This document discusses asepsis and sterile technique in healthcare. It defines key terms like pathogens, indigenous microflora, and types of human-microbe relationships. Factors that increase the risk of surgical site infections are described. The document outlines the characteristics, growth requirements, and transmission of different microbes. It also explains the principles of asepsis, sterilization, disinfection, and the processes for cleaning and sterilizing surgical instruments.
Aseptic strategy implies utilizing practices and methodology to keep pollution from pathogens. It includes applying the strictest standards to limit the danger of disease. Human services laborers utilize aseptic system in medical procedure rooms, facilities, outpatient care focuses, and other social insurance settings.
EtO sterilization is an alternative to high temperature steam sterilization found in medical and pharmaceutical industries. EtO sterilization validation or testing allows users to accurately sterilize and maintain regulatory requirements. Rugged and durable, MadgeTech’s EtO data loggers makes retrieving data fast and easy to use.
How to care and handle surgical instruments?raj_chandra
The proper care and handling of your valuable surgical instruments will improve their longevity and function. Choose a protocol appropriate for your environment from these cleaning techniques.
Cleaning, Disinfection, and Sterilization Validations of Reusable Medical Dev...Pacific BioLabs
This presentation provides important details on how to save time and money in the process of reusable medical device design. The main focus is on how device material choice and design affects the cleaning and disinfection process, and what considerations design engineers need to make when creating reusable medical devices.
This Presentation is presented by tuba nafees Graduate in university of Karachi from department of biotechnology.
This presentation will cover Bio-safety levels.
Video link is attached below:
https://www.youtube.com/watch?v=eavkVHsSO1E
Aseptic strategy implies utilizing practices and methodology to keep pollution from pathogens. It includes applying the strictest standards to limit the danger of disease. Human services laborers utilize aseptic system in medical procedure rooms, facilities, outpatient care focuses, and other social insurance settings.
EtO sterilization is an alternative to high temperature steam sterilization found in medical and pharmaceutical industries. EtO sterilization validation or testing allows users to accurately sterilize and maintain regulatory requirements. Rugged and durable, MadgeTech’s EtO data loggers makes retrieving data fast and easy to use.
How to care and handle surgical instruments?raj_chandra
The proper care and handling of your valuable surgical instruments will improve their longevity and function. Choose a protocol appropriate for your environment from these cleaning techniques.
Cleaning, Disinfection, and Sterilization Validations of Reusable Medical Dev...Pacific BioLabs
This presentation provides important details on how to save time and money in the process of reusable medical device design. The main focus is on how device material choice and design affects the cleaning and disinfection process, and what considerations design engineers need to make when creating reusable medical devices.
This Presentation is presented by tuba nafees Graduate in university of Karachi from department of biotechnology.
This presentation will cover Bio-safety levels.
Video link is attached below:
https://www.youtube.com/watch?v=eavkVHsSO1E
Malignant Hyperthermia - Essential Charactistics:
>An inherited disorder of skeletal muscle triggered in susceptibles (human or animal) in most instances by inhalation agents and/or succinylcholine, resulting in hypermetabolism, skeletal muscle damage, hyperthermia, and death if untreated.
>Underlying physiologic mechanism – abnormal handling of intracellular calcium levels.
Aseptic Technique
The media on which you culture desirable microorganisms will readily grow undesirable contaminants, especially molds and other types of fungus, and bacteria from your skin and hair. It is therefore essential that you protect your cultures from contamination from airborne spores and living microorganisms, surface contaminants that may be on your instruments, and from skin contact.
Bacteria and other contaminants cannot fly. Nearly all forms of contamination are carried on microscopic dust particles that make their way onto sterile surfaces when they are carelessly handled. One exception is insect contamination, such as by ants for fruit flies. Fruit flies are a particular nuisance because they can crawl under the lids of agar plates and lay eggs. You would think that people doing genetics research would have developed a model by now that can't fly into other peoples' experiments!
A contaminated culture can often be rescued, however there is always the risk that you will re-isolate the wrong microorganism. Besides, you don't have that kind of time to waste. Exercise extreme care to keep your cultures pure.
by - dr. sheetal kapse, 2nd year p.g. student, dept. of oral & maxillofacial surgery, RCDSR, Bhilai, C.G. please contact for any question...email id - sheetal.kpse@yahoo.com
this presentation involves the various sterilization and asepsis procedure that can be carried out in our dental clinics for proper maintenance of surgical as well as other procedures.
