, under the influence of which one part of the H2O2 molecules is simultaneously divided into two groups (OH-), and the other part into one hydroperoxy group (OH- ) and one hydrogen atom, accompanied by the release of visible and ultraviolet radiation. As a result, a biocidal environment is created, consisting of hydrogen peroxide molecules, free radicals and ultraviolet radiation.
slide 13
Plasma is formed under the influence of strong electromagnetic radiation in an atmosphere of hydrogen peroxide vapor. When the electromagnetic field is turned off, free radicals are converted into water and oxygen molecules, leaving no toxic waste. The minimum processing time in a plasma sterilizer is from 35 minutes, the operating temperature is 36-60°C. One of the main advantages of this method is the absence of toxic waste, only oxygen and water vapor are formed. Plasma sterilization destroys all forms and types of microorganisms. Plasma sterilizers are promising equipment, but too expensive for most Russian medical institutions
Slide 14
Chemical sterilization (antiseptic solutions)
Sterilization with solutions of chemical antiseptics, as well as radiation and gas sterilization, refers to cold sterilization methods and does not lead to blunting of instruments, and therefore is used primarily for processing cutting surgical instruments. For sterilization, three solutions are mainly used: triple solution, 96 ° ethyl alcohol and 6% hydrogen peroxide. Recently, an alcohol solution of chlorhexidine, Pervomur, and others have been used for cold sterilization of optical instruments. For cold sterilization, the instruments are completely immersed in the open (or disassembled) form in one of the indicated solutions. When soaked in alcohol and a triple solution, the instruments are considered sterile after 2-3 hours, in hydrogen peroxide - after 6 hours. This method is of interest for the sterilization of solutions containing medicinal substances that change when exposed to high temperature. The following are used as antiseptics: phenol, tricresol, chinosol, nipagin, nipazol, chloreton, mercurofen and cefirol. There are also reports in the literature on the use of chlorocresol, chlorobutol, phenylmercuric nitrate, quaternary ammonium compounds (benzalkonium, cetrimide) and some other substances for this purpose.
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Carbolic acid is included in the ternary solution (Krupenin's solution). They sterilize cutting tools and plastic items. It stores sterilized needles, scalpels, forceps, polyethylene tubes. Lysol with green soap is used to wash the walls, floors, furniture of the surgical dressing unit, as well as to treat instruments, rubber gloves, objects contaminated with pus or feces during the operation. Sublimate (mercury dichloride) 1:1000, 1:3000 Gloves, drains and other items are sterilized. Mercury oxycyanide 1:10000 is used to sterilize ureteral catheters, cystoscopes and other instruments with optics. Diocide is a preparation of mercury that combines antiseptic and detergent properties. Some use a surgeon to treat the hands - they wash their hands in the pelvis with a solution of 1: 3000, 1: 5000 - 6 minutes. Ethyl alcohol is used to sterilize cutting instruments, rubber and polyethylene tubes, surgeons' hands are tanned with 96% alcohol before surgery. Although 70% alcohol is more bactericidal than 96%, however, the spore-like infection does not die for a long time. The causative agents of gas gangrene and anthrax spores can persist in alcohol for several months. To increase the bactericidal activity of alcohol solutions, thymol (1: 1000), 1% brilliant green solution (Bakkal solution), formalin, etc. are added to them.
slide 16
The bactericidal properties of halogens have long been used. N. I. Pirogov used alcohol iodine 2%, 5% and 10%, not yet knowing about the existence of microorganisms. Iodine has a bactericidal and sporicidal effect. It has not lost its significance even today. However, its complex compounds with the surface are used more often - active substances, the so-called. iodophors, which include iodonate, iodopyrodon, iodolan, etc. They are more often used to treat the hands of the surgeon and the surgical field. Chlorine compounds have long been used for disinfection (bleach) and sterilization (sodium hypochloride, chloramine, etc.). The bactericidal activity of these drugs depends on the content of active chlorine in them. In chloramine, active chlorine is 28-29%, and dichloroisocyanuric acid - 70-80%, sodium hypochloride - 9.5%. Hydrogen peroxide (33% hydrogen peroxide - perhydrol) in 3% and 6% concentrations is used for sterilization and disinfection. It is harmless to humans. A mixture of hydrogen peroxide with formic acid, proposed by I. D. Zhitnyuk and P. A. Melekhoy in 1970, was called Pervomour. In the process of preparing C-4, performic acid is formed - it is the active principle. It is used to treat the surgeon's hands or sterilize instruments In Czechoslovakia, persteril was proposed for sterilizing rubber and polyethylene tubes. Beta-propiolactone released in Russia. At a concentration of 1: 1000 Pseudomonas aeruginosa in a 2% solution dies within 10 minutes. It is added in an amount of 0.2% to prepared nutrient media, which are then incubated for 2 hours at 37°C. If the medium is left overnight, the propiolactone will completely decompose.
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Sterilization by ionizing radiation
Antimicrobial treatment can be carried out using ionizing radiation (y-rays), ultraviolet rays and ultrasound. U-ray sterilization has received the greatest use in our time. The radiation method or radiation sterilization with γ-rays is used in special installations for industrial sterilization of a single use - polymer syringes, blood transfusion systems, Petri dishes, pipettes and other fragile and thermolabile products. The isotopes Co60 and Cs137 are used. The dose of penetrating radiation should be very significant - up to 20-25 μGy, which requires compliance with particularly strict security measures. In this regard, radiation sterilization is carried out in special rooms and is a factory method of sterilization (it is not performed directly in hospitals). Sterilization of instruments and other materials is carried out in sealed packages and, with the integrity of the latter, lasts up to 5 years. The hermetic package makes it convenient to store and use the tools (you just need to open the package). The method is beneficial for the sterilization of simple disposable instruments (syringes, suture material, catheters, probes, blood transfusion systems, gloves, etc.) and is becoming more and more widespread. This is largely due to the fact that the properties of the sterilized objects are not lost at all during radiation sterilization.
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Sterilization by ultraviolet radiation
Sources of UV radiation (wavelength 260 nm) - mercury quartz lamps. Their powerful bacteriostatic action is based on the coincidence of the emission spectrum of the lamp and the absorption spectrum of the DNA of microorganisms, which can be the cause of their death during prolonged exposure to quartz lamp radiation; with insufficiently powerful UV exposure, the processes of light and dark repair are activated in the prokaryotic cell, that is, the cell is restored. The method is used for sterilization of premises, equipment in biks, as well as for sterilization of distilled water.
