Cleaning Chemicals and Lubricants

Bioburden

the number of microorganisms on an item

D-Value

the amount of time required to kill 90% of the microorganisms present on an item

PPE

personal protective equipment (shoe covers, gloves, fluid-resistant gown, eyewear, mask)

STANDARD PRECAUTIONS

treat each item as if it carries the potential for being infectious by protecting yourself using PPE

IFU

Instructions for Use (written reprocessing instructions and steps for operation for each item in CS)

pH levels

0 - acidic

7 - neutral

14 - basic

Hardness

may need water softener

Tap water

water right out the faucet- city or country has filtered

Softened water

minerals in tap water are reduced usually by using salts

Deionized water

water that has all the ions removed through an ion exchange process

Distilled water

water is heated to steam, then allowed to cool and condense. Distillation removes impurities, like gases and organic material and some bacteria

Reverse osmosis (RO)

water purification in which water has impurities removed after being forced through a semi permeable membrane

Temperature

higher temperature does NOT equal more effective disinfection

Acidic Cleaner

used to remove mineral deposits such as hard water, urine, and minerals and scale

Advantages of acid cleaner

excellent for mineral deposits and urine, works well on inorganic soils and makes stainless steel shine

Disadvantages of acid cleaner

can damage surfaces of stainless steel and aluminum bronze and glass, disposal into drains is restricted in some states

Acid cleaner pH

pH 1.6-3

Neutral cleaners

most common

Advantages of neutral cleaner

effective on organic and inorganic souls and safe for aluminum

Disadvantages of neutral cleaner

not effective in hard water, produce foam and more difficult to rinse

Neutral cleaner pH

pH 6-8

Alkaline (Basic) cleaners

Highly effective at removing organic material (blood, fat, and oils) Must follow IFU

Advantages of alkaline cleaner (basic)

remove a wider range of soil than any other type of detergent, economical and low foaming

Disadvantages of alkaline cleaner

if not rinsed properly can leave a powdery residue on instruments. Cannot be used on bronze, copper, or aluminum)

Alkaline (basic) cleaner pH

pH 8-11

Proteolytic Enzymes (Protease)

: breaks down proteins

-Blood

-Mucous

aFeces

-Albumin

Protease

They target large insoluble molecules and convert them into small ones to ensure that they can easily be dissolved in water and easily cleaned

Fats-degrading enzymes (Lipase)

breaks down fats

-bone marrow

-Adipose (fatty) tissue

Lipase

These molecules are not as large as proteins and rarely dissolve in water. ____ properties make fats water soluble so that they can dossolve in water

Sugar-degrading enzyme (Amylase)

-Catalyzes (changes)

-Starch (sugars)

Amylase

They are utilized as a substance in detergents which are made for complex cleaning of clinical devices

Detergents

-used to enhance cleaning ability

-When properly used, detergents penetrate and remove soil from instruments and keep soil suspended do it does not reattch to instruments

Detergents do not kill

microorganisms (unless they contain a germicide), but they remove the soil that contains bacteria

Each detergent has a specific task

some work better in hard water, some are low foaming, some are specifically designed for certain types of equipment, such as ultrasonic cleaners

Detergent can be

liquid, solid or foam

Emulsifer

ingredient used to bind together substances that normally do not combine, like water and oil

Surfactant

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

Chelating agents

chemicals that hold hard water minerals in solution and prevent soaps and detergents from reacting with the minerals

Lubricants

often called instrument “milk” because of its milky appearance. Preformed after cleaning as one of the final steps in the mechanical wash cycle, or can be applied manually with a spray bottle. Practices used to soak instruments in “baths”, but this has been discontinued due to increase risk of contamination. Follow IFU for proper dilution and ensure it is compatible with instrumentation

Stain and rust removers

used when normal cleaning does not remove . Stains are usually a result of soaking instruments in saline. The chemicals remove hard water deposits, rust scale and discoloration from instruments and are usually acid based (pH 0-6.9)

Use ____ to remove discoloration

pencil eraser

If pit marks under strain

it is corrosion or rust

No pit marks (dots)

it is a stain (not rust or corrosion)

FOLLOWING SHOULDNT BE USED (unless recommended by device manufacturer)

-abrasive cleaners

-Saline

-Buffered iodine

-Hydrogen peroxide

-Any chemical not recommended by medical by device manufacturer

Brown/orange

high ph

Dark brown

low ph

Bluish/black

reverse plating due to mixed metals during cleaning process

Multicolor

excessive heat

Light/dark spots

water droplets drying on surface

Black

contact with ammonia

Gray

excessive use of rust remover solution

Rust

dried on blood or bio-film

many of the following stains can be the result of

poor steam quality or poor water quality. It is important to determine whether these symptoms are occurring before or after sterilization