STERILIZATION AND DISINFECTION BY DR RAHUL ACHARYA.pptrahulacharya52
sterilization using chemical methods, sterilization using physical methods, sterilization using sun light, heat, autoclave, hot air oven . tindalisation, inspisation .
contents:
Introduction;
Historical Background;
Definitions;
Factors That Influence Degree Of Sterilization;
Classification of Instruments;
Instrument washer;
Thermal disinfectors;
Objectives;
How sterilization works;
New methods of sterilization;
New methods of sterilization;
Monitors of sterilization;
Dental radiology asepsis;
Laboratory asepsis;
Precautions by operator;
Disposal of waste;
Osha standards;
Handpiece sterilization;
Ultrasonic scalars asepsis;
GTR membranes, Implants, Bone Grafts presterilization ;
Conclusion;
References.
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
2. Human microbe relationships
Indigenous microflora: microbes that live on the skin and inside human
body
- “opportunistic pathogens”
- bacteria, fungi, viruses, and protozoa
- microflora=harmless, however, microflora + surgical wound = pathogen
Symbiosis
-Mutualism
-Commensalism
-Parasitism
3. Pathogen and Infection
Pathogens- microorganisms that cause infection
- commensal microbes: opportunistic by entering through a surgical skin
incision
- nosocomial: UTI
- airborne viruses: common cold
4. Human-Microbe Relationships
Mutualism- both organisms benefit and depend on one another to a certain extent
Escherchia coli: in the colon, produces vit K
1) Synergism- 2 organisms work together to achieve a result neither could obtain alone
-Fusobacteria and spirochetes work together to cause trench mouth
Commensalism- one organism benefits but the other neither benefits nor is harm
-indigenous microflora on the skin can obtain nutrients but do not affect the skin
-competitive exclusion
Parasitism- one benefits and the host is harmed
-endoparasites-: intestinal worms
5. Pathogens associated with SSI
Bacteria
-prokaryotes, binary fission
Tuberculosis (TB)
-Mycobacterium tuberculosis: airborne droplet nuclei
-Precautions : wearing gloves, gowns, eyewear, and NIOSH approved respirators
Viruses
- nonliving particles that are completely reliant on the host cell for survival
-largest: 300nm -smallest: poliovirus-30nm
-Capsis: protein covering of DNA/RNA
-Capsomeres: the capsis is composed of protein molecules
-Nucleocapsid: nucliec acid-capsid combo
7. Pathogens- SSI
Parasites
-unicellular and multicellular protozoan
-Helminths: round and flat
-tapeworm, flukes, and roundworms
-transmission: ingestions of contaminated food/water that contains the worm
or eggs
-skin, fecal-oral contamination, arthropod bite
-protozoa-unicellular eukaryotes that are responsible for causing human
diseases such as malaria and chronic sleeping sickness.
- amebas, flagellates, ciliates, coccidia, and microsporidia
-Entamoeba histolytica- cause of amebic dysentary
8. Pathogens-SSI
Fungi
-Mycology- study of fungi
- examples: yeast, mushrooms, and molds
-Mycoses- fungal diseases
-Zygomycosis- bread mold
-rhinocerebral zygomycosis
- increased organ transplants and immunosuppressive drugs and
antibiotics
-plastic surgery and bone transplant
9. Methods of Transmission
Primary agent: bacterium, virus, fungi, or parasite
SSI: acquired at time of surgery, than after
-environmental and endogenous
Personnel-WEAR PROPER OR ATTIRE!
Environment
Fomites- inanimate object that harbors microorganisms.
The Patient
10. Factors that increase SSI
Age
Obesity
General Health
Nasal Carriers of S. aureus
Remote Infections
Pre-op Hospitalization
11. Factors of SSI
Preexisting illness and related treatment
Pre-op hair removal
Type of procedure
Duration of procedure
12. Surgical conscience
Is the practice of strict adherence to aseptic technique by ALL surgical
team members, which includes, YOU, the SURGICAL TECHNOLOGIST!