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An effective sterilizer that allows you to sterilize surgical instruments and dressings with dry heat and ultraviolet rays. It has a powerful bactericidal effect. The recirculator is designed for indoor air disinfection in the presence and absence of people in the process of forced circulation of the air flow through the housing, inside which two low-pressure bactericidal lamps are placed. Bactericidal chamber for storing sterile medical products
Slide 20
The method consists in separating the microbes from the liquid using sterile microporous filters. The filtration mechanism is explained mainly by the adsorption of microbes that takes place in the pores of the filter media, which in most cases are negatively charged. Kaolin, porcelain, paper-asbestos mass, diatomaceous earth, collodion and other porous materials, as well as glass are used as microporous filtering material.
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Mechanical method of sterilization. Bacterial filtration
The mechanical method of sterilization using microporous filters has some advantages over heat sterilization methods where the solution is subjected to high temperature. For many solutions of thermolabile substances, it is essentially the only sterilization method available at all. Microporous filters are widely used in chemical and pharmaceutical plants and in the production of vaccines and sera. Bacterial filters
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Plan Introduction Sterilization methods allowed for use in healthcare facilities Sterilization stages a) Disinfection b) Pre-sterilization treatment c) Sterilization Products to be sterilized Disinfection methods a) Boiling b) Steam c) Air d) Chemical Pre-sterilization treatment a) Algorithm of actions Types and methods of sterilization 1) Chemical method of sterilization 2) Steam method of sterilization 3) Air method of sterilization Sterilization control methods Software control is carried out using the following samples References
Introduction One of the most important areas of work for all medical personnel is to ensure and monitor the implementation of sanitary and hygienic and anti-epidemic measures and the requirements provided for by the relevant orders of the Ministry of Health of the Republic of Kazakhstan. Sterilization is the process of destroying all types of microorganisms, as well as spores and bacteria.
Sterilization methods permitted for use in healthcare facilities Physical (thermal) Steam - Water saturated steam under excess pressure Air - Dry hot air Infrared - Infrared radiation Glasperlen - Medium of heated glass beads Chemical, Gas - Ethylene oxide or its mixture with other components Plasma - Vapors hydrogen peroxide in combination with their low-temperature plasma Liquid - Solutions of chemicals (aldehyde-, oxygen- and chlorine-containing)
Stages of sterilization 1) Disinfection is a set of measures aimed at the destruction of pathogens of infectious diseases and the destruction of toxins in environmental objects. Disinfection reduces the number of microorganisms to an acceptable level, but may not completely eliminate them. 2) Pre-sterilization treatment is the cleaning of medical devices before their sterilization in order to remove protein, fat and mechanical contaminants, as well as drugs. 3) Sterilization is the complete destruction of all forms of microbes and their spores under the influence of high temperatures and other physical factors, chemicals, ionizing radiation.
Products subject to sterilization 1) Medical and laboratory instruments of all kinds are subject to disinfection after each use. 2) All medical products that come into contact with skin and mucous membranes, organs, wound surfaces, contact with blood and other biological fluids are subjected to sterilization. 3) Disposable instrumentation (syringes, systems, scarifiers, spatulas, gynecological mirrors) is disposed of by burning in special or muffle furnaces at a temperature of at least 6000 C
Disinfection methods 1) Boiling Applied: for glass, metal, heat-resistant polymeric materials, rubber. 2) Steam Applied: for products made of glass, metal, heat-resistant polymer materials, rubber, latex. Note: When disinfecting by boiling and steam method, products made of polymeric materials must be packed in gauze 3) Air Applied: for glass and metal products. 4) Chemical Applied: for glass products, corrosion-resistant metals, heat-resistant polymer materials, rubber. Note: After chemical disinfection, the products must be washed in running water until the smell of the disinfectant is completely removed.
Pre-sterilization treatment Algorithm of actions: 1) Upon completion of disinfection, medical instruments are rinsed with running water for 30 seconds. Then they are soaked with full immersion in a solution of detergent at a temperature of 20-250 C for 15 minutes. 2) Washing each product in a cleaning solution with a brush or cotton-gauze swab for 30 seconds. 3) Rinsing with running water for 10 minutes. 4) Rinsing with distilled water for 30 seconds 5) Drying with hot air in an oven at a temperature of 850 C until the moisture disappears completely.
Types and methods of sterilization 1) Chemical sterilization method This method is recommended for products made of polymeric materials, rubber, glass, corrosion-resistant metals. It is carried out with the complete immersion of the product in the solution, after which the product is washed with sterile water. The shelf life of a sterile product in a sterile container lined with a sterile sheet is 3 days. For immersion of products in dez. solution should be used containers made of glass, plastic or enameled 1) 6% hydrogen peroxide solution t = Not less than 18 0 C for 360 min 2) 10% gigasept solution for 300 min 3) 2, 5% solution of lysoformin-3000 t = 40 -50 0 С for 60 min 4) Cydex activated 2% solution of glutaraldehyde with p. H=8, 2-9, 2 t= 20-25 0 C for 240 min 5) Glutaraldehyde 2.5% p. H=7, 0 -8, 5 t= Not less than 20 0 C for 360 min
2) Steam sterilization method Sterilization is carried out in sterilization boxes without filters or in sterilization boxes with a filter or in double soft packaging made of coarse calico or parchment, bag paper, unimpregnated wet-strength bag paper, paper for packaging products on brand E machines, paper creped in a steam sterilizer . Shelf life of products sterilized in boxes with a filter - 20 days, in the rest of the package - 3 days Sterilization mode Vapor pressure, kg / cm 2 0, 11 products made of corrosion-resistant metals, glass, rubber products 45 Recommended for products made of rubber, latex and certain polymeric materials (high density polyethylene, PVC
3) Air sterilization method Dry products are subjected to sterilization, and it is carried out in a package made of unimpregnated bag paper, wet-strength bag paper, paper for packaging products on brand E machines, high-strength packaging paper, crepe paper, two-layer crepe paper or without packaging in an open container in air sterilizer Products sterilized without packaging are used immediately after sterilization, in packaged form - within 3 days. Sterilization mode Applicability Operating temperature, 0 С Holding time, min 180 60 150 Recommended for products made of metals, glass and silicone rubber
Sterilization control methods 1)Physical and chemical Sterilizers operating mode parameters are monitored. Chemical methods are based on the color change of the indicators upon reaching a certain temperature. 2)Bacteriological Sterilization efficiency is being assessed.
