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  • Sterilization

    Sterilization of is a method that ensures the death of vegetative and spore pathogenic and non-pathogenic microorganisms in a sterilizing material. With the help of sterilization, regardless of the method of application, they achieve complete maintenance, which practically means no signs of life on the object being sterilized. Sterilization should be performed on all products that come into contact with the wound surface, in contact with blood or injection preparations, and certain types of medical instruments that come into contact with mucous membranes during operation and can cause damage to it.

    Methods of sterilization:

    • steam;

    • air;

    • chemical;

    • gas.

    Steam sterilization method

    It is used for products made of corrosion-resistant metals, glass, textiles, rubber. Sterilization is performed by saturated steam under excess pressure in a steam sterilizer-autoclave.

    The autoclave is a boiler with double walls, between which there is a water-vapor chamber. Water is poured into it through a funnel. The resulting steam passes into the sterilization chamber where the sterilizable material is located. The water level is determined from the water pipe. The device is hermetically sealed with a lid, which is bolted with nuts or a central bolt. On the cover there is a pressure gauge, the arrow of which indicates the pressure in the apparatus. Outside the device is covered with a casing. Under the lower part of the apparatus, a heat source is supplied to heat the water and steam. When the steam is filled with steam, the pressure in it increases and the temperature rises accordingly. Steam penetrates into all the pores of the object, and the microbes contained in it perish. Sterilization is carried out in sterilization boxes( bix), in a double soft package of coarse calico, parchment, paper, bagged non-impregnated paper, bagged waterproof.

    To control the sterilization in a bix, a Vinara tape is laid, which changes the color to the standard.

    Metal beads used for sterilization are produced with a diameter of 16 cm( small bix), 25 cm( medium bix) and 45 cm( large bix).The most common round bixes, but there are also square ones. In the surgical department for 70-100 beds you need to have at least 10 small, 15 medium and 25 large bix. In order for the steam to penetrate inside the drum, openings are formed along the circumference of the bix that are opened or closed by moving the metal rim with windows corresponding to the groups of holes. The tightness of the bix provides a clamping device that tightly presses the rim against the drum wall. The correctness of this device must be checked every time before the dressing material or linen is placed in the drum, since if the leakage is breached the contents of the bix can be infected. Stacking of clothes in bikes.

    Beeks are wiped from the inside and outside with a 0.5% solution of ammonia, then pushed off on the side wall of the beech a circular plate covering the side holes, folds the lid and lays the bottom and walls of the bix with a canvas bag, napkin, and sheet. When laying clothes and dressings, you must observe the order established once and for all - this allows you to quickly and easily find what you need. Carefully folded linen is laid sectorally one behind the other in an upright position so that you can remove any thing from the bix without touching the rest. The dressing material is also laid in such a way that each pack or bag can be removed separately. When the bix is ​​filled, the edges of the lining sheet are wrapped one over the other on top of the contents. In one of the beads over the sheets lay a robe, and on it a few gauze napkins and a towel. It is necessary that, after washing their hands, the operating sister could wipe them and put on a sterile dressing gown, without opening the rest of the linen and material. On the lid of each bix, an oilcloth label with a list of everything contained therein must be attached, with the date of sterilization, indicating the surname of the sister who cooked the bix. Closing the cover of the beech, it is strengthened with an existing hook on the chain and firmly tied with a braid so that it does not accidentally open. In conclusion, check whether the side openings of the bixons are open.

    Laying bix with gauze napkins

    First lay large napkins - 6 packs of 10 pieces, then medium napkins - b packs of 10 pieces, on top small napkins - 5 packs of 20 pcs.

    Bixing with balls and tampons

    First small tampons - 4 packs of 5 pieces, medium tampons - 6 packs of 10 pieces, then large tampons - 4 packs of 10 pieces, on top gauze balls - 2 bags of 30 pcs.

    Mixed loading: bathrobe - 1 piece, sheet - 3 pieces, towel - 3 pairs, shoe covers - 14.

    Modes and conditions of steam sterilization method.

    1. At a temperature of 132 ° C, the vapor pressure in the sterilization chamber is 2 atm.for 20 minutes recommend sterilization for products of anti-corrosion material, glass, textile materials.

    2. At a temperature of 120 ° C, the vapor pressure is 1.1 atm.within 45 minutes recommend sterilization for products made of rubber and latex, polymer materials.

    The period of sterilization of products sterilized, in boxes without filters is three days, in sterilization beads with a filter - up to 20 days.

    Suitable for rubber, silicone, metal, glass. Sterilization is carried out with dry hot air in an air sterilizer - dry-fire cabinet.

    Drying cabinet is an electrical cabinet of round or rectangular shape. The sterilization chamber has grids or trays to accommodate objects to be sterilized, a thermometer and a special device for mixing dry and heated air during sterilization. The desired temperature is set and maintained by means of a thermoelectric relay. Before sterilization, moist air is completely removed from the cabinet, for which, with the door open, knives are switched on and the chamber is heated to 80 ° C.After that, the cabinet is closed, and after 10-15 minutes the temperature reaches 150-170 ° C.Sterilization is carried out in a package of paper not impregnated, paper bag waterproof or unpackaged in open containers.

    Sterilization modes.

    1. At a temperature of 180 ° C for 60 minutes for metal products.

    2. At a temperature of 100 ° C for 150 minutes.

    Applied for products made of polymer materials, rubber, glass, corrosion-resistant metals - this method is also called cold sterilization. At present, 6% hydrogen peroxide and deoxone-1 solution are used as working solutions. Sterilization is carried out in closed containers made of plastic or coated with enamel. Enamel coating should be free from damage.

    Sterilization modes.

    1. A solution of 6% hydrogen peroxide at a temperature of not less than 18 ° C - 360 minutes.

    2. At a temperature of 50 ° C - 180 minutes.

    Used for disinfection of optics, pacemakers, glass, metal, products made of polymer materials. Sterilization is carried out in stationary gas sterilizers. An effective mixture is a mixture of ethylene oxide and methane bromide( mixture of OB and OKEMB).Sterilization is carried out in a package of two layers of a polyethylene film with a thickness of 0.06-0.2 mm, parchment, paper bag wicking. The dose of gas 2000 mg / dm3 exposure is 240 hours. The shelf life of articles sterilized in polyethylene packaging is up to five years, in kraft paper - 20 days. Apply sterilization in pairs of 16% formalin. For this purpose a special steam-formalin sterilizer is used. Applied for products made of rubber, polymeric materials, glass. The conditions for sterilization and the timing of sterility remain identical to sterilization with a mixture of OB and ethylene oxide.