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Name the 3 recommended types of chemical disinfectants
- Glutaraldehydes
- Chlorine compounds
- Iodophors
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What must the label state on a chemical disinfection solution container in order for us to use it?
- shelf life
- use life
- reuse life
- directions for activation
- type of container for storage
- toxic effects
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What chemicals must be included in a chemical disinfection solution for us to use it?
- tuberculocidal
- bacteriocidal
- virucidal
- fungicidal
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What is the criteria for selecting a chemical disinfectant agent?
- EPA approved
- Chemicals included
- Labels
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Can chemical disinfectant solutions be altered by foreign materials?
Yes
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How is disinfection achieved by use of chemical disinfectants?
by coagulation, precipitation, or oxidation of protein, or denaturation of enzymes of cells
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What are chemical disinfectants used for?
- treatment area after appointment
- impressions
- dentures/partials
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Low level disinfectant
incactivates vegetative bacteria and certain lipid-type viruses, but does not destroy spores, tubercle bacilli, or non-lipid viruses
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Intermediate level disinfectant
inactivates all forms of microorganisms, but does not destroy spores
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High level disinfectant
inactivates spores, fungi, bacteria, and viruses, is a disinfectant, or a sterilizer
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What are chemical disinfectants used for?
- surface disinfectants
- immersion disinfectants
- immersion sterilants
- hand antimicrobials
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Why isn't chemical sterilization effective?
- Can't verify effectiveness with spore testing
- can't package instruments
- must rinse with sterile water
- must be completely immersed in solution (immersion)
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How long does chemical sterilization take?
10-12 hours
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What are chemical sterilants used for?
items that can't be sterilized with heat
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environmental
- no contact with pt. surfaces
- -low level disinfection
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non-critical
- doesn't touch mucous membrane (light, some x-ray materials)
- -low level disinfection
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semicritical
- touch intact mucous membrane (mirror)
- -sterilize or high level disinfection
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Critical
Penetrates soft tissue or bone (needle, explorer, etc)
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Critical
- penetrates soft tissue or bone. (needle, explorer, etc)
- -sterilize or dispose
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What are the limitations of using gluteraldehydes?
- irritates skin and eyes
- corrosive to some instruments
- bad to inhale
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How do you prepare Gluteraldehyde solutions?
mix 2 components to activate
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How do gluteraldehydes disinfect?
- high level disinfectants (used in immersion disinfection)
- damage proteins and nucleic acids
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What are the types of gluteraldehydes used?
- 2% nuetral
- 2% alkaline
- 2% acidic
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How do chlorine compounds disinfect?
oxidation of enzymes, and cell wall components
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What are chlorine compounds used for?
- water purification
- denture cleaning
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what are chlorine compounds made up of?
sodium hypochloride 5.25% (household bleach)
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What are the limitations of chloride compounds? And why are they so widely used?
- a. you must change it every day
- harmful and corrosive
- bad smell
- b. It's cheap and breaks things down easily
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How do idophors disinfect?
Iodine is released slowly
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What are idophors used for?
- surgical antisepsis
- liquid soaps
- mouth rinses
- surface antiseptics
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what are idophors made up of?
- 1% 0-benzyl-pehlorophenol
- 9% 0-phenylphenyl
- diluted with distilled water
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High concentration idophor
protoplasmic poison- destroys cell wall and precipitates protein
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Low concentration idophor
- surface disinfectant- inactivates enzymes
- dilluted with distilled water
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Describe typical care of sterile instruments
- store in package/wrapper
- put package in clean cabinet or drawer and make sure it's dated
- resterilize instruments after 3 months
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How do chemical vapor sterilizers sterilize?
combination of alcolhols, formaldehydes, keytone water, and acetone heated under pressure produce gases that sterilize
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what are chemical vapor sterilizers used for?
- low melting plastics
- liquids
- heat sensitive hand pieces
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What temperature is used for chemical vapor sterilization?
127-132 C (260-270 F)
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What pressure is used for Chemical vapor sterilization?
20-40 lbs
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Do instruments need to dry and cool after use of chemical vapor sterilizer?