Software control is carried out using the following samples: 1) Azopyram test is carried out for the presence of hemoglobin, oxidizing agents, chlorine-containing substances, washing powder, rust. Prepare 1, 0 -1, 5% solution of aniline hydrochloride in 95% alcohol. It is stored in the refrigerator for up to 2 months, out of it - no more than a month. Before setting up the sample, mix equal volumes of azopyram and 3% hydrogen peroxide. Use the mixture within 1-2 hours. Do not check hot instruments, do not keep the solution near heating devices and in bright light. Upon contact with a reactive blood spot, a purple color appears within one minute.
2) Amidopyrine test is carried out for the presence of blood. Mix equal amounts of a 5% alcohol solution of amidopyrine, 505 acetic acid and 3% hydrogen peroxide solution (2-3 ml each). 2-3 drops of the reagent are applied to the controlled product. In the presence of blood contamination, a blue-green color appears (exposure 3 minutes 3). The phenolphthalein test is carried out to check the quality of washing the active substances of the washing instrument from the surface of the instrument. A 1% solution of phenolphthalein is applied. When present, a pink coloration occurs.
References 1) San. Pi. N No. 8. 013. 03 dated 31. 01. 2003 “Sanitary and epidemiological requirements for the quality of sterilization and disinfection of medical devices” 2) http: //ru. wikipedia. org
STERILIZATION Glossary:
Disinsection - destruction
insect vectors
infectious diseases
Insecticides - preparations for
insect extermination
Deratization - destruction
rodent carriers
infectious diseases
Disinfection -
Disinfection1.
2.
is the destruction of pathogenic and opportunistic microorganisms of vegetative
forms in the human environment.
The main task is to interrupt the mechanism
transmission of infection by disinfection
various objects.
Target:
Destruction of infectious agents
diseases in the environment.
Protection of personnel handling
medical instruments and equipment, from
possible infection
Types of disinfection
- Preventive - carried out with the aimHAI warnings, regardless of the presence
infections. Disinfection of drinking water and sewage
water, dishes, rooms, objects.
Effective with continuous use.
- Focal - current - in the focus of infection, at the bedside
sick, repeated, hinders
spread of the pathogen to others.
-Final - once after leaving
patient (inf. department, extract) for a complete
destruction of the pathogen in the focus of infection. Disinfection modes, PSO and
sterilization
regulated by order
OST-42-21-2-85 -
"Sterilization and
disinfection of products
medical purpose"
Disinfection methods
mechanical,physical,
chemical
combined Classification of items by categories of risk of transmission of nosocomial infections
Non-critical -
in contact with
healthy skin and
items
environment
not in contact with
patient: canes,
crutches, blood pressure monitor,
thermometer, walls,
wheelchairs, furniture.
Cleaning and
disinfection low
level. (1% solution
chloramine,
double
wiping or
soaking at 15m) Semi-critical -
in contact with
biological
liquids, with
mucous membranes and
damaged skin:
respiratory and
anesthetic
equipment, endoscopes,
vessels, rectal and
vaginal instruments
Cleaning and disinfection
medium or high
level (3% solution
chloramine for 60 minutes),
PSO, sterilization. Critical -
cleaning,
penetrating into
disinfection,
body cavity
PSO, sterilization.
, sterile tissues and
vessels: surgical
tools,
implants, needles,
vascular and urinary
catheters,
intrauterine
facilities
Mechanical Methods
shaking,gouging,
vacuum cleaning,
washing and washing,
airing and ventilation
premises,
water filtration,
sweeping.
Physical Methods
burning,calcination,
burning,
boiling,
pasteurization,
tyndalization (fractional pasteurization),
sunlight,
radiation,
UV radiation
ultrahigh frequency currents,
radioactive radiation
Freezing
Chemical Methods
-irrigation-rubbing
-full immersion
- falling asleep
Chemical groups of disinfectants:
HalogenatedOxygen-containing
SAW (HOUR)
Guanidines
Aldehydes
Alcohols
PhenolsProduct name
Concentration,
exposition
Peculiarities
applications
1. Chlorine
Dry-200 g per 1 liter, 60 min
Rough disinfection
secretions of the patient
10%
2. Chloramine
mother liquor
3%-60 min
Garbage, purulent
dressing
1%
floors, surfaces,
ships, baths
0,5%
Dishes, surfaces
0.5%-30 min, 1%-15 min
3%-60 min
thermometers
Semi-critical and Hypochlorites Ca, Na
0,5%
Like bleach
Javel
1-2 tab. for 10 l. Water Premises,
15-60 min.
plumbing, furniture,
underwear
Neutral anolyte
0.03-0.05% - 60 min.
Disinfection of medical devices,
PSO, sterilization
Precept (table)
0.5g, 2.5g, 5.0g
Solid
surface,
biological
liquids
0.056%-90 min.
Hepatitis 2t per 5l
0.28% - 45 min.
Tuberculosis 10 tons per 5 liters.
Oxygenated:
6% peroxidehydrogen
Virkon
Clean-60 min.
Products
polluted
blood
spring-cleaning,
sterilization
With the addition of 5g
"SMS"
2% 10-30 min.
PSO
Disinfection of medical devices
Disinfection of medical devices:
Mercury thermometers, medical-1% solution of chloramine - 15 minutes. When fully immersed, then
rinse with water, store dry.
Metal spatula
- Boiling in distilled water -30 minutes or treatment
dry air at a temperature of 120 degrees C - 45 minutes.
Daybeds
-The couch is completely covered with oilcloth.
1% chloramine solution, rubbed twice or 3% solution
chloramine, double wiping if contaminated with blood and
its components or other biological fluids.
Scissors
- Boiling in distilled water - 30 minutes or 2%
soda solution - 15 minutes. When fully immersed.
Washcloths for washing patients.
