The Central Sterile Supply Department (CSSD) is responsible for receiving, processing, sterilizing, storing, and distributing medical equipment and supplies. It aims to provide safe sterile supplies and reduce hospital-acquired infections. CSSD developed from the need for aseptic techniques after the discovery of microorganisms. It has specific areas for receiving, cleaning, sterilizing, storing and distributing supplies following a one-way workflow. CSSD uses various sterilization methods like heat, ETO, radiation and chemicals depending on the item to be sterilized. Regular bacteriological testing of sterilizers is done to ensure sterility.
Laundry services in hospitals –linen handling
During any given hospital stay, patients spend most, if not all, of their time in bed.
•That means they are surrounded all day with hospital linens.
•From their gown to their sheets and blankets patients have more contact with these items than anything else in the hospital.
•Adequatesupplyofcleanlinensufficientforcomfortandsafteyofpatientandpersonalappereance&pleasant,neatlyattiredemployeesattendingpatientsinfreshcrispuniformdomuchsellthehospitaltothepublic
•Thereforeitmakessensetoensurethattheyareproperlycleaned,driedandtransportedtoavoidcrosscontamination
Planning & day today management of OT services is very complex and needs to be understood by all Hospital administrators for successfully running a hospital.
Central Medical Gas Distribution System
MedicalGasDistributionSystemisacentralsupplysystemtosupplyamedicalgas(O2,N2O,N2),medicalair,andmedicalvacuumtoeachwardofhospitalsafelyandconvenientlythroughacentralsupplypipingfrommedicalgassupplysources.
•Thesystemhasathoroughgoingcolorcoordinationaccordingtothekindofgas.
•Anaudio-visualmonitoringsystemcapableofcheckingthesituation
The Central Sterile Supply Department (CSSD) is the service responsible for receiving, storing, processing, distributing and controlling the professional supplies and equipment (both sterile and non-sterile) for all user unit of hospital for the care and safety of patient under strict quality control
You will be able to have a brief idea about CSSD from this ppt
Thanks
Laundry services in hospitals –linen handling
During any given hospital stay, patients spend most, if not all, of their time in bed.
•That means they are surrounded all day with hospital linens.
•From their gown to their sheets and blankets patients have more contact with these items than anything else in the hospital.
•Adequatesupplyofcleanlinensufficientforcomfortandsafteyofpatientandpersonalappereance&pleasant,neatlyattiredemployeesattendingpatientsinfreshcrispuniformdomuchsellthehospitaltothepublic
•Thereforeitmakessensetoensurethattheyareproperlycleaned,driedandtransportedtoavoidcrosscontamination
Planning & day today management of OT services is very complex and needs to be understood by all Hospital administrators for successfully running a hospital.
Central Medical Gas Distribution System
MedicalGasDistributionSystemisacentralsupplysystemtosupplyamedicalgas(O2,N2O,N2),medicalair,andmedicalvacuumtoeachwardofhospitalsafelyandconvenientlythroughacentralsupplypipingfrommedicalgassupplysources.
•Thesystemhasathoroughgoingcolorcoordinationaccordingtothekindofgas.
•Anaudio-visualmonitoringsystemcapableofcheckingthesituation
The Central Sterile Supply Department (CSSD) is the service responsible for receiving, storing, processing, distributing and controlling the professional supplies and equipment (both sterile and non-sterile) for all user unit of hospital for the care and safety of patient under strict quality control
You will be able to have a brief idea about CSSD from this ppt
Thanks
Introduction to CSSD, Decontamination is an entry-level program for new entra...Talal Albudayri
Decontamination is an entry-level program for new
entrants to the field of decontamination and sterilization in
a hospital, dental or ambulatory clinic setting.
In this module, we will discuss about reusable medical
device reprocessing, the facilities required to carry out
this function, and how the life cycle of a reusable medical
device fits in.
Process flow, CSSD IS A SERVICE UNIT IN A HOSPITALTalal Albudayri
CSSD IS A SERVICE UNIT IN A HOSPITAL THAT
PROCESSES, ISSUE & CONTROLS THE STERILE
STORES SUPPLY TO ALL DEPARTMENTS OF THE
HOSPITAL.