Need to cool, but not dry
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How often must you clean/ refill chemical vapor sterilizer?
once a week
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What are the advantages of using a chemical vapor sterilizer?
- easy to use
- short amount of time
- corrosion and rust free
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What are the disadvantages of using the chemical vapor sterilizer?
you need a lot of ventilation, the fumes are very dangerous
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How does Dry Heat sterilizer sterilize?
Oxidation-from heat conducted from the outside to inside
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What is the dry heat sterilizer used for?
- materials that can't be steam autoclaved
- oils
- powders
- small instruments that might be corroded or rusted
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Does oil, debris, or grease protect microorganisms from sterilization in using Dry Heat sterilizer?
yes
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What temperature is used for Dry Heat sterilizer?
- 160 C (320 F) for 2 hrs
- 170 C (340 F) for 1 hr
- -sterilization/timing doesn't start til after machine preheated
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What happens if the tempurater exceeds 160 C using Dry heat sterilizer?
it can ruin/destroy sharp edges
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What are the advantages of using Dry Heat sterilization?
- useful for materials that can't be autoclaved
- if at right tempurature, good for sharp instruments
- no rust or corrosion
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What are the disadvantages of using Dry heat sterilization?
- it takes a LONG time
- must maintain very high tempuratures
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How does Moist Heat Steam under pressure (steam autoclave) sterilize?
- Heat destroys by inactivating cell proteins or enzymes
- moist heat coagulates proteins
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What are steam autoclaves used for?
- materials except:
- oils
- powders
- waxes
- or items that can't get too hot
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What purpose does pressure serve in steam autoclave?
to increase temperature
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Steriliztion in steam autoclave depends on what?
penetrating ability of steam
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What are the conditions for packing and preparing instruments and steam autoclave?
- no air
- leave space between objects
- instruments are cleaned and air dried
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What is the tempurature used for steam autoclave?
121 C (250 F)
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What amount of pressure is used for steam autoclave?
15 lbs pressure
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How long do you run steam autoclave?
- 15 min
- 30 min if load is heavy
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What are the advantages of the steam autoclave?
- quick and efficient
- most economic method
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What are disadvantages of using steam autoclave?
- corrosion
- no oils, liquids, powders, waxes, or materials that can't handle heat
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what are the three tests for adequate sterilization?
- external chemical indicater
- internal chemical indicator
- biologic monitor
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external chemical indicator
seals package and changes color if correct temperature of autoclave was reached (external on package)
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internal chemical indicator
color change shows instruments exosed to heat and steam for the right time
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Biologic monitor
tests that autoclave functions right-run organisms through machine then culture them
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What microorganism is used for the biologic monitor test in the steam autoclave?
geobacillus stearothermophilus strips
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How often must you perform the biologic monitor test?
once a week
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sterilization
all forms of life are destroyed
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3 methods for sterilization
- dry heat
- chemical vapor
- steam autoclave
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What are the causes for incomplete sterilization?
- inadequate preperation
- misuse of equipment
- inadequate maintenance
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Describe the seal on the package for instruments
- indicator tape
- indicator strip changes color during sterilization indicating that auclave reached right tempurature for penetration, but it does not indicate in sterilized
- black strip should appear when done
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When do you unwrap your instruments
Not until you are infront of your patient
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What materials do you need to prepare for instrument packaging?
- sturdy wrapping to preven tears
- wrapping that permits steam or chemical vapor to pass through contents
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what are the indications for thourgough drying?
- when sterilizing by dry heat, chemical heat, chemical vapor, or ethylene oxide
- nonstainless steal must predip in rust inhibitor before steam autoclaving
- packaging in paper wrap
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How do you arrange you instruments when packaging?
- preplan and preload cassette for specific appointment
- date and mark tray or package
- use clear see through package
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How long do you run the ultrasonic?
15 minutes
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is the ultrasonic a substitute for sterilization?
No
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How do instrument wahsers disinfect
high velocity, and hot water
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How do instrument washers/thermal disinfectants and ultrasonics disinfect?
higher degree of temp and high velocity
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