- Boiling in distilled water - 30 minutes.
Safety precautions when working with disinfectants
Persons over 18 years of age who have passedbriefing.
Persons with elevated
sensitivity to chemicals.
Specially equipped rooms for
preparation of solutions, overalls.
Storage in special rooms, tight
closed, in a dark glass container.
Labels with names,%, date of manufacture.
Take care of your skin.
First aid in case of contact with disinfectants on the skin and mucous membranes
In case of contact with skin, rinse immediately with water.In case of contact with eyes, rinse for 10-15 minutes
running water, drip if necessary
albucid 30%, if pain, pain - drops with novocaine
2%.
If the respiratory tract is irritated, go to another
indoors or outdoors, rinse mouth and
nasopharynx with water or 2% solution of soda, drink warm
milk with soda, if necessary, appoint
cardiac, sedative and antitussive
facilities.
If the disinfectant enters the stomach:
Grind 10-20 activated charcoal tablets,
take and drink several glasses of water. At
need to see a doctor
Pre-sterilization cleaning
The purpose of pre-sterilization treatment isremoval from medical devices
prescription of protein, fatty, medicinal,
mechanical impurities, including
invisible (blood, mucus), disinfectants
means, detergents, which provides
effectiveness of subsequent sterilization and
safe use
sterilized products.
Stages of JI
Stage 1 - washing after disinfectionrunning water over a sink for 30 seconds to
complete removal of disinfectant odor
facilities;
Stage 2 - soaking (full immersion)
products in one of the cleaning solutions - 15 min:
"Biolot" 0.5% - temperature 40°C;
hydrogen peroxide 0.5% with the addition of 0.5%
one of the synthetic detergents (CMC):
≪Progress≫, ≪Lotus≫, ≪Lotus-machine≫,
≪Aina≫, ≪Astra≫ - temperature 50°C. Stage 3 - washing each product in the same
the solution in which it was soaked,
using a ruff or cotton-gauze swab in
for 30 s;
Stage 4 - rinsing with running water after
use of ≪Biolota≫ during
3 min, hydrogen peroxide solutions in CMC
≪Progress≫, ≪Marichka≫ - 5 min; CMC
≪Astra≫, ≪Lotus≫, ≪Lotus-machine≫ -10 min;
Stage 5 - rinsing with distilled water
within 30 s;
Stage 6 - drying with hot air at
temperature 75-87°C in ovens.
JI quality control
Azopyram test. Prepare a solution:aniline hydrochloride 1.0 - 1.5 gr
amidopyrine 100.0 gr
Add up to 1 liter of 95% ethyl alcohol.
Store in a tightly closed vial at 4°C (in
refrigerator) 2 months, and in the dark at room
temperature (18-23°C) - no more than 1 month.
A solution is prepared immediately before the sample:
mixed in equal amounts
azopyram and 3% hydrogen peroxide. Amidopyrine test. Prepare an alcohol 5% solution of amidopyrine
in 95% ethyl alcohol, which
can be stored in glass bottles
stopper in the refrigerator for 1 month.
30% acetic acid and 3% hydrogen peroxide solution
prepared with distilled water. mixed
equal amounts of 5 percent
alcohol solution of amidopyrine, 30% acetic acid and 3%
hydrogen peroxide before use.
Sterilization
method for deathsterilized material
vegetative
and spore forms of pathogenic and
non-pathogenic microorganisms.
Sterilization Methods
thermal: steam, air;chemical: gas, chemical
drugs;
radiation,
plasma and ozone (group
chemicals).
Steam method
- 2 atm - 132 C - 20 minutes - forcorrosion-resistant metal, glass
, textiles.
-1.1 atm - 120 C - 45 minutes - products
rubber, latex, polymers Search info
air method
180°C - 60 min;160°C - 150 min.
gas method
The gas has a sterilizing effect at normaltemperature, with this method of sterilization can
to be used:
- ethylene oxide with ethyl bromide
This method sterilizes: optics, pacemakers,
polymeric materials (rubber, plastic, glass,
metal; exposure time - 6 hours, t in the chamber - 35 * C)
- vapors of 40% solution of formaldehyde in ethyl alcohol.
This method sterilizes: endoscopic
instruments, heart-lung machines,
products made of plastic and catgut; exposure time: for
plastics and rubber - 180 min.; for glass and metal - 120
min.; t - 80 * C, formaldehyde dose - 150 ml per 1 liter
(should be sprayed).
Chemical preparations
- 6% hydrogen peroxide: 6 hours - atroom t; 3 hours - with a single
heated (50 * C);
- Pervomur C4: for suture material - 4.8%,
exposure 15 min.;
- sideks: metal products - 4 hours; products
made of polymeric materials, endoscopes - 10
hours; cleaning tools after
sterilization:
Radiation
The sterilizing agent isionizing at (gamma) - and β (beta) radiation
Sterility is maintained in such
packaging for years
Sterility of materials, products, shelf life:
closed biks of a new sample - 20 days;Closed biks without filter
- 3 days
with an open bix of any sample
sterility of materials, products
lasts up to 24 hours;
kraft bags sealed - 20 days;
kraft bags on paper clips - 3 days.
Bix laying rules
treat the inner surface of the bix with 70% alcohol and on its bottomput the sheet in such a way that then cover it with the ends
bix content;
put in the bix sets of rubber products, dressings,
underwear;
wrap the tools in a towel or diaper and put them in bix;
after loading the bix, place 5 indicators in it: 4 - on the inside
side of the bix walls and 1 - in the center of the bix (indirect control method
sterility);
on the cover of the bix, fix the tag on which to mark: type
material and medical department for which
sterilization of instruments and materials;
close the bix lid hermetically. At the bix of the old sample, move
a metal belt-belt and thereby open windows on its walls,
which after completion of sterilization must be closed;
after sterilization, put the date and signature on the bix tag
autoclaving nurse.
There are various options for completing bixes: only one type
material, kits for a typical or specific operational
intervention.
Sterilization quality control
Technical method - thermometers in the chambers,pressure gauges.
The bacteriological control method is carried out with
with the help of a biotest - an object from a certain
material contaminated with test microorganisms.
Thermal For operational control earlier
recommended by numerous chemical
substances whose melting point is
sterilization temperature.