CSSD IS THE DEPARTMENT WHICH DEALS WITH
RECEIVING, CLEANING, PACKING,
DISINFECTING, STERILIZING, STORING AND
DISTRIBUTING ALL SURGICAL INSTRUMENTS
AND EQUIPMENTS AS PER WELL-DELINEATED
PROTOCOLS AND STANDARDIZED PROCEDURES.
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.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
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2 Case Reports of Gastric Ultrasound
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
2. Definition
The Central Sterile Supply Department (CSSD) is the
service responsible for receiving, storing, processing,
distributing and controlling the professional supplies
and equipments(both sterile and non sterile) for all
user unit of hospital for the care and safety of patient
under strict quality control.
3. It is an important facility of hospital that supplies
sterile instruments and materials for dressing and
procedures carried out in ward and other departments
of hospital.
CSSD has a great role in reducing Hospital Acquired
Infection (HAI)
4. Normally the following types of article are entertained
by CSSD:
-Diagnostic sets like L.P set, Sternal Puncture set etc
-Treatment sets like Cut down sets, aspiration set etc.
-Dressing materials
-OT linen & instruments
-Rubber Gloves, Catheters,
-IV sets & infusion sets
5. History & Development
The development of concept of sepsis was coined by
Lister and Koch as a result of discovery of
microorganism. With this discovery, the need for
aseptic technique in handling and sterilizing the
equipment used in surgery and medicine was felt for
the care of patient.
The mordern concept of CSSD was derived during
ssecond world war.
6. 1928
• American College of Surgeon first started CSSD in their
Hospital
1955
• Cambridge Military Hospital
1958
• Belfast
--
• Actual development took when Nuffield Provincial Hospital
Trust (UK), a central Health council began to take interest
Now
• CSSD is an integral part of every hospital
7. AIMS & OBECTIVES
Aims:
To provide the safe and sterile supplies to all the user unit of hospital.
Objectives:
To provide efficient, economic and uniform source of sterile supply for the care
and treatment of sick
To assist purchase department for decision making and selection of goods.
To assist management of hospital in standardization of good
Cleaning ,Packaging ,labeling and dating of material
To supply equipments to highly specialized units.
To educate students, Nurse and ancillary persons
To save nursing time at nursing station
To participate effectively in Hospital infection control committee.
Applied research for improvement techniques.
8. Physical Facility
Location: Should be ideally located in close proximity
to Casualty, ward, OT and labor room for effectiveness
and efficiency. The location should have adequate
supply of water, both hot and cold, steam, compressed
air and three phase electricity.
9. No. of Beds Space Requirement
75-99 Beds 10 sq. ft per bed
100-149 Beds 9 sq. ft per bed
150-200 8.5 sq ft. per bed
200-249 8 sq. ft. per bed
250-299 7.5 sq ft. per bed
More than 300 7 sq. ft. per bed
Space requirement: The minimum area in sq. ft required
per bed as recommended (Giford, DL-1963)
10. Floor Space requirement: (Acc. To Committee on Plan Project)
Facility Bed Strength
50 100 200 500 750 1000
GENERAL Space in Sq. Feet
1.Admin. Office 120 120 120 120
2.Store Room
(unsterile)
120 240 160 240 240 240
STERILIZATION
UNIT
1.Reception &
Washup Area
120 120 180 180 240 240
2.Checkup &
Assembly
180 180 240 240 320 320
3.Autoclave
Room
80 80 120 120 160 160
4.Storage & Issue 120 120 180 180 240 240
Total: 620 740 1000 1080 1320 1320
11. Total space is functionally divided into foll0wing areas:
Receiving and clean up area-10%
Clean work area including area for sterilization-30%
Unsterile storage area=15%
Sterile storage area-16%
Syringe needle and instrument processing and sterile
area-12%
Glove processing area-5%
Office room/ rest room/gauze/dressing assembly-14%
12. Staffing
Supervisor of CSSD
CSSD Technician
Clerks
Assistant or Helper
Messenger
Staff strength varies from hospital to hospital
depending upon bed strength and work load.For 30
bedded hospital 1 supervisor and CSSD worker is
recommended(1961)
13. Work flow of CSSD
The functional area should be clearly differentiated
and there should be no cross by work flow, particularly
the sterile and contaminated good.
