Check offs 11/3/2026

what do detergents contain?

emulsifiers, surfactants, chelating agents

what are chelating agents

chemicals that hold hard water minerals in solution and prevent soap or detergent from reacting with the minerals

what is an emulsifier?

any ingridient used to bind together substances that typically do not combine such as oil and water

what is a surfactant

a substance that lowers the surface tension of the water and increases the solubility of organic compounds

what do detergents do?

• penetrate and remove soil from instruments and keep soil in suspension so it does not reattach to the instrument

• do not kill microorganisms (unless they contain biocide)

• help clean instrument by removing bacteria-laden soil

what is the PH balance of natural detergents?

6-8

what are the advantages of neutral detergents?

are effective against organic and inorganic soils and are safe to use on aluminum products

what are the disadvtantages of neutral detergents

detergents are not very effective in hard water. Produce more foam and are more difficult to rinse than other types of detergents

what is the most commonly used type of detergent used in the U.S?

neutral

what are alkaline detergents most highly effective at removing?

organic soils (blood, fat, oil)

what is the range of alkaline detergents

8-11

what are the advantages of using an alkaline detergent?

removes a wider range of soil than any other type of detergent

what are the disadvantages of using an alkaline detergent?

require thorough rinsing because htye can leave a powdery residue on the instruments surface. Alkaline detergents cannot be used on devices made of bronze, copper or aluminum

what are acid detergents typically used to remove?

mineral deposits such as hard water, urine, minerals and scale

what is the usualy PH scale for acid detergents

1.6-3

what are the advantages of acid detergents

excellent for removing mineral deposits and uring. Work well with inorganic soils. Neutralize alkaline residues and make stainless steel shine

what are the disadvantages of using alkaline detergents

can damage surfaces of stainless steel and aluminum, bronze and glass. Disposal into drains and sewerlines may be restricted in some states

what are some common precleaning agents?

detergent solutions, enzymatic detergents and combination enzyme-germicide detergents

what must be done to precleaning solutions prior to cleaning?

must be removed

what is the main purpose of manual cleaning soils

• penetrate under the soil and break the bond that attaches the soil to the instruments, not kill microorganisms

• usually neutral or alkaline

what quality of manual cleaners makes them special

low foaming

when should instruments be cleaned?

• after use

• after they have been opened, placed on the sterile field, but have not been used

• when new instruments are recieved at the facility

• when used instruments return from repair or refurbishing

• when instruments are pulled from back-up stock

• when instruments are inadvertently contaminated

  • when loeaned instruments are recieved

what are the different types of cleaning methods

• precleaning (at point of use)

• manual cleaning (by hand)

• mechanical cleaning (using specialized equipment)

how should lumened items be cleaned?

• full submerged, then flushed with fresh cleaning solution

• if available, placed in a vertical soaking cylinder also helps ensure air bubbles are not inside the lumens

• cleaned with brush after soaking in cleaning solution

• after being brushed, run second clean brush through to make sure there is no debris

do you still process damaged instruments?

yes
cleaned and decontaminated

what is TASS?

• toxic anterior segment syndrome

• acute postoperative inflammatory reaction in which a noninfectious substance enters the anterior segment of the eye and induces toxic damage to the intraocular tissues

what must you make of before running a cycle on ortho screws and implants?

cycle does not have lubrication

what does the decontamination process involve?

• the use of physical or chemical procedures to remove, inactivate or destroy bloodborne pathogens on an item’s surface

what is the goal of decontamination

• to make devices safe for people who are not wearing gloves and reduce bioburden to make the next processing steps easier

what are the levels to the spaulding classification system?

• critical - enters sterile vascular system

• semi-critical - touches mucous membranes, except dental

• non-critical - touches intact skin

how do you disinfect critical items?

sterilization

how do you disinfect semi critical items

sterilization, if possible: it not then high-level disinfection (HLD)

what kind of disinfection to non-critical items require

low level disinfection

what is a bactericidal

substance that kill bacteria

what is a disinfectant

chemical that kills most pathogenic organisms but does not kill all spores

what is disinfection

the destruction of nearly all pathogenic microorganisms on an inanimate (non-living) surface

what is the spaulding classification system definition?

a system developed by DR E.H spaulding that divides medical devices into categories based on the risk of infection involed with their use

what is sterile/sterilization

completely devoid of all living microorganisms

what is high level disinfectin

destruction of all vegetative microorganisms but no bacterial spores

what is low level disinfection

the destruction of some vegetative forms of bacteria

intermediate level disinfection definition

the destruction of viruses, mycobacteria, fungi and vegetative bacteria (but not bacterial spores)

what is wet contact time?

amount of time the device must remain wet with the disinfectant

what should be used to rinse items

critical water

what levels of the spaulding classification system require critical water

semi & critical unless sterile water is specified

what should items be dried with after decontamination

• dried with clean, non-linting cloths

• lumens with pressure regulated, forced instrment air of high efficieny particulate air

what is important regarding safety SP techs must know?