-urea (132)
-thiourea (180), succinic acid (180-192) Final control of knowledge:
1. The main task of disinfection
2. Types of disinfection
3. Disinfection methods
4. Chemical methods of disinfection
5. Stages of JI
6. What is sterilization
7. Sterilization methods
8. Parameters of sterilization of products from
steam rubber
9. Drugs used in chemical
sterilization
10. Melting point of thiourea Presentation prepared by:
student.
STERILIZATION
- a method that ensures death in the sterilized materialvegetative and spore forms of pathogenic and non-pathogenic
microorganisms.
Sterilization must be
all items or individual types
diagnostic equipment,
in contact with a wound, blood,
injectables, with
mucous membranes.
Sterilization methods.
Thermal: steam and air (dry heat)Chemical: gas or chemical solutions (sterilants)
Plasma (hydrogen peroxide plasma)
Radiation sterilization - used in the industrial version
Membrane filter method - used to obtain a small
quantities of sterile solutions, the quality of which can dramatically
deteriorate under the action of other methods of sterilization (bacteriophage,
selective culture media, antibiotics)
Sterilization methods approved for use in healthcare facilities.
Method typeMethod
Physical
Steam
(thermal)
Chemical
sterilizing agent
Saturated water vapor
overpressure
Air
dry hot air
Infrared
Infrared radiation
Glasperlenic
Heated glass medium
balls
Gas
Ethylene oxide or its mixture with
other components
Plasma
Vapors of hydrogen peroxide in
combined with their
low temperature plasma
Liquid
Solutions of chemicals
(aldehyde-, oxygen- and
chlorine-containing)
Steam sterilization
carried out by supplying saturated steam under pressure in steam sterilizers(autoclaves).
Steam sterilization under pressure is considered the most effective method, since the
the higher the pressure, the higher the temperature of the steam sterilizing the material; bactericidal
The properties of steam are higher than those of air, so supersaturated steam is used for sterilization.
steam sterilization is used for textile products (linen, cotton wool, bandages, suture
material), rubber, glass, some polymeric materials, culture media,
medications.
Steam sterilization modes:
132 °C - 2atmosphere(2
kgf/cm2) - 20 minutes
- main mode.
Sterilize everything
products (glass,
metal, textile,
except rubber).
120 °C - 1.1
atmosphere(1,1
kgf/cm2) - 45 minutes
- gentle mode
(glass, metal,
rubber products,
polymer products
- according to
passport, textiles)
Packing materials for steam sterilization:
The sterilization box (bix) is simple. Shelf life3 days after sterilization.
Sterilization box (bix) with filter. Term
storage 20 days after sterilization.
Kraft bags with paper clips. Shelf life - three
days after sterilization.
Kraft bags are sealed. Shelf life - 20
days after sterilization.
Fabric (coarse calico - EXCEPT for gauze). Shelf life - three
days after sterilization.
Combined packaging (transparent synthetic
film + paper) (dgm sterigard). Shelf life from 180
days to 720 days.
Beaks
KSKF
Medical craft bags for sterilization
There are various ways to remove air from the steam chamber, fromof which two are used in modern medical sterilizers:
gravitational;
forevacuum.
The gravitational method of removing air is when
through the purge valve at the bottom
sterilizer removes air, heavier than
compared to the steam that enters through the valve
at the top of the camera. The steam gradually fills
chamber, replacing the air.
In fore vacuum sterilizers, air removal
carried out by repeated cyclic pumping
air from the sterilization chamber. Into the camera
saturated steam is supplied and pumped out
a mixture of steam and air, such a removal cycle
repeated many times from 3 to 9 times (depending on
from the brand of the device) until the complete removal of air from
chamber, porous loading and products with voids.
The steam-air mixture is pumped out either
backing pump or injector.
Air sterilization
DFor this method, dry heat
cabinets. Sterilizing agent - dry
hot air
At
packaging: kraft bags, coarse calico.
M
Materials: metal, textiles.
D
advantages: cheap, simple method, not
causes metal corrosion, does not occur
humidification of packaging and products.
H
cons: limited choice of packaging,
slow and uneven heating
products, the need to use more
high temperatures, impossibility
use rubber materials
polymers. Operating mode: at a temperature of 180°C for 60 minutes
Sterility period: When opened, they are used immediately.
or transferred to a sterile table and
saved 6 hours
Packed in sealed bags
metal clips - 3 days,
sealed with special glue - 20 days
Glasperlen sterilizers
Glasperlen method is designed for fast sterilizationsmall solid metal tools that do not have
cavities, channels and lock parts.
This method is mainly used by dentists to
express sterilization of small instruments - burs,
pulp extractors, root needles, diamond heads, etc., and
also working parts of larger ones - probes, trowels,
excavators, spatulas, etc. You can also sterilize
acupuncture needles.
Advantages of the method - short sterilization time
and lack of consumables. The method is extremely simple - the tool
immersed in the environment of small
glass beads heated to
temperatures 190 - 2900C (such
way to over working
tool surface
there was a layer of balls of at least
10 mm) for 20 - 180 seconds, in
depending on size and weight
tool.
Sterilizes in just 5 seconds:
forceps, tongs, scalpel holders, probes, spatulas,
chisels, chisels, diamonds, files,
burs, root elevators,
extensions, angled
tips, needle holders,
tweezers, etc.
Chemical sterilization
It is carried out in sterile conditions. room forsterilization should be equipped with a fume hood,
bactericidal irradiator. Nurse working in sterile
overalls, gloves, respirator.
sterile container with a sterilant, products are immersed
for medical purposes, which have undergone decontamination and PSO,
close the lid tightly. The log shows the start time
sterilization. At the end of sterilization honey. products
removed from solution sterile
tweezers or forceps,
transferred to another sterile
container with sterile water,
washed, dried and
laid out in bix with sterile
diaper. End of sterilization time
also recorded in the sterilization log.
The following sterilizing agents and modes are used:
6% solution of hydrogen peroxide at a temperature of + 50 ° C - 3 hours; at a temperature of + 18°С - 6 hours. Solutionhydrogen peroxide can be used within 7 days from the date of preparation, provided it is
storage in a closed container in a dark place. With a longer shelf life, the use of the solution may
carried out only after control of the content of active substances. Solution temperature in
sterilization process is not supported.
