Foundations of Respiratory Care: Cleaning, Disinfection, and Sterilization

Flashcards testing knowledge on respiratory equipment reprocessing, high-level disinfection, sterilization technologies, and device risk classifications based on the lecture notes.

What are enzymatic cleaners and what is their specific role in equipment reprocessing?

Enzymatic cleaners are neutral detergents with added enzymes that help remove organic (proteinaceous) material from medical equipment.

How is disinfection defined, and what form of bacteria can resist it?

Disinfection is a process that destroys the vegetative form of pathogenic organisms on medical equipment or inanimate objects. It does not destroy bacterial spores, which can survive in the environment for an extremely long time.

What is the most common physical method used for disinfection?

Pasteurization.

What chemical agents does the FDA list for high-level disinfection of semicritical medical devices?

$2.4\%$ or greater glutaraldehyde, $0.55\%$ orthophthaldehyde (OPA), $3100\text{ to }3800\,\text{ppm}$ peracetic acid, and $2.0\%$ hydrogen peroxide.

What specific procedure must be followed after soaking equipment in a high-level disinfectant solution?

The equipment must be removed, rinsed in sterile or filtered water to remove toxic residues, thoroughly dried, and handled carefully to prevent recontamination.

How is sterilization defined, and what level of item requires it?

Sterilization destroys all microorganisms on the surface of a device or in a fluid. Medical devices that come into contact with sterile body tissues or fluids are critical items and must be sterile before use.

What is the primary physical method used for sterilization?

Heat in the form of steam under pressure.

Which low-temperature chemical sterilization methods are used for heat- and moisture-sensitive devices like bronchoscopes?

Ethylene oxide (ETO) gas and hydrogen peroxide.

Which type of nebulizer is most commonly linked to healthcare-associated infections (HAIs)?

Large-volume (jet) nebulizers.

What condition has been specifically linked to contaminated small-volume medication nebulizers (SVNs)?

Healthcare-associated pneumonia, including Legionnaires' disease.

How should spirometry equipment be processed after being used on a patient with pulmonary tuberculosis?

All disposable single-patient-use components (e.g., mouthpiece, tubing) must be changed, reusable internal components cleaned and disinfected or sterilized per manufacturer instructions, and external surfaces cleaned and low-level disinfected.

How are semicritical medical devices defined, and what processing level do they require?

Semicritical devices directly or indirectly contact mucous membranes. They require high-level disinfection.

What are examples of semicritical devices in respiratory care?

Bronchoscopes and bronchoscope forceps/brushes, oral/nasal/tracheal airways, ventilator circuits/humidifiers, pulmonary function testing mouthpieces and tubing, nebulizers and their reservoirs, resuscitation bags, laryngoscope blades/stylets, and pressure, gas, or temperature probes.

How are noncritical medical devices defined, and what reprocessing level do they require?

Noncritical devices touch only intact skin or do not contact the patient. They require detergent washing and low- to intermediate-level disinfection.

What are examples of noncritical medical devices in respiratory care?

Face masks, blood pressure cuffs, and ventilators.

Why is cleaning considered the most essential first step in device reprocessing?

Cleaning removes all dirt and organic material from equipment; failure to clean equipment correctly can render all subsequent processing efforts (disinfection or sterilization) ineffective.

What type of product is recommended for dual cleaning and low-level disinfection of noncritical items such as stethoscopes and external ventilator surfaces?

An EPA-registered product that combines a germicide with a detergent.

What steps must be performed on equipment prior to applying a cleaning agent?

The equipment should be disassembled per the manufacturer's recommendations and examined for worn parts, which ensures thorough exposure to the cleaning agent.