This document discusses sterilization and disinfection techniques used in healthcare facilities. It defines key terms like sterilization, disinfection, antisepsis, and pasteurization. It describes medical and surgical asepsis, and outlines techniques for each. It also discusses the Spaulding system for classifying patient care items based on infection risk and appropriate sterilization or disinfection levels needed. Methods of sterilization like heat, radiation, filtration and chemicals are covered, as well as various categories of disinfectants and their uses. Cleaning is distinguished as the removal of foreign materials prior to sterilization or disinfection.
Spauldings classification ppt by Dr C P PRINCEDR.PRINCE C P
Disinfection of medical instruments is important for preventing the spread of disease. Cleaning and disinfecting reusable equipment after it comes into contact with patients can be expensive, both in the cost of the disinfection procedure, but also in terms of time away from the patients themselves.
Not all medical instruments can be fully sterilized after each use. Thankfully, not all reusable instruments need the highest level of disinfection. But how to determine the minimum level of disinfection in a given situation?
Earle H. Spaulding devised a rational approach to disinfection and sterilization of patient-care items and equipment
Spaulding believed the nature of disinfection could be understood readily if instruments and items for patient care were categorized as critical, semi-critical, and non-critical according to the degree of risk for infection involved in use of the items.
Spaulding recognized that the need for disinfection of equipment in medical settings ranged from non-critical to semi-critical to critical, depending on the likelihood of spreading disease.
For example, sterilization is necessary for equipment that comes into contact with a patient’s bloodstream or sterile tissue. This category of equipment, such as surgical knives, is designated “critical” because it presents a high risk of disease transmission from patient to patient.
Equipment that only touches healthy, unbroken skin presents a low risk of contamination because intact skin acts as an effective barrier to most microorganisms. Examples in this “non-critical” category include bedpans, blood-pressure cuffs, and bedrails.
In between those two scenarios, a “semi-critical” level of disinfection presents a medium risk of contamination. This would include equipment such as endoscopes used on mucous membranes or areas of broken skin.
Spauldings classification ppt by Dr C P PRINCEDR.PRINCE C P
Disinfection of medical instruments is important for preventing the spread of disease. Cleaning and disinfecting reusable equipment after it comes into contact with patients can be expensive, both in the cost of the disinfection procedure, but also in terms of time away from the patients themselves.
Not all medical instruments can be fully sterilized after each use. Thankfully, not all reusable instruments need the highest level of disinfection. But how to determine the minimum level of disinfection in a given situation?
Earle H. Spaulding devised a rational approach to disinfection and sterilization of patient-care items and equipment
Spaulding believed the nature of disinfection could be understood readily if instruments and items for patient care were categorized as critical, semi-critical, and non-critical according to the degree of risk for infection involved in use of the items.
Spaulding recognized that the need for disinfection of equipment in medical settings ranged from non-critical to semi-critical to critical, depending on the likelihood of spreading disease.
For example, sterilization is necessary for equipment that comes into contact with a patient’s bloodstream or sterile tissue. This category of equipment, such as surgical knives, is designated “critical” because it presents a high risk of disease transmission from patient to patient.
Equipment that only touches healthy, unbroken skin presents a low risk of contamination because intact skin acts as an effective barrier to most microorganisms. Examples in this “non-critical” category include bedpans, blood-pressure cuffs, and bedrails.
In between those two scenarios, a “semi-critical” level of disinfection presents a medium risk of contamination. This would include equipment such as endoscopes used on mucous membranes or areas of broken skin.
There are nearly 100 viruses of the herpes group that infect many different animal species.
Official name of herpesviruses that commonly infect human is Humans herpesvirus (HHV)
herpes simplex virus types 1 (HHV 1)
Herpes simplex virus type 2 (HHV 2)
Varicella-zoster virus (HHV 3)
Epstein-Barr virus, (HHV 4)
Cytomegalovirus (HHV 5)
Human herpesvirus 6 (HHV 6)
Human herpesvirus 7 (HHV 7)
Human herpesvirus 8 (HHV 8) (Kaposi's sarcoma-associated herpesvirus).
Herpes B virus of monkeys can also infect humans
hELMINTHS#corona virus#Aspergillosis#BUGANDO#CUHAS#CUHAS#CUHAS
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
It includes
1. Definitions
2. Classification of medical asepsis
3. Which procedure to use?
4. What to sterilize?
5. Types of Disinfection
6. Conclusion
There are nearly 100 viruses of the herpes group that infect many different animal species.