The drug "Sydex" (glutaraldehyde) at room temperature - 10 hours. Working with the drug
should be carried out in a well-ventilated area. Has a fairly strong unpleasant
smell. May cause allergic reactions in personnel.
Cydex NU preparation (peracetic acid) at room temperature - 10 min. Optimal for
today a drug for emergency sterilization. It does not have the disadvantages of the usual Sidex.
Expensive.
Previously, a 1% solution of a domestic drug was used at temperatures above + 18°C. Sterilization time 45 minutes. IN
the latest "Deoxon-1" (peracetic acid) at a temperature of not years is not produced, and therefore
out of use.
A significant disadvantage of chemical sterilization of surgical instruments is the need
thoroughly washing them from the sterilizing solution before use. 6% hydrogen peroxide
causes burns even on intact skin. "Sydex" causes necrosis. Pervomur - hemolysis.
The period of preservation of sterility of products sterilized by a chemical method and located in
sterilization box lined with a sterile sheet - 3 days.
Store sterile products in 70° ethanol or chlorhexidine alcohol solution (as
done earlier) is impossible, because. it has no sterilizing effect and resistant
forms of microorganisms (spores), which can lead to secondary contamination of previously sterilized
products.
Gas sterilization
This method uses gassterilizers.
The sterilizing agent is formaldehyde or
ethylene oxide.
Packaging: laminated paper, parchment,
kraft paper.
Materials: polymers, glass, metal.
Advantages: low temperature,
use of any material.
Disadvantages: toxicity to personnel and
explosion hazard if not observed
safety precautions, continuous
sterilization cycle.
Radiation sterilization method
necessary for the sterilization of products from heat-labilematerials.
- the main method of industrial sterilization. used
manufacturers of sterile products
single use.
Sterilizing agent - ionizing γ and β radiation.
Packaging: in addition to paper bags, they use
polyethylene.
Advantages: sterility is preserved in the package for a long time.
Disadvantages: the high cost of the method. An effective sterilizer that allows you to sterilize surgical
instruments and dressings with dry heat and
ultraviolet rays. It has a powerful bactericidal effect.
The recirculator is intended for disinfection of indoor air in
the presence and absence of people in the process of forced circulation
air flow through the housing, inside which two bactericidal
low pressure lamps.
Quartz lamp.
Sterilization with infrared rays
The small-sized sterilizer is designed for sterilizationdental and microsurgical instruments made of metals in
conditions of hospitals, polyclinics, hospitals and other medical and
cosmetology establishments. Sterilization is carried out
infrared powerful short-term thermal effect.
t 200+3°С. Full cycle of sterilization of instruments in unpackaged
form takes from 10 to 25 minutes in an infrared sterilizer (in
depending on the instruments), including the stages of entering the mode and
cooling, after which the instruments can be used for
appointment.
The design of these sterilizers
allows you to place the entire
sterilization chamber and
sterilize and then leave
for cooling even
dental forceps. In addition, the sterilizer can perform the functions
very economical and fast heater
medicines, water, etc. up to the set temperature at
minimal time and electrical
energy. However, it can keep the temperature
in the thermos mode and keep it in the mode
autoclave.
Cons: no
opportunities to sterilize
packed tools,
also a common disadvantage
thermal methods limited acceptance due to
damaging effect on
polymer materials
(plastics, rubbers, etc.)
Infrared sterilizer IKS-1
Plasma sterilizers
This is the most modern sterilization method known today.day. It allows you to sterilize any medical device, from hollow
tools to cables, electrical appliances, to which in some cases
none of the known methods can be applied at all
sterilization.
The minimum processing time in a plasma sterilizer is from 35
minutes, operating temperature - 36-60°C. One of the main advantages
this method - no toxic waste, only
oxygen and water vapor. Plasma sterilization
destroys all forms and types of microorganisms.
Plasma sterilizers - future
equipment, but for most Russian
medical facilities are too costly.
Plasma sterilization process
Before sterilization, items are wrapped andplaced in the chamber on racks, while using
mechanical vacuum pump is reduced
pressure. Plasma is formed in a strong
electric field (pulse direct current).
Immediately after this, a certain amount
sterilizing steam is injected into the chamber
sterilizer and evenly distributed,
filling all internal cavities. In the cell
a rack is located (to accommodate
sterilized items), which also serves in
as an electrode in the process of plasma formation. This rack is connected
electrical circuit with a source of energy, which
generates pulses and excites the plasma. combined action
vacuum and sterilizing mixture on objects placed in the chamber, enough to
achieve the desired level of sterilization. During the cleaning phase
filtered atmospheric air is injected into the chamber and quickly removed.
This process is repeated at least 2 times. The pressure is constantly reduced by
mechanical vacuum pump. Plasma begins to form at a pressure of 0.1
mbar, vacuum maintenance continues until sterilization conditions are reached
(temperature around 45°C_50°C), the pressure drops to 5x10-2 mbar. door can
open after the filtered atmospheric air enters again into
camera. Plasma heating (up to 45°C) achieved with UV irradiation enhances
the action of a chemical solution, which guarantees the absence of toxic waste on
sterilized items. Plasma excitation is a simple process,
which depends little on the type of material to be sterilized (metal, ceramic glass
or plastic). The design of modern
plasma sterilizers
Control Panel
audiovisual
alarms (including
signal history)
Program
services for
preventive care
Level control
operator access
Calibration and
technical pages
(password protected)
Programming
new cycles or
modification of the standard
loop (password protected)
Clear texts
messages
opening/closing
doors
Manual control
Pages with tips for
elimination
faults
interface function
operators
Touchpad
Touch panel control allows
track the following transactions
monitoring.
Phase
Pressure value
Temperature value
Time
Selected cycle
date and time
Navigate to other management pages and
monitoring
Manual action selection
Setpoint monitoring
There are also touch panels
multi-language support: English,
Italian, French, Spanish,
Arabic, Russian, Portuguese, German,
Turkish, Polish, Chinese, Greek,
Romanian, Korean, Bulgarian, etc. Alarms
Cartridge alarm
Door close signal
Maximum phase time
Vacuum and pressure signal
Power outage
Air deficiency alarm
Reducing the charge of the internal
_batteries
Low/high temperature
range
Network systems and software
security
The plasma sterilizer can be connected to
computerized control system and/or
sterilizer control system.