Honesty, moral integrity, responsibility
Need the ability to recognize and correct breaks in aseptic technique
If there is hesitation and/or unable to admit = there is no place for you in the OR
THERE CAN BE NO COMPROMISE OF ASEPTIC TECHNIQUE
STANDARD PRECAUTIONS
17. Principle of Asepsis
Principle 1: sterile field is created for each procedure
Principle 2: sterile team member must be appropriately attired prior to
entering sterile field
Principle 3: movement in and around the sterile field must not compromise
the sterile field
18. Principle 1
Time
Instrument sets, peel packs and wrappers
Chemical indicators
Sterile edges
Opening packages
Items that fall below table edges
Questionable sterility
Causes of contamination
19. Principle 2
Sterile portion of gown
Sterile portion of table
Proper technique with arms and hands
Surface for gowning and gloving
Sitting during surgery
Platform standing
20. Principle 3
Sterile to sterile
Sterile individuals keep within sterile area
Nonsterile to nonsterile
26. Pathogenicity
Ability to cause disease
- release of exotoxins and endotoxins
- release of enzymes
- presence of a protective capsule
- attachment to host cell
27. Metabolism, proteins, & genetics
Metabolism is the secretion of waste products
Proteins specific to bacterial species
DNA is unique to each bacteria species
29. Spore forming
Bacterial species capable of forming spores
Unfavorable conditions = cell is enclosed in a protein capsuleto
High survival
NOT REPRODUCTION
Difficult to destroy
30. Disinfection, decontamination, &
sterilization
Disinfection: process in which most but NOT ALL the microorganisms on
INANIMATE are destroyed
-Decontamination
Antisepsis: process in which most but NOT ALL microorganisms on ANIMATE
surfaces are destroyed
-Antiseptic: solutions
-Sterilization: destruction of ALL microorganisms, including SPORES, on
inanimate surfaces
31. Disinfection principles and disinfecting
agents
Cleaning physical removal of blood and body fluids, as well as
BIOBURDEN, from inanimate objects.
Disinfection
-high, intermediate, and low levels
Sterilization
-steam, chemical agents, high velocity electron bombardment, and
ultraviolet radiation
-critical, semi-critical, and noncritical
32. Disinfectant efficiency
Concentration level of disinfectant solution
Number and type of microbes present
Physical factors of the solution
- temperature
- water hardness
- pH level
- exposure time
ALWAYS FOLLOW MANUFACTURER’S INSTRUCTIONS!
33. High Level Disinfectant Compounds
Glutaraldehyde/Cidex
pH: 7.5-6.5
Best overall disinfectant/liquid sterilant
Complete immersion in liquid
Endoscopes
Shelf life of 14 days/28 days
34. High Level Disinfectant Compounds
Sodium hypochlorite
Household bleach
Disinfectant for surfaces, floors, and equipment
CDC recommended on blood and body fluid spills
35. Intermediate Level Disinfectant Compound
Phenol
Carbolic acid
Large areas and general basis
Quaternary Ammonium Compounds
“quats”
Bactericidal, fungicidal, pseudomonacidal
Not sporicidal or tuberculocidal
Common: benzalkonium chloride, dimethyl benzyl ammonium chloride and the newer, diakyl quat
Alcohol
Isopropyl and ethyl alcohol: diluted 60-70%
Bactericidal, virucidal, fungicidal, tuberculocidal, NOT sporicidal
36. Environmental decontamination
Role: minimize microbial counts in the OR environment
Surfaces and characteristics
Pre-op, intra-op and post-op
Standard precautions and PPE
38. Surgical Instrument Decontamination
Process
ALL ITEMS USED ON STERILE FIELD AND/OR ON OPEN TISSUE MUST BE STERILIZED!
Decontamination is the first step
Cleaning
Disinfected
Lubricated (if necessary)
Sorted
Reassembled
Wrapped
Sterilized
Stored properly
39. Cleaning
Presoaking in basin
Sterile water
Enzymatic solution
Proteolytic enzymatic cleaner
Lipolytic enzymatic cleaner
Detergent solutions
Table 7-8
Rinsed and dried
Chelation, enzymatic, emulsification, and solubilization
Table 7-9
40. Manual cleaning
1. Instruments immersed in a solution. Friction will loosen organic material.
With stainless steel: back and forth motion; circular can scatch.