• PPE requierments

• enviornmental (ventilation) requirements

• spill and leak procedures

• storage requirements

• disposal requirements

what are some examples of low level disinfectants

• ammonium compounds

• alcohols

• phenolics

• chlorines

• iodophors

what do low level to intermediate disinfectants have in common?

germicidal action is reduced by the presence of organic materials

what are quaternary ammonium compounds?

low level disinfectants

what is the most common chemical in most quats?

benzalkonium chloride

what are the advantages of quats?

• bactericidial, fungicidal and virucidal against lipophilic viruses

• wetting agents with built in detergents

what are the disadvantages of quats?

• may be inactivated (absorbed or neutralized) by cotton or paper

• not compatible with soap

  • deactivated by organic material

what is the minnimum wet contact time for alcohol

5 minutes

what are the advantages of alcohol

• no residue

• non-staining

• relitavely fast acting

what are the disadvantages of alcohol

• no residual activity

• volatile: flammable

• inactivated by organic material

• non-sporicidal

• can be fixative for debris on stainless steel

what level are phenolics?

intermediate to low level disinfection

what department prefers phenolics?

• EVS

• enviornmental services departments

what level is chlorine?

intermediate level disinfectantw

what is chlorine most commonly used for?

treatment of water and sewage

why wouldnt chlorine be a preffered choice in SPD?

corrosive, metla instruments may have their finishes damaged by exposure to chlorine solution

what are the disadvantages of chlroein?

corrosive to metal

no sporicidal

staoms fabrics, plastics and other synthetic materials

relitavely unstable

what should iodophors not be used for?

cleaning surgical equipment

what are high level disinfectants inactivated by?

organic material

what level is glutaraldehyde, what spaulding classification is it used to clean?

high level, semi-critical

waht air rate exchange for using glutaraldehyde must be used?

10 per hour

what form of disinfection does glutaraldehyde have to be used in?

automated or manual HLD processes

what is MEC?

• minnimum effective concentration

• the percentage concentration of the active ingridient in a disinfectant or chemical sterilant that is the minimum concentration at which the chemical meets all its label claims for activity against specific microorganisms

why should you consult the IFU if processing urilogical devices using ortho-pthaladehyde?

has been associated with anaphylactis lie reactions in bladder cancer patients

what chemical achieves HLD in 5 minutes?

peracetic acid

how long does it take paracetic acid to reach HLD?

5 minutes

what is the most common used mechanical disinfection methods?

washer-disinfector

what are the processes inside of a washer disinfector?

cleaning process followed by a thermal disinifection process.

how do pastuerizers provide thermal disinifection? what is needed to provide disinifection?

• heats water to 150-170

• minnimum of 30 minutes in exposure to medical devices needed

• items must be able to withstand full submersion and thorough cleaning prior to pausterizing

what are some advantages of using AER?

• reduce personnel exposure to HLD disinfectant and its vapors

• consistent exposure to cleaning agent

• timed contact with liquid chemical substance

• continous movement of HLD

• use an air flush cycle to remove excess moisture

• use of copious and consistent amounts of rinse water

• documentation of the cycle parameters

what steps should you follow when using an AER?

• follow the endoscope manufacturerers IFU

• use correct tubing and adapters and manufacturers instructions to connect the endoscope to the AER

• if possible, place valves and removeable parts in AER

what documentation is needed for HLD?

• MEC

• lost # of HLD process, including the AER or soak basin number

• items being disinfected, including quantities and device serial numbers

• patiens name or identifier

• physicians name and procedure

• HLD solution formulation

• exposure time and temp

• date and time of process

• technician identification

• MEC test strip results

what is biofilm?

a collection of microoragsnisms that attach to surfacse and each other and form a colony. The colony produces a protective gel that is very difficult to penetrate with detergents and disinfectants

what is cleaning defined as?

the removal of all visible and non-visible soil and other foreign material from medical devices being reporcessesd.