Official name of herpesviruses that commonly infect human is Humans herpesvirus (HHV)
herpes simplex virus types 1 (HHV 1)
Herpes simplex virus type 2 (HHV 2)
Varicella-zoster virus (HHV 3)
Epstein-Barr virus, (HHV 4)
Cytomegalovirus (HHV 5)
Human herpesvirus 6 (HHV 6)
Human herpesvirus 7 (HHV 7)
Human herpesvirus 8 (HHV 8) (Kaposi's sarcoma-associated herpesvirus).
Herpes B virus of monkeys can also infect humans
hELMINTHS#corona virus#Aspergillosis#BUGANDO#CUHAS#CUHAS#CUHAS
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
It includes
1. Definitions
2. Classification of medical asepsis
3. Which procedure to use?
4. What to sterilize?
5. Types of Disinfection
6. Conclusion
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
2. Introduction
A major risk of all surgical and nonsurgical
procedures performed in healthcare facilities is
the introduction of infection.
Failure to properly disinfect or sterilize
equipment carries not only the risk associated
with breach of the host barriers but also the
additional risk of person-to-person
transmission and transmission of
environmental pathogens.
3. Types of aseptic techniques
1. Medical asepsis.
2. Surgical asepsis.
4. Medical Asepsis
•Medical asepsis, or clean technique, involves
procedures and practices that reduce the
number and transmission of pathogens.
5. •Medical asepsis includes all the
precautionary measures necessary to prevent
direct transfer of pathogens from person to
person and indirect transfer of pathogens
through the air or on instruments, bedding,
equipment, and other inanimate objects.
6. Medical aseptic techniques include
1. frequent and thorough hand washing;
2. wearing of clean masks, gloves, and gowns
when appropriate;
3. proper cleaning of supplies and equipment;
4. disinfection;
5. proper disposal of needles, contaminated
materials, and infectious waste;
6. and sterilization.
7. Surgical asepsis
•Surgical asepsis, or sterile technique, includes
practices used to render and keep objects and
areas sterile (i.e., free of microbes).
8. Note the differences between medical and
surgical asepsis:
Medical asepsis is a clean technique, whereas
surgical asepsis is a sterile technique.
The goal of medical asepsis is to exclude
pathogens, whereas the goal of surgical
asepsis is to exclude all microbes
9. Surgical aseptic techniques are practiced in
•Operating rooms,
• in labor and delivery areas,
•and during invasive procedures: such as drawing
blood, injecting medications, urinary catheter
insertion, cardiac catheterization, Which must
be performed using strict surgical aseptic
precautions.
10. Surgical aseptic techniques include:
•surgical scrubbing of hands and fingernails
before entering the operating room;
•wearing sterile masks, gloves;
•using sterile solutions and dressings;
•using sterile drapes and creating a sterile field.
11. STERILIZATION AND DISINFECTION
The prevention of hospital infection depends in part
upon :
the availability of clean, and where necessary sterile,
equipment, instruments and dressings, isolation
facilities and the safe disposal of infected material.
12. •It must be stressed that the concept of sterility is
central to almost all areas of medical practice.
• An understanding of the rationale of sterilization and
disinfection will aid intelligent use of the range of
sterile equipment (from needles to prostheses) and
techniques (from surgery to hand washing) employed
in medical practice.
13. Cleaning
• Cleaning is the removal of foreign material (e.g., soil and
organic material) from objects.
• it is normally accomplished using water with detergents
or enzymatic products.
• It can be done manually (friction and . Fluidics) or using a
mechanical unit (e.g., ultrasonic cleaner, or washer
disinfector).
14. •Using friction (e.g., rubbing/scrubbing the soiled
area with a brush) is an old and dependable
method.
•Fluidics (i.e., fluids under pressure) is used to
remove soil and debris from internal channels
after brushing and when the design does not
allow the passage of a brush through a channel.
•Cleaning is done manually when the use area
does not have a mechanical unit or for fragile or
difficult-to-clean instruments.
15. Sterilization
Sterilization: is the process of killing or
removing all viable organisms.
An item that is sterile is free from all viable
organisms – in this sense, viable means capable
of reproducing.