2. Rinse in distilled water. NO TAP WATER!
3. AVOID spotting the instruments, so DRY!
41. Decontamination
Washer-sterilizer
Washer decontaminator
Ultrasonic washer
Considerations:
Use of tray- perforated/wire mesh
Heavier instruments place on the bottom
Hinges left open
Disassemble any instrument
Concave surfaces should be placed upside down
42. Washer decontaminator
“WD”
DOES NOT INCLUDE STERILIZING PHASE
Purpose: allow hands off processing
Considered “clean”
43. Washer sterilizer
“WS”
Stainless steel and heat tolerated items
MUST BE CLEAN BEFORE USE!
Stainless steel must not be placed near other metals = fusion
Use free rinsing, low sudsing, neutral pH detergent
NOT USED DIRECTLY ON PATIENTS NOT A BIOLOGICALLY MONITORED PROCESS
Types of WS machines
Tunnel like chmaber
Horizontal/cabinet type
Gravity cycle of 270 degrees
44. Ultrasonic cleaner
After instruments are placed in WD or WS, they’re place in the ultrasonic
cleaner
Removes small organic particles, or places that cannot be reached
Box locks, serrations, and ratchets
Cavitation
High frequency sound waves
Molecules are forced in a rapid motion which form bubbles
Implosion occurs to create a vacuum, dislodging particles
Metal mesh trays
Each cycle last 4-5 minutes
45. Special Care
Items with lumens
Rigid and flexible endoscopes
Lubrication
“milking”
Editor's Notes
Symbiosis-human host and indigenous microflora: harmless, harmful or beneficial to one or both
Competitive exclusion- indigenous microflora benefit human by occupying space and preventing other potentially harmful microbes from colonizing
Infection: multiplication of organisms in the tissue of a host
Nosocomial: infection developed in a hospital
-patient, family, and health care personnel
25% nosocomial infections acquired are not apparent until the pt is discharged from the hospital
PRIMARY GOAL: use sterile technique to prevent the transmission of microbes and preventing SSI: surgical site infections
Characteristics of bacteria on pg 143
Infects lungs, kidneys, bone, joint, or skin
Elective operations are post-poned until drug therapy is effective
Patients must wear a mask and given info on how to prevent cross- contamination
3)Have students read bullets on pg 142 for characteristics of viruses
Viruses enter the body though: inhalation of respiratory droplets, exchange of body fluids, ingestion of food and water, bites by arthropod vectors
Steps of the process of infection- rhinovirus: common cold pg 142
1)Follow hospital policy on how to take special care to these patients to protect yourself and others
-neutral zone and signage
2)Prion is short for proteinaceous infectious particle
-built of proteins but do not contain DNA/RNA
-human body produces the same protein called PrP but the human PrP is slightly different than the infectious prion. PrP changes from a alpha helical form to a beta sheet: when a prion contact normal PrP, it starts a chain reaction to create all beta sheets. Prions attack the brain- Diseases they cause are subacute spongiform encephalitis. Beta sheet prions accumulate in the lysosomes and eventually kill the neurons causing holes in the brain tissues, which allows prions to continue to attack healthy neurons.
PRIONS TRANSMISSION- is not through human to human, but contaminated surgical instruments with the prion from an infected individual.
CDJ: mimics alzheimers and depression; later dementia and loss of physical function
Diagnosis: Electroencephalogram, histologic exam….NO VACCINE OR CURE
HIGH RISK: eye tissue, dura mater, brain tissue and spinal cord
When working with a patient with CJD, due to the resistance of chemical and physical sterilization such as pressure, Ethylene oxide and dry heat, it is recommended to use single use, disposable instruments.
Pg. 147 table 7-5
3) Worms can damage body tissues and organs to the point that require surgery; intestinal blockage and may rupture intestinal wall
E. histolytica- pt’s who undergo sigmoidoscopy / colonoscopy- nondisposable instrumentation should be thoroughly decontaminated and should be carefully handled during the surgery as to not cross contaminate other parts of the body
Reproduce sexually or asexually by production of spores; a true spore is formed by asexual cleavage or sexual meiosis.