CSSD layout should be designed for unidirectional
flow. and have four zone for smooth workflow i.e
1.Unclean and washing area, 2. Assembly and packing
area, 3. Sterilization area 4 .The sterile area
Arrangement of the work area may differ with each
institution but flow of material will essentially be the
same as given in the following chart.
15. Operation
1.Rinsing
2.Cleaning:manually or ultrasound washer
3.Drying:manually or in natural way
4.Inspection and assembly: Damaged item should be
condemned ,repairable should be repaired then
assembled
5.Packaging: done with linen/draper after drying and
assembling
6.Labeling:Done for identification. Date, contents,
identification number, bar codes, initial of person who
carried out sterilization, initial of packers are used
16. Sterilization
Sterilization is the process of freeing any articles from
living microorganisms including bacteria, Fungi, Virus
etc. This process is carried out through sterilizers.
1.Heat Sterilization
Dry Heat Sterilization
Steam Sterilization
2.ETO (Ethylene Oxide Sterilization)
3.Chemical Sterilization
4.Radiation Sterilization (Gamma)
17. Heat Sterilization
1.Dry Heat Sterilization:
In conventional Hot air oven, sterilization is carried
out at 160 degree C for 1 hour. The most suitable article
for DHS is glass wares, particularly glass syringe, But
nowadays use of glass syringe has become obsolete.
Another article is cutting edge instrument, Articles
with oil, paraffins are also suitable for this sterilization
as dry heat can penetrate all kind of materials.
18.
19. Steam Sterilizer
It is most commonly used sterilizer because it is safe
,inexpensive and time saving. There should be proper
coordination between pressure, temperature and time .
Articles are subjected to sterilize in 121 degree Celsius in 10-
15 minutes and 134 degree Celsius in 3 minutes in 20 PSI
pressure.
The outer layer of microorganism is softened by steam
which coagulates internal portion of organism. In this way
steam sterilization is effective against microorganism.
Machine is operated either by supply of steam through a
boiler or by inbuilt electrical steam generator.
They are used for sterilization of glass wares, container,
vessel, linen, rubber articles, OT instruments etc.
23. ETO Sterilization
It is carried out by use of ethylene oxide as biocide to
destroy bacteria , virus ,fungus and other
microorganism.
This method was developed by American army for
sterilizing articles, which are damaged by high
temperature, like plastic product and sensitive surgical
materials.
It is used for those materials that are heat and
moisture sensitive.
Since it is explosive, it is mixed with co2 or nitrogen
and supplied in a cartridge.
24. Delicate surgical instrument like cystoscope, heart
lung machine, bronchoscope, implants etc are
sterilized by this method.
Commonly used in tertiary level hospital for
sterilization of costly and sensitive materials.
The disadvantage of ETO is that it is expensive and
takes a longer time and requires constant
bacteriological testing of each load.
25.
26. Chemical sterilization
This is an absolute process where spores are also
eliminated with microorganisms.
Chemical sterilization is typically used for devices that
would be sensitive to the high heat used in steam
sterilization, and for devices that may be damaged by
irradiation (rubbers and plastics can become more
brittle after irradiation.)
27. Chemicals Used for Sterilization or Disinfection
Glutaraldehyde and Formaldehyde
Orthophtaldehyde
Superoxide water
Rapid read our ethylene
Endo cleans (liquid sterilzers)
Halogens
28. Gamma Radiation Sterilizer
Gamma rays are used for sterilization of articles.
Useful for sterilization of disposables.
It has high reliability, high degree of penetration and
diverse shape article can also be sterilized
Its limitation of used is due to high cost.
29. Distribution from Sterile store
Four major system of distribution
1.Topping up: Each department set predetermined stock
level for each user and distributing routinely with record.
2.Clean for dirty exchange: one clean article for each dirty is
exchanged
3.Regular complete stock issue: demand for box, trolley,
basket containing article for need for specific period.
4.Ordinary order system :straight forward ordering system
of user in order to keep their local store full.