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Basic Sterilization & Asepsis.pptx
- 1. Essential Asepsis & Sterilization Practical Suggestions for a clean practice DR.CHITRA CHAKRAVARTHY PROF. & HOD DEPT OF OMFS NAVODAYA DENTAL COLLEGE
- 2. The 4 areas of interest DENTAL INSTRUMENTS DENTAL UNIT ENVIRONMENTAL SURFACES DENTAL LABORATORY
- 3. Classification based on risk of transmission CRITICAL SEMI-CRITICAL NON-CRITICAL Penetrate MUCOUS MEMBRANES or CONTACT BONE, BLOODSTREAM, or other normally sterile tissues. HEAT STERILIZE between uses or use sterile single- use, DISPOSABLE devices. Examples include SURGICAL INSTRUMENTS, SCALPEL BLADES, PERIODONTAL SCALERS, AND SURGICAL DENTAL BURS
- 4. Classification based on risk of transmission CRITICAL SEMI-CRITICAL NON-CRITICAL Contact MUCOUS MEMBRANES but do NOT PENETRATE SOFT TISSUE HEAT STERILIZE or HIGH- LEVEL DISINFECT Examples: DENTAL MOUTH MIRRORS, AMALGAM CONDENSERS, AND DENTAL HANDPIECES
- 5. Classification based on risk of transmission CRITICAL SEMI-CRITICAL NON-CRITICAL Contact intact SKIN Clean and disinfect using a LOW TO INTERMEDIATE LEVEL DISINFECTANT Examples: X-RAY HEADS, FACE BOWS, PULSE OXIMETER, BLOOD PRESSURE
- 6. METHODS OF STERILIZATION HEAT CHEMICAL RADIATION BOILING WATER CHEMICLAVE IONIZING RADIATION HOT AIR OVENS ETHYLENE OXIDE GAS STEAM AUTOCLAVE
- 7. HEAT STERILIZATION PRE SEALED AUTOCLAVABLE POUCHES AUTOCLAVE - COOKER TYPE, B CLASS, C CLASS
- 8. HEAT STERILIZATION - AUTOCLAVE Sterilization with STEAM UNDER PRESSURE Time required at 1210 C is 15 mins at 15 lbs of pressure. Advantages † Rapid and effective † Effective for sterilizing cloth surgical packs and towel packs Disadvantages † Items sensitive to heat cannot be sterilized † It tends to corrode carbon steel burs and instruments
- 9. DRY HEAT STERILIZATION Dry Heat Sterilization by CONVENTIONAL DRY HEAT OVENS. Achieved at temperature above 1600 C. Have heated chambers that allow air to circulate by gravity flow. 6-12mins is required for sterilization Disadvantages Without careful calibration, more chances sterilization failures The most accurate way to calibrate a sterilization cycle is by using external temperature gauge (pyrometer) attached to a thermocouple wire.
- 10. CHEMICAL STERILIZATION Operates at 1310 C and 20 lbs of pressure. They have a cycle time of half an hour. Advantages † Carbon steel and other carbon sensitive burs, instruments and pliers are sterilized without rust or corrosion Disadvantages † Items sensitive to elevated temperature will be damaged † Instruments must be very lightly packed. † Towel and heavy clothing cannot be sterilized.
- 11. STERILIZATION MONITORING Types of Indicators Mechanical † Measure time † Temperature † Pressure Chemical † Change in color when physical parameter is reached Biological (spore tests) † Use biological spores to assess the sterilization process directly
- 12. DENTAL UNIT DISINFECTION Cleaned by DISPOSABLE TOWELING Use an EPA registered hospital disinfectant (EPA-Environmental Protective Agency) Cleaning Agents Like PHENOLICS, IODOPHORS, CHLORINE containing compounds
- 13. ENVIRONMENTAL SURFACES DISINFECTION CLINICAL CONTACT SURFACES High potential for DIRECT CONTAMINATION from spray or spatter or by contact with gloved hand. HOUSEKEEPING SURFACES Do not come into contact with patients or devices –LIMITED RISK of disease transmission
- 15. CLINICAL CONTACT SURFACES Risk of transmitting infections greater than for housekeeping surfaces. Surface barriers can be used and changed between patients. OR Clean, then disinfect using an EPA-registered low- (HIV/HBV claim) to intermediate-level (tuberculocidal claim) hospital disinfectant.
- 17. HOUSEKEEPING SURFACES Routinely clean with SOAP AND WATER or an EPA- REGISTERED DETERGENT/HOSPITAL DISINFECTANT routinely Clean MOPS AND CLOTHS and allow to dry thoroughly before re-using. Prepare FRESH CLEANING AND DISINFECTING SOLUTIONS daily and per manufacturer recommendations.
- 18. DENTAL PLASTER LAB Need COORDINATION between DENTAL OFFICE AND LAB Use of proper methods/materials for handling and decontaminating soiled incoming items All contaminated INCOMING ITEMS should be cleaned and DISINFECTED before being HANDLED BY LAB PERSONNEL, and before being returned to the patient
- 19. DENTAL PLASTER LAB AS A RULE ALLOW ONLY BIOLOGICALLY CLEAN ITEMS ONLY A SIGN AND MONITOR SYSTEM BE IMPLEMENTED
- 20. DENTAL PLASTER LAB INCOMING ITEMS † Rinse under running tap water to remove blood/saliva † Use ultrasonic cleaners to remove macro debris † Disinfect as appropriate † Rinse thoroughly with tap water to remove residual disinfectant † No single disinfectant is ideal or compatible with all items
- 21. DENTAL PLASTER LAB OUTGOING ITEMS † Clean and disinfect before delivery to patient † After disinfection: rinse and place in plastic bag with diluted mouthwash until insertion † Do not store in disinfectant before insertion † Label the plastic bag: “This case shipment has been disinfected with ______ for _____ minutes”
- 22. In “Cleanliness” lies “Godliness”