NCS: central data monitoring system,
archiving and messages using the interface
data in real time.
ITINERIS: Service Branch Management System
centralized sterilization and tracking system
behind the tools.
RMS: remote service system for external
service checks and interface.
Automatic sliding doors
Automatic sliding function with
pneumatic system allows you to safely and
smoothly open/close the door. The doors have
window for monitoring the process and loading
Methods for monitoring the effectiveness of sterilization
In the complex of measures for the sterilization of medical productsappointment, it is important to organize and conduct control
for its effectiveness. The methods used so far
control means do not always allow to detect sterilization defects,
leading to an increase in nosocomial infections.
Physical methods;
Chemical methods;
biological methods.
Physical methods:
Physical control methods are carried out using meanstemperature measurements (thermometers, thermocouples), pressure
(manometers, pressure and vacuum meters) and time (timers). Modern
sterilizers are also equipped with recording devices,
fixing individual parameters of each sterilization cycle.
vacuum gauge
Thermometer and pressure gauge
Chemical methods:
carried out using chemical tests and thermochemicalindicators that change their state of aggregation and color when
reaching a certain melting point:
used for steam sterilizers
urea (urea) with pink dye temperature
melting point 132 degrees Celsius
benzoic acid with fuchsin - melting point 120°C;
thermal indicator paper that changes its color under
exposure to a certain temperature (l20 ° C-132 C);
for air sterilizers:
thiourea (thiocarbamide) without dye, temperature
melting point 180°C;
succinic acid, the melting point of which is 180 ° C
thermal indicator paper changes color with temperature
180°C.
Since January 2002, GOST R ISO 11140-1 "Sterilization of medical products. Chemical indicators. General requirements" has been put into effect in Russia. WITH
Since January 2002, GOST R ISO 11140-1 has been put into effect in Russia"Sterilization of medical products. Chemical indicators. General
requirements". According to this document, chemical indicators are distributed
for six grades.
1st class are indicators ("witnesses") of the process. An example of such an indicator
is a heat-indicating tape, pasted before sterilization on
textile packages or sterilization boxes. A change in the color of the ribbon indicates that
the packaging has been exposed to the sterilization process. The same indicators can
be placed in sets of surgical instruments or surgical linen.
The 2nd class of indicators is intended for use in special test procedures,
for example, when performing the Bowie-Dick test. This test does not control
sterilization parameters, it evaluates the efficiency of removing air from the steam chamber
sterilizer.
Indicators of the 3rd class are indicators of one parameter. They rate
maximum temperature, but do not give an idea of the time of its exposure. Examples
such indicators are the chemicals described above.
4th class - these are multi-parameter indicators. They contain dyes that change their color
with the combined effect of several sterilization parameters, most often - temperature and
time. An example of such indicators are thermo-time indicators for monitoring
air sterilization.
5th class - integrating indicators. These indicators respond to all critical
sterilization method parameters. The characteristic of this class of indicators is compared with
inactivation of highly resistant microorganisms.
6th grade - indicators-emulators. These indicators should respond to all control
values of critical parameters of the sterilization method. Indicators
1 class
4th grade
Grade 2
3rd grade
6th grade
5th grade
biological method
Currently, for bacteriological controlbioassays are used that have a dosed amount of test culture spores. Monitoring sterilization efficiency with bioassays
it is recommended to carry out 1 time in 2 weeks. In foreign practice
It is customary to use biological testing at least once a year.
week.
In some cases, it becomes necessary to control
using biotests of each sterilizer load. First of all, speech
is about the sterilization of instruments used to perform
complex surgical interventions requiring the use of
highly reliable sterile materials. Every download
implantable devices must also be subjected to
bacteriological control. At the same time, the use
sterilized materials are delayed until receipt
negative control results. The same principles for
determining the frequency of control, it is recommended to adhere to
regarding gas sterilization, which is compared to other
more complex methods.
biological indicators.
They are a plastic container withcap containing a fragile ampoule with
reducing medium and a paper strip,
infected with control spores
microorganisms. The indicator is placed
directly in the sterilization chamber, or
placed in containers and packages,
intended for sterilization, in the course of their
preparation. No prior
do not manipulate the indicator
required - it is completely ready for use.
After the end of the sterilization cycle
indicator must be removed and subjected to
incubation to control inactivation
spores of microorganisms contained in it. After
removal from the sterilizer chamber
crush the ampoule inside and
incubate at the recommended temperature in
within the required time - usually 24
hours. Sterilization error appears
discoloration and/or turbidity of the medium.
slide 1
Types and methods of sterilization of medical instruments and materials Kazakh - Russian Medical University Department of VK - II Course of Propaedeutics of Internal Diseases and Nursing F.I.O. Student Redkina Maria Faculty General Medicine Course 2 Group 206 A Checked by Amanzholova T.K. Almaty 2010slide 2
Plan: Introduction Sterilization stages Stage 1 - disinfection Stage 2 - pre-sterilization treatment: Phenolphthalein test Azopyram test Stage 3 - sterilization Sterilization methods Preventive disinfection and sterilization of various objects of the therapeutic department. Conclusion Literature
slide 3
Introduction: ... It is necessary to strictly observe the rules for the use of disinfection, pre-sterilization cleaning and sterilization of medical instruments, equipment, when carrying out manipulations related to the violation of the integrity of the skin, observe OST 42-21-2-85. The polyclinic has a centralized sterilization department, where two medical workers work in two shifts. They are responsible for working out the medical instrument, as well as dressings ... (“Order No. 408 “On measures to reduce the incidence of viral hepatitis in the country” dated 07/12/89”)
slide 4
Sterilization methods Sterilization of medical instruments is carried out by air, chemical, steam methods.
slide 5
Sterilization stages Stage 1 - disinfection After use, medical instruments and gloves are immersed in a container with a disinfectant in a 3% chloramine solution for 1 hour, then washed under running water until the smell of chlorine disappears, disinfection by boiling metal instruments, glass.
slide 6
Stage 2 - pre-sterilization treatment The instrument and gloves are soaked in a washing solution (33% hydrogen peroxide solution - 14 g, detergent - "Lotus" - 5 g, distilled water - 981 g) for 15 minutes at a temperature of 50 ° C. each product is washed for 20 seconds, and then washed for 10 minutes under running water. After pre-sterilization treatment, control tests are carried out - for washing away from alkali (phenolphthalein) and for occult blood - azopyram. Pre-sterilization treatment
Slide 7
Phenolphthalein test 1% of the batch is checked, but not less than 3-5 products of each item. Sample technique. Cotton wool soaked in a 1% solution of phenolphthalein is used to wipe work surfaces and joints. The sample is considered positive (bad wash) if a pink color appears. In this case, the entire batch is subjected to repeated washing.