16. •Sterilization is achieved by
•Physical: by the removal of organisms from an
object. (High-pressure, saturated steam using an autoclave, or dry heat using an oven,
• are the most common and readily available methods used for sterilization.)
• or chemical means: by killing the organisms in
situ, sometimes leaving toxic breakdown
products (pyrogens) in the object.
• An alternative to high-pressure steam or dry-heat sterilization is chemical
sterilization (often called “cold sterilization”). If objects need to be
sterilized, but using high-pressure steam or dry-heat sterilization would
damage them or equipment is not available (or operational), they can be
chemically sterilized.
19. Methods of Disinfection :
•A chemical ‘disinfectant’, which kills
pathogens but may not kill viruses or spores,
or
•A physical process such as boiling water or
low-pressure steam, which reduces the load
of viable organisms.
20. Antiseptics
•Antiseptics are used to reduce the number of
viable organisms on the skin.
•Antiseptics are a particular group of disinfectants.
•Some act differentially, destroying the transient
flora but leaving untouched the normal skin flora
deep in the skin pores and hair follicles.
21. •It is impossible to sterilize the skin, but
thorough washing with antiseptic soaps can
reduce the numbers of organisms on the
surface considerably and therefore reduce
contact spread of infection. However, the
resident bacteria in the hair follicles and
ducts of sweat glands can recolonize the skin
surface within hours.
22. Pasteurization
Pasteurization can be used to eliminate pathogens in
heat-sensitive products.
Pasteurization reduces the total numbers of viable
microbes in bulk fluids such as milk and fruit juices
without destroying flavor and palatability. It does not
affect spores, but is effective against intracellular
organisms such as Brucella and mycobacteria and many
viruses.
23. Categories of Disinfectants
• A few disinfectants will kill bacterial spores
with prolonged exposure times (3–12 hours);
these are referred to as chemical sterilants.
• Other disinfectants used within healthcare
settings are categorized as high-level,
intermediate-level, and low-level disinfectants.
24. •High-level disinfectants kill all microbes (including
viruses), except large numbers of bacterial spores.
•Intermediate-level disinfectants might kill
mycobacteria, vegetative bacteria, most viruses,
and most fungi, but do not necessarily kill bacterial
spores.
•Low-level disinfectants kill most vegetative
bacteria, some fungi, and some viruses within 10
minutes of exposure.
28. Spaulding System for Classification of
Instruments and Items for Patient Care
More than 30 years ago, Earle H. Spaulding devised a
system of classifying instruments and items for
patient care into three categories according to the
degree of risk for infection that was involved.
This system is still used to determine how these
items are to be disinfected or sterilized.
29. Spaulding System for Classification of
Instruments and Items for Patient Care
1- Critical items confer a high risk for infection
if they are contaminated with any microbe.
Thus, such objects must be sterile.
30. • Critical items include surgical instruments, cardiac and
urinary catheters, implants, and ultrasound probes
used in sterile body cavities.
• Items in this category should be purchased as sterile or
be sterilized using steam (preferably), ethylene oxide
gas, hydrogen peroxide gas plasma, or liquid chemical
sterilant.
31. Spaulding System for Classification of Instruments and
Items for Patient Care
2- Semi critical items contact mucous
membranes or non-intact skin and require
high-level disinfection.
32. • These include respiratory therapy and anesthesia
equipment, some endoscopes, laryngoscope blades,
esophageal manometry probes, cystoscopes, anorectal
manometry catheters, and diaphragm fitting rings.
• They minimally require high-level disinfection using
glutaraldehyde, hydrogen peroxide, ortho-
phthalaldehyde, or peracetic acid with hydrogen peroxide.
33. Spaulding System for Classification of Instruments and
Items for Patient Care
3- Noncritical items are those that come in contact
with intact skin, but not mucous membranes.
Such items are divided into two subcategories:
noncritical patient-care items (e.g., bedpans, blood
pressure cuffs, crutches, computers)
and noncritical environmental surfaces (e.g., bed rails,
bedside tables, patient furniture, floors).
34. •Low-level disinfectants may be used for noncritical
items.
•Any of the following disinfectants may be used for
noncritical items: 70% to 90% ethyl or isopropyl
alcohol, sodium hypochlorite (household bleach
diluted 1:500), phenolic germicidal detergent
solution, iodophor germicidal detergent solution,
and quaternary ammonium germicidal detergent
solution.
