Pre-sterilization cleaning( processing) tools
All products of medical purpose must be presterilized for to remove protein, fat and mechanical contaminants, as well as drugs. The quality of the presterilization treatment of medical instruments is checked by placing samples for the presence of blood residues and the completeness of washing products from alkaline components. Control is subject to 1% of each type of products processed per day. To prevent corrosion( inhibition) using a washing solution containing 0.5% hydrogen peroxide and 0.5% synthetic detergent "Lotus" apply a corrosion inhibitor - 0.14% sodium oleate.1.4% sodium oleate is added to 1 liter of washing solution. To protect instruments from corrosion, tools used during operation or manipulation, contaminated with blood, can be immersed in a 1% solution of sodium benzoate and a corrosion inhibitor at room temperature for a period of at least 60 minutes.
Quality control of pre-sterilization cleaning is carried out by setting the following samples:
• phenolphthalein - on the quality of washing from synthetic products "Lotus", "Astra", "Aina".On "Biolot", "Progress", "Novosti" phenolphthalein does not work;
• azopiramic or amidopyrine - on the quality of washing from blood and drugs.
Phenolphthalein test - a few drops of 1% alcohol solution of phenolphthalein are applied to a cotton swab and this test tool is wiped with this swab. The appearance of a pink color indicates a poor-quality detergent from detergents.
The azopyrum sample contains 10% amidopyrine: 0.10-0.15% aniline hydrochloride, 95% ethyl alcohol. The prepared solution can be stored in a tightly closed bottle in a dark place in the refrigerator for two months, at room temperature 18-23 ° C for not more than a month. Moderate yellowing of the reagent during storage without precipitation does not reduce its performance.
Preparation of working solution: just before checking the quality of cleaning, a working solution is prepared, mixing equal volumes of "azopiram" and 3% solution of hydrogen peroxide. The prepared solution of "azopiram" is applied to the blood stain. If no more than 1 minute later, a violet color appears, then turns into a lilac color, the reagent is usable, if the color does not appear for 1 minute, then the reagent can not be used.
Reaction statement technique. The working solution is treated with the tested products, wiped with swabs, moistened with reagents, various surfaces of equipment and equipment, apply a few drops to the object under study. Needles, catheters, syringes are checked as follows. A working solution( 3-4 drops) is poured into the syringe and several times advanced by the piston to moisten the inner surface of the syringe with the reagent, especially the place of connection of the syringe with the metal. The reagent in the syringe, the catheter is left for 0.5-1 minutes. After that, the reagent is forced out onto cotton wool or white paper. In the presence of traces of blood less than 1 minute after the contact of the reagent with the contaminated area, a violet stain appears first, then rapidly, within a few seconds, turning into a pink-lilac. Brownish coloration is observed in the presence of rust on the investigated objects, violet - in the presence of chlorine-containing oxidants.
Reaction features:
1. Staining that occurs more than 1 minute after the treatment of the test items is not taken into account.
2. The items to be tested should be at room temperature. Do not test hot items.
3. Do not store the working solution in bright light or at elevated temperatures.
4. The working solution of "azopyra" should be used within 1-2 hours.
5. After verification, regardless of the results, it is necessary to remove the remains of azopiram from the objects under investigation, wash them with water or wipe with a swab soaked in water or alcohol, and then repeat the presterilization cleaning of these items.
1. After disinfection, tools are rinsed under a strong stream of running water for 3-5 minutes.
2. Then completely immerse in the washing solution at a temperature of 50 ° C for 15 minutes. The temperature of the washing solution is not maintained during the washing process. The unchanged solution can be heated up to 6 times during the day, with the exception of the "Biolot" detergent. It is used once, because with repeated use, the enzyme, which is part of the detergent, is destroyed during the cleaning process.
3. Wash each product in a soapy solution with a ruff or cotton-tampon swab for 30 seconds.
4. Rinse under running water for 10 minutes with a "Biolot" detergent - for 3 minutes, "Progress" detergent - for 5 minutes.
An amidopyrine sample is made by mixing equal amounts of 5% alcohol solution of amidopyrine and 5% hydrogen peroxide, a few drops of 30% acetic acid are added. In the presence of blood, a blue-violet coloration occurs. Self-monitoring conducting!daily, the main nurse - once a week, SES - once a quarter.
Pre-sterilization cleaning is carried out manually or mechanically( using special equipment).Inkjet method:
5. Rinse with distilled water in the tank for 30 seconds.
6. Drying with hot air at a temperature of 85 ° C until the moisture in the drying cabinet completely disappears.
7. Then put the samples. With a positive sample, pre-sterilization cleaning is carried out again. If the instrument contaminated with blood can be rinsed under running water immediately after its use during this or that manipulation, it is not immersed in a solution of the corrosion inhibitor - sodium benzoate. If this is not possible, then before the sterilization cleaning, the instruments contaminated with blood are immersed in a 1% solution of sodium benzoate immediately after use for 60 minutes, the solution temperature is 22-27 ° C.If necessary, tools can be left immersed in a solution of sodium benzoate for up to 7 hours.
Preparation of a cleaning solution.
Detergent 5 g, perhydrol 27.5% - 17 g, 33% - 16 g. You can use hydrogen peroxide 6% 85 g, 3% - 170 g, water up to 1 l( 978 g).