Hydrogen peroxide low temperature sterilization (H2O2)

H2O2 is an extremely powerful ______

Oxidant

Does H2O2 sterilization require aeration?

No

List some temperature sensitive items that would benefit from H2O2 sterilization

Small-diameter endoscopes, light chords, batteries, telescopes

Does ETO have a shorter duration than H2O2

No, hydrogen peroxide has a shorter sterilization duration

Bronchoscope parts

What is this used for?

Davinci scope

MIS

intubation blade

How is plasma ccreated?

the gas is energized to the point where electrons are stripped away from their atoms resulting in free radicals

Does STERRAD or STERIS V-pro use plasma?

which uses a vacuum?

STERRAD uses plasma

V-pro uses vacuum

4 cycle types

________ (24 min)

_______ (42 min)

_______ (47 min)

______ (60 min)

Express cycle 24 minutes

Flex cycle 42 minutes

Standard cycle 47 minutes

Duo cycle 60 minutes

Steris (AMSCO) V-PRO ® maX

3 cycles

_____ 30 minutes

_____ 40 minutes

_____ 60 minutes

Non-lumen 30mins

Flexible cycle 40 minutes

Lumen cycle 60 minutes

STERIZONE ® VP4 Sterilizer

How many cycles?

weight capacity?

One cycle for all items

75 pounds

Low temperature H2O2 times vary from __ to __

24 to 75 minutes

H2O2 sterilant is provided in _____ or ____

cassettes or disposable containers

Can you use powders, liquids, or cellulose-based materials?

some models may have ____ restrictions

Are dead end lumens allowed?

No

Lumen

No dead-end lumens

_____ are sometimes required on lumen devices
of a specific length and diameter

Boosters

What can happen if all the devices are not completely dry?

The cycle will abort

Can you use H2O2 on vacuum sensitive items?

No

No cellulose materials
Which include,

cloth, towels, paper or cotton

What color handles on cases for steam sterilization?

How about low temp?

Silver handle for steam

Gold handle for low temp

What is the vacuum phase?

the chamber is evacuated to remove air and other gases to create low pressure inside the chamber

What is the injection phase?

What concentration needs to be reached?

liquid H2o2 is injected into the chamber.
Water is removed from the liquid H2o2 until the concentration
reaches 90%

What is the diffusion stage?

Vaporized h2o2 is then transferred to the
chamber and diffuses throughout, surrounding the items to be
sterilized

What is the plasma phase?

an electromagnetic field is created in which
the H2o2 vapour breaks apart, producing a low-temp plasma that
contains free radicals

What is the vent phase?

the chamber is brought back to atmospheric
pressure by introducing HEPA-filtered air and the cycle completed

Which three phases are repeated for added efficacy?

Injection, diffusion, plasma phases

4 critical process variables

Temperature

Time

H2O2 concentration

plasma (if applicable)

What form of sterilization removal do the STERRAD and Human Meditek use?

Plasma breaks down H2O2 into water and oxygen

What form of sterilization removal does the STERIS V-pro system use?

Vacuum

What should you do if you see powder in the chamber or on items?

Tell your supervisor right away

If the cycle is aborted for any reason, what do you need to do with the instruments?

Send them back to decontamination

Sterility Assurance Monitoring

All systems and processes have the same
requirements: list the three

Biological indicators

Chemical indicators

Sterilizer displays and cycle printouts

Ozone

Requires a supply of _____ to create
ozone

Oxygen tanks and concentrators need to
be _____ compliant

Hospital facility oxygen line can or cannot be
used ?

Oxygen

CSA compliant

Cannot be used, goes against CSA

Ozone

Can sterilize lumens up to _____ long- such
as flexible gastroscopes, colonoscopes, and
flexible multi-channel endoscope

3.5 m long

Ozone cycle length _____

4 phases:

after half cycle, which 3 steps are repeated?

45 to 110 minutes

Pre-conditioning (warm air injected)

Humidification

Injection

Vent

Pre-conditioning, Humidification, Injection

What is the use dilution from 35% PAA? (STERIS)

0.2%

System 1 cycle time: about ___ min

System 1 plus: about ___ min

System 1 express: about ___ min

30

23

18

Is the dilution from the system 1 plus/express safe to discharge into hospital drainage?

water-soluble?

Yes

Yes

Where must Steris systems be located?

can items be stored in sterile?

Near point of use

No

What areas would STERIS systems have applications?

OR

Outpatient surgery

Endoscopy

Urology

For STERIS systems

what must you do to rigid devices?

Pre-clean and rinse

ensure all surfaces can be contacted by use dilution

Disassemble to the smallest point

Ensure devices are in open position allowing flow

STERIS system for flexible endoscopes

what must you do/check for?

Leak test

Pre-clean and rinse

Place in appropriate trays/containers

Utilize required quick connect following reprocessing instructions

Check placement and connections before starting up the cycle

Ph of use dilution?

6.4

Sterilizing temperature of System 1?

Sterilizing temperature of the system 1 plus/express ?

after these temperatures are reached, what phase starts?

50

43

Exposure phase

STERIS 20 PAA at MEC of _____ ppm for ___ min

STERIS 40 PAA solution at MEC of ____ ppm for __ min

1800 ppm for 12 minutes

1800 ppm for 6 minutes

Physical monitors

Three essential parameters necessary for sterilization during the exposure phase

1-3

How often are you to run diagnostic cycle runs? These diagnostic runs monitors for both ______ and sterile water filter

Time-temperature and concentration

Daily, electromechanical

Chemical indicators,

When exposed to peracetic acid 1800 ppm or more greater

STERIS 20 changes from ____ to ___

STERIS 40 changes from ____ to ____

Purple to white

blue to pink

Geobacillus Stearothermophilus is used to test everything other than ____ which uses _____

ETO

bacillus atrophaeus

Geobacillus Stearothermophilus, vivid ___ to ____ color change indicates growth, biological indicator requires ___ hours incubation period

Red to yellow, 24 hours incubation period

Operation maintenance

The units should be _____ ____ daily with 70% isopropyl alcohol

Check the ____ screen below sterilant cup

Remove residual water from the ___ ___ daily

Change paper reel when ____ ____ appears

damp wiped

drain screen

drip pan

red border appears

Change the sterile water filter every ____ days or as indicated by a diagnostic fault code

Change the sterile air filter every ___ months

inspect ___ ___ and ____ probes for cracks or damage

Perform ____(how often) diagnostic cycle and monitor for fault codes

Function of the pre-filter A and B can be monitored from the “____ ____” reported on the printout

90 days

6 months

trays, containers, aspirator

daily diagnostic

Fill time

When handling sterilant cup after the cycle is done, you should dispose ____ after

gloves

Liquid PAA is an effective _____ agent, it is a colorless solution with a ____ odor

Sterilizes in ___ to ____ min at ___ to ____ degrees C

Liquid PAA provides a “________” sterilization

Liquid PAA will kill gram-negative and positive bacteria, fungi, and yeasts in less than 5 min less than __ ppm

Anti-microbial agent

30 to 45 min at 50 to 56 degrees C

Just in time sterilization

5 minutes 1000 ppm

PAA vapors can cause irritation to eyes skin and mucous membranes, true or false?

True