35. Deciding whether sterilization or disinfection
should be used
Sterilization and disinfection processes are costly, and so it is
important to choose the appropriate method and the one that
causes the least damage to the material involved.
A variety of considerations influence the choice of method. The
detailed mechanisms of the death process of microorganisms may
vary with the sterilizing technique used, but the net effect is
similar in that essential cell constituents (nucleic acids or proteins)
are inactivated.
36. The hospital should choose one or two clearly defined
and documented disinfectants that are:
easy to handle,
easy to understand and
easy to throw away after use.
the chemicals should not trigger allergies or other
illnesses.
37. Techniques for sterilization
Sterilization may be achieved by:
heat
irradiation (gamma or ultraviolet)
filtration
chemicals in liquid or gaseous phase
Other techniques of doubtful efficiency include freezing
and thawing, lysis, desiccationتجفيف, ultrasonication and
the use of electrical discharges, but these are not
applied in hospital practice.
38. 1- Heat:
•Exposure of the objects to heat will kills microbes
by coagulation of protein, denaturation of
enzymes and oxidation.
•Heat, as a way of transferring energy, is the
preferred choice for sterilization on the grounds
of ease of use, controllability, cost and efficiency.
•Dry heat sterilizes by oxidation of the cell
components. Incinerationالحرق and the use of
the laboratory Bunsen burner are examples of
sterilization by dry heat.
39. The most effective agent for sterilization is saturated
steam (moist heat) under pressure.
This can be achieved using an autoclave.
Steam under pressure aids penetration of heat into the
material to be sterilized (such as dressings), and there is a
direct relationship between temperature and steam
pressure. Steam under pressure has a temperature in
excess of 100°C, which results in increased killing of
microbes.
40. Uses of Moist heat in an autoclave is used to
sterilize:
-surgical instruments and
-dressings and
-heat-resistant pharmaceuticals.
-method for the sterilization of heat-sensitive
instruments such as endoscopes.
41. 2- Irradiation
Gamma irradiation energy is used to sterilize
large batches of small-volume items.
The use of gamma irradiation energy for
sterilization is an industrial process that works
well with products such as needles, syringes,
intravenous lines, catheters and gloves, and
even to prevent food spoilage.
42. •Irradiation can cause materials to deteriorate
and is thus not suitable for resterilization of
equipment.
•The killing mechanism involves the production
of free radicals, which break the bonds in DNA.
43. 3- Filtration
Sterilization through removing of microbes from fluids by
exposing to small size filter.
Used for sterilization of heat sensitive fluids like serum,
antibiotic, suger (glucose), urea, and Amino acids.
Filtration techniques are also used as a method for
quantifying bacteria in fluids.
44. 4- Chemical agents
The gases ethylene oxide and formaldehyde kill by
damaging proteins and nucleic acids.
Ethylene oxide and formaldehyde are examples of
alkylating gases:
Ethylene oxide has been widely used to sterilize
single-use medical requisites such as heart valves.
However, it is toxic and potentially explosive.
45. Formaldehyde is not explosive, but has an extremely
unpleasant odor and is an irritant to mucous
membranes.
oIt has been used as a disinfectant to decontaminate
rooms (such as isolation rooms) and in the laboratory
to disinfect exhaust-protective cabinets.
oA high relative humidity is essential for effective
killing.
46. •The liquid glutaraldehyde is used to disinfect
heat-sensitive articles.
oGlutaraldehyde is less toxic than formaldehyde
and can be stabilized in solution to remain active
for up to several weeks at in-use concentration.
oIt is used for the disinfection, but does not
sterilize, heat-sensitive articles such as
endoscopes and for inanimate surfaces.
47. •Hydrogen peroxide dry aerosol can be used
for infection outbreaks and as terminal
disinfection of isolates after infections with
effect on surfaces, air and inner parts of
mechanical equipment.
48. FACTORS AFFECTING THE EFFICACY
OF DISINFECTION AND STERILIZATION
•Number and Location of Microorganisms.
•Innate Resistance of Microorganisms.
•Concentration and Potency of Disinfectants.
•Physical and Chemical Factors.
•Organic and Inorganic Matter.
•Duration of Exposure.
•Biofilms.