Fungi are opportunistic pathogens that cause disease when the host is immunocompromised; common in ADIS patients and related to spread of HIV
R. zygo causes extensive damage to the bone and tissues of the face, including loss of one/both eyes
ex. Cranial bone damage, then brain tissue is invaded
Frequent hand washing to avoid transient microbes
SSI are the 2nd most frequent nosocomail infections….pg 148 read bullets to describe SSI facts to remember
Environmental: personnel, environment, and contaminated instruments
Endogenous: patient’s flora
4) Personnel:skin, hair and nares of surgical personnel are reservoirs of bacteria, which can ve discharged in the air; S. aureus increased rate of infection, so wear hair covers and mask. Primary purpose is to create a barrier from patient to personnel. Human error!
Errors should be noted, communicated and corrected immediately. A practice called SURGICAL CONSCIENCE!
4)FOMITES AND AIR! Safe, clean, and spacious OR helps to provide alower level of microbes. Minimize airborne pathogens with laminar air and proper attire. Contamination is #1 environmenal SSI. Fomites include walls, floors, cabinets, furniture, and non sterile supplies.
5)2 risks are ENDOGENOUS FLORA FROM CONTAMINATED PROCEDURES AND RESIDEN FLORA OF THE SKIN. Preoperative prophylaxis with antibiotics reduces SSI. Carriers of S.aureaus are at particular risk for SSI in clean procedures- they’re deep into the skin making skin prep ineffective; this is as well for pt with UTI.
Have students read bullets; other factors include malnutrition, smoking, diabetes, immunosuppresion, and malignancy
Aseptic technique: prevent microbial contamination of the surgical environment
Standard precautions: prevent personnel from exposure to infections from pathogens in blood/body fluids on surfaces, instruments, or equipment!
Have students fill out their outline at this time, then go over any questions….THEY MUST KNOW ALL TERMS!!!
2) Rate is a key characteristic for which bacteria multiply
1)Classified to nutritional needs
Obligate aerobes: require oxygen
Microaerophiles: require little oxygen 5%
Obligate anaerobes: will not grow if there is any oxygen
Facultative anaerobes: both
Aerotolerant: grow best without oxygen but can survive up to 15%
Capnophiles: high conc. of carbon dioxide
Acid fast: Purpose: To differentiate between acid-fast and non acid-fast bacteria.
Principle: Some bacteria contain a waxy lipid, mycolic acid, in there cell wall. This lipid makes the cells more durable and is commonly associated with pathogens. Acid fast cell walls are so durable that the stain (carbol fuschin) must be driven into the cells with heat. The cells are then decolorized with acid-alcohol, all other cells will decolorize with this strong solvent, but acid fast bacteria will not. Other cells are then counterstained with methylene blue.
Bioburden: gross debris
High: all microorganisms including spores and prions
Intermediate: most, including HBV and M. tuberculosis
Low: fungi and viruses
Critical: used on tissue or within body cavity; must be sterile prior to use; ex: surg instruments, implants, hypodermic needles
Semi: used on mucous membrane or non intact skin, but not within body cavity; ex: cystoscopes, colon and laryngo scopes
Non: used with intact skin and environmental services; ex: blood pressure cuff, OR furniture
High conc. Of disinfectant increase disinfection it may cause corrosion such as on rubber
-MUST CLEAN ITEMS PRIOR TO STERILIZING/DISINFECTING DUE TO BIOBURDEN
-INSTRUMENTS THAT HAVE MULTIPLE PARTS MUST BE DISESSEMBLED
- 20-30 mins for high level disinfection, intermediate/low=10-15 mins
Read safety list on pg 157
Surfactants are wetting agents that lower the surface tension of a liquid, allowing easier spreading, and lower the interfacial tension between two liquids
-make sure items are dry before immersion to avoid dilution
-rinsed with sterile water so patient doesn’t get burned
-minimum exposure of 20 mins to render sterile; immersed for 10 hours render sterile
Read bullets on 160-162- discuss in further in between
Read bullets on 163
Read bullets on 163 left column
-first step: purpose is to remove debris, use neutral pH detergent other may damage instrument
-pH 0 high pH 14 alkaline; distilled water is 7; high or low pH damaging to metals, rubber, plastics
