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ICVP - Sterilisation
Principles of Sterilisation
| Question | Answer |
|---|---|
| Define Sepsis | Presence of pathogens in the blood or tissues = Infection. |
| Define Asepsis | Absence of pathogens = Freedom from infection. |
| Define Antisepsis | Prevention of sepsis by the destruction of pathogens. |
| Define Sterilisation | Destruction of all microorganisms, including spores. |
| Define Disinfection | Destruction of all microorganisms, except for spores. |
| Define Disinfectant | A chemical agent that destroys microorganisms. |
| What Does It Mean If Something Is Sterile? | The item, area or compartment is completely free of micro-organisms. |
| What Are The Principles Of Sterilisation? | Tissues within the body are sterile. Any equipment coming into contact with them must also be sterile. |
| What Are The Four Main Sources Of Potential Contamination During Veterinary Surgery? | -The operating theatre and environment. -Equipment. -Personnel. -Patient. |
| How Can Contamination Through The Environment Be Minimised During Veterinary Surgery? | -Minimise movement. -Good ventilation. -Avoid hot humid conditions. -Clean procedures go first. |
| How Can Contamination Through Equipment Be Minimised During Veterinary Surgery? | -Equipment must be sterile. -Use a new kit for each operation. |
| How Can Contamination Through Personnel Be Minimised During Veterinary Surgery? | -Keep numbers of personnel to a minimum. -No through traffic. -Correct theatre attire. -Aseptic preparation of hands. |
| How Can Contamination Through The Patient Be Minimised During Veterinary Surgery? | -Control of exogenous and endogenous microorganisms. |
| What Are The Five Methods Of Sterilisation? | -Dry heat sterilisation. -Heat under pressure sterilisation - autoclave. -Ethylene oxide. -Commercial solutions. -Gamma irradiation. |
| How Does Sterilisation Via Ethylene Oxide Work? | Polythene bag sealed with metal tie and placed in unit. Glass ampoule snapped from outside bag to release gas. Door closed, ventilator switched on, cycle runs for 12hrs. Pump activated to ventilate container for 2hrs. Door opened and items left for 24hrs. |
| What Equipment Can Be Sterilised Via Ethylene Oxide? | -Fibre optic equipment. -Plastic catheters. -Endotracheal tubes. -Plastic syringes. -Ophthalmic instruments. -Sharp cutting instruments. |
| What Are The Advantages/Disadvantages Of Sterilisation Via Ethylene Oxide? | -Can be used to sterilise most items. -If correctly wrapped items can be stored for several months . -Effective against bacteria, fungi, viruses and spores. -Toxic, irritant to tissue and gas highly inflammable – COSHH provisions required. |
| How Does Sterilisation Via Commercial Chemicals Work? | Place equipment within tray or bowl with a lid to prevent evaporation. Completely immerse equipment within disinfectant for the required length of time. Rinse with sterile water and dry. |
| What Are The Advantages/Disadvantages Of Sterilisation Via Commercial Chemicals? | -Good for delicate equipment. -Cheap, and easy. -Very toxic, unable to store equipment. -Only kills microbes after 10 minutes of contact time. -Should only be considered as a form of disinfection. |
| How Does Sterilisation Via Gamma Irradiation Work? | -Electromagnetic gamma rays. -Only performed in controlled areas within the industry - does not occur within practice. Any pre-packed sterile equipment is commonly sterilised using this method (syringes, needles, suture materials, etc). |
| How Does Sterilisation Via Dry Heat Work? | -Kills micro-organisms by causing oxidative destruction of bacterial protoplasm. -Micro-organisms are more resistant to dry heat to that of moisture sterilisation, higher temperatures required. -150 – 180°C. |
| What Are The Advantages/Disadvantages Of Sterilisation Via Dry Heat? | -If correctly packaged equipment can be stored, will sterilise sharps, oils and powders. -Small and economical to run. -Safety device fitted to the door to prevent opening during the cycle. -Long cooling period, unable to sterilise certain items. |
| How Does Sterilisation Via Heat Under Pressure Work? | -Items packaged and placed in autoclave, which runs cycle. -Different types: vertical pressure cooker, vertical downward displacement, vacuum assisted. -Destruction of heat resistant micro-organisms and spores by coagulation of cell proteins. |
| In More Detail, Describe The Process Of Sterilisation Using An Autoclave | Pressure is raised and steam enters the chamber. Air is displaced downwards and is evacuated, steam remains within the chamber. Steam condenses on colder surfaces (instruments/equipment) producing heat, this penetrates the innermost layers of the package. |
| What Are The Advantages/Disadvantages Of Sterilisation Via A Vertical Pressure Cooker? | -Simple autoclave, operates by water boiling at the bottom of the chamber. -Air vent is at the top of the chamber, meaning air can easily become trapped underneath the steam. -Manually operated, user error can affect sterilisation. |
| What Are The Advantages/Disadvantages Of Sterilisation Via A Vertical Downward Displacement Autoclave? | -Larger and completely automatic, choice of cycles. -Designed for sterilisation of loose instruments rather than packaged items. -Damp packaging allows micro-organisms to penetrate packaging known as strike through. |
| What Are The Advantages/Disadvantages Of Sterilisation Via A Vacuum Assisted Autoclave? | -Cheap, easy to maintain and use. -Sterilises most items. -Items can be stored for longer periods of time providing they are stored correctly. -Initial cost significant. -Special equipment needed, delicate items cannot be sterilised. |
| What Are Some Ways In Which Sterilisation Can Be Monitored? | -Chemical test strips (change colour at correct pressure, temp and time, autoclave only). -Browne's tube (colour change at correct temp and time, autoclave and hot air oven). -Bowie dick tape. -Spore tests. -Thermocouples. |
| What Is A Disadvantage To Only Using Bowie Dick Tape To Monitor Sterilisation? | -Changes colour when temperature is reached, but will not indicate whether temperature has been held = not a reliable indicator. -Hence used to seal instrument packaging along with another method to monitor sterility. |
| How Do Spore Tests Work To Monitor Sterility and What Is The Main Disadvantage? | -Strips of paper impregnated with dried bacterial spores. Placed within the load, on cycle completion placed in culture medium and incubated at the correct temperature for 72 hours. -More accurate than the indicator test strips but big delay in results. |
| How Do Thermocouples Work To Monitor Sterility? | -Electrical leads with temperature-sensitive tips. Placed in various parts of the sterilising chamber, monitoring device fixed upon the outside of the steriliser. -Chamber continuously checked and recorded throughout the cycle. |
| What Factors Must Be Considered When Choosing How To Package Instruments For Sterilisation? | -Resistant to damage. -Adequate size. -Size of the autoclave. -Steam or gas must be able to penetrate and easily exhaust when cycle is completed. -Cost. -Micro-organisms must not be able to penetrate during storage. -Time taken to reach sterility. |
| What Different Methods Are There To Package Instruments For Sterilisation? | -Nylon film. -Seal and peel. -Disposable paper draping. -Metal drum. -Textiles (drapes). |
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