Slide 8
Azopyram test Preliminarily prepare a solution consisting of azopyram and a 3% hydrogen peroxide solution in equal amounts. The prepared solution is tested for suitability with cotton wool with blood. The appearance of a purple color, quickly turning into a pink-lilac color, indicates the suitability of the drug. The working solution can be used for no more than 2 hours. Pure solution of azopyram is stored in the refrigerator for up to 2 months. When conducting an azopyram test, the result is interpreted as follows: when a purple color appears, the entire batch of instruments is reprocessed - poor-quality pre-sterilization cleaning was performed.
Slide 9
Rules for pre-sterilization treatment of Medical Devices 1. Upon completion of disinfection, medical instruments are rinsed with running water. Holding time 0.5 min Then: soaked with full immersion in one of the detergent solutions permitted by the authorized body in the field of sanitary and epidemiological welfare of the population. The initial temperature of the solution is 20-25, the holding time is 15 minutes.
slide 10
2. Washing each product in a cleaning solution using a brush or cotton-gauze swab. Holding time 0.5 min. 3. Rinsing with running water. Holding time 10 min. 4. Rinse with distilled water. Holding time 0.5 min. 5. Drying with hot air in an oven. The initial temperature of the solution is 85. Until the complete disappearance of moisture.
slide 11
Stage 3 - sterilization For sterilization, the instrument is placed on the grids, and to control the quality of sterilization, a temperature-time indicator is laid - a vinar tape. It is sterilized by the open method in an air sterilizer for 1 hour at a temperature of 180°C. The time of the beginning and end of sterilization is noted in the journal, and a temperature-time indicator is glued, which changes color after sterilization. Dressings, cotton wool, linen are sterilized in bixes or two-layer bags by autoclaving at a temperature of 120°C at a pressure of 1.1 atm. within 45 min. The dates and hours of sterilization are put on biksah.
slide 12
Preventive disinfection and sterilization of various objects of the therapeutic department. Mercury thermometers, medical -2% solution of chloramine - 15 minutes. When completely immersed, then rinse with water, store dry. Metal spatula - Boiling in distilled water - 30 minutes or treatment with dry air at a temperature of 120 degrees C - 45 minutes. - Treatment with dry air at a temperature of t = 180 degrees C - 60 minutes. Couches - The couch is completely covered with oilcloth. 1% chloramine solution, 2 wipes or 3% chloramine solution, 2 wipes if contaminated with blood and blood components or other bodily fluids. Scissors - Boiling in distilled water - 30 minutes or in 2% soda solution - 15 minutes. When fully immersed. Washcloths for washing patients. - Boiling in distilled water - 30 minutes.
slide 13
Steam sterilization The sterilizing agent is saturated water steam under pressure. Sterilization is carried out in steam sterilizers for 20-22 minutes at a steam pressure in the sterilization chamber of 2 ± 0.2 kgf/cm2 (0.2 ± 0.02 MPa) and a temperature of 132 ± 2°. The steam method sterilizes products made of textile materials, glass, corrosion-resistant metal, rubber.
slide 14
Sterilization by air method It is carried out with dry hot air in air sterilizers at a temperature of 180 ° for 60-65 minutes or at a temperature of 160 ° for 150 minutes. Sterilize products made of metal, glass and silicone rubber, as well as collapsing under the influence of moisture. They are packed in kraft paper bags. The air method cannot be used for sterilization of heat-labile materials.
slide 15
Chemical methods Performed in closed containers covered with intact enamel, and also made of glass or plastic. The objects to be sterilized are immersed in the solution at a temperature of 18 ± 2°. Sterilization exposure time in 6% hydrogen peroxide solution - 60 ± 5 min, deoxone-1 - 45-50 min. After sterilization, the products are washed with sterile water under aseptic conditions.
slide 16
The sterile table is covered 2 times a day. Disinfection solutions for instruments and gloves are also changed 2 times a day. Disinfectants are prepared centrally in a separate room. For work, a 3% solution of chloramine is used to process tools, gloves, rags; 1% chloramine solution for surface treatment, thermometers, mopping, couches; 0.5% chloramine solution for hand treatment.
slide 17
Individual washcloth and soap. Bath - Disinfection with 3% solution of bleach, double wiping (or 1% solution of chloramine, exposure 60 minutes or other unglazed solution. - Rub with a rag with detergent-disinfectant or cleaner-disinfectant at the rate of 1-2 g per 100 sq. cm, exposure 5 minutes, then rinse in running water Rubber mats in the shower room -5% chloramine solution with 5 grams of detergent in 1 liter of solution -Total immersion for 30 minutes or rub, but do not rinse until completely dry. Shoes - 25% formalin solution or 40% acetic acid solution, put in a plastic bag for three hours, ventilate until the smell disappears. rinsing, storage in a dry place.
slide 18
Heating pads, ice cubes, rubber mugs. -Double rubbing with 1% solution of chloramine. - Wash with hot soapy water, rinse, dry and store in a dry place. Enema tips, catheters. -3% chloramine solution - 60 minutes. -0.5% washing solution at a temperature of 46 degrees C - 15 minutes, or boiling in 2% soda solution -15 minutes, followed by washing. -Autoclaving. Beakers. -1% solution of chloramine - 60 minutes, rinsing or boiling - 30 minutes. Gloves - 3% solution of chloramine - 60 minutes or other regulated disinfectant solution, full immersion. -0.5% washing solution - 15 minutes - Autoclave, gentle mode. Eye pipettes. - Boiling in distilled water - 30 minutes, sterilization in a gentle autoclave mode in disassembled form.
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