What is a pulsating vacuum sterilizer
I. What is a pulsating vacuum sterilizer? What are its advantages?
A pulsating vacuum sterilizer is a sterilizer that alternates between multiple vacuums and multiple fills of steam. Advantages: thorough sterilization, high efficiency, low damage to the articles, normal temperature in the operating room, saving energy, manpower and material resources, it is an excellent sterilization instrument.
II. Why does a pulsating vacuum steriliser sterilise quickly?
As there is about 98% air inside the cabinet and the package, pre-exhausted, the temperature inside and outside the package are the same, the killing rate reaches 99.9%, and the temperature can reach 132-134℃, these two important factors make it can reach sterilization thoroughly.
III. Scope of application of the sterilizer: it is suitable for sterilization of high temperature, high temperature medical instruments and articles, not for oil and powder sterilization.
IV. Requirements for sterilised items in cabinets
1 Cloth bags must be clean, dry, without holes, breathable, of suitable size and cleaned once used.
2 The bundle must not be too loose or too tight, the volume of the cloth bundle ≤ 25×25×30㎝ weight ≤ 5㎏
The volume of the instrument bag is ≤30×30×50㎝ and the weight is ≤7㎏.
Try to pack the instrument bag and cloth bag separately, and separate the instruments with padding to ensure the sterilization effect.
3 In order to ensure vacuum and air circulation, the storage tank should be opened with holes and the box should be opened with a lid, which should not be dense and airless. The total loading volume should not exceed 90% of the cabinet room, nor should it be less than 10% of the cabinet room volume, otherwise the sterilization effect will be affected.
4 Place large packages that are difficult to sterilize on the upper layer, easier to sterilize packages on the lower layer, metal items on the lower layer and fabrics on the upper layer, items should not be loaded close to the cabinet wall.
V. Handling of sterilised items
1 Check the integrity of the package, if it is damaged it may not be used as a sterile package.
2 Wet packets and packets with visible water spray are not used as sterile packets, open and close containers and check that sieves are closed.
3 Check the colour change of the chemical indicator tape, if it does not reach or has doubtful points, it should not be issued as sterile package** for use in the department, check whether the indication card inside the package reaches the colour and state of sterilisation before opening the package for use, if it does not reach or has doubtful points, it should not be used as sterile package.
4 Sterilised items shall not be mixed with unsterilised items.
5 Qualified sterilised items should be marked with the sterilisation date pass mark.
6After each batch of sterilisation is completed, a record is kept of the type and number of sterilised packages, the sterilisation temperature, the time of action, the date of sterilisation and the operator, according to the running number.
7 Tools for transporting sterilised items should be cleaned and kept dry daily and should be cleaned and disinfected immediately when contamination is suspected or found.
8 Sterilised items should be placed in sterile cabinets or sent down to the item trolley** in the department, the cabinets should be made of materials that do not easily absorb moisture, the sterilisation cabinets should be 20-25cm high from the floor, 50cm high from the ceiling, and cm from the wall, sterile items should be placed in order and sorted, with storage cabinets in the sterile room, with cleaning and disinfection measures, dedicated rooms, dedicated staff, and restricted access for unrelated personnel.
9 sterile goods storage expiry date, for cotton bag type, loading material and open container temperature below 37 ℃, every week use.
VI. Three checks and four pairs of aseptic articles, three checks: check when put, check when stored, check when issued
Four pairs: check the name, check the quantity, check the department and check the date.
VII. How to ensure effective sterilization
1 Do a BD test every day before sterilization and use only after the results are qualified.
2 Each time the sterilisation process is carried out, a chemical indicator monitoring kit is placed in the cabinet.
3 The various instrument indicators should also be observed during the sterilisation process.
4 Large instrument pack dressing packs should have a chemical indicator placed in the centre of each pack and an indicator tape pack should be applied outside each pack.
5 Regular daily bioassays should be carried out on sterilizers in daily use.
VIII. Microbiological monitoring standards for surfaces of objects and staff hands in each area of the supply room
Object surfaces: sterile area ≤ 5 cfu/cm3 clean area ≤ 10 cfu/cm3 contaminated area ≤ 15 cfu/cm3
Staff hands: sterile area ≤ 5 cfu/cm3 clean area ≤ 10 cfu/cm3 contaminated area ≤ 15 cfu/cm3
IX. Monitoring standards for airborne bacteria culture in the clean zone of the sterile area of the supply room
Sterile area ≤ 200 cfu/cm3 clean area ≤ 500 cfu/cm3 contaminated area ≤ 2500 cfu/cm3
x. The significance of mechanical monitoring of pressure steam sterilization
The mechanical monitoring part of pressure steam sterilisation can indicate whether the steriliser is functioning properly and can directly observe the sterilisation process to identify problems in time, but mechanical monitoring cannot directly monitor whether sterilisation is actually achieved in each package, so it cannot replace other monitoring methods.
XI What types of sterilisation monitoring are available? How are the various types of monitoring judged to be satisfactory?
Sterilisation monitoring is process monitoring, chemical monitoring and biological monitoring
1 Process monitoring: working hours, pressure and temperature, loading and unloading methods, adequacy of water, electricity and gas, and compliance with working requirements.
2 Chemical monitoring: the test placed on the indicator card, the tape's properties or colour are degraded to the prescribed conditions, meet or exceed the standard colour, are qualified.
3 biological monitoring: thermophilic fatty bacillus bacteriophage tablets, after sterilization, remove the tablets from the monitoring package, and then by culture according to the colour change of the medium to determine the sterilization effect, the control tube is purple, proving no thermophilic fatty bacillus, growth and reproduction, indicating good sterilization effect, such as the colour of the medium from purple to yellow, proving the growth and reproduction of the bacillus, indicating sterilization failure.
XII Try to describe the selection of air sampling points, the requirements of the sampler?
1 Generally, rooms smaller than 30 m²** should have at least 3 points inside and outside, while rooms larger than 30 m² should have 4 corners and 5 points in the centre for sampling.
2Sampling height is 1.5m
3 Samplers should wear isolation clothing and masks, and maintain a distance of 50cm from the sampler when sampling
XIII How is surface monitoring carried out?
Sampling time: select sampling within 4h after disinfection treatment.
Sampling area: Take the entire surface if the surface to be sampled is less than 100㎝2, and take 100㎝2 if the surface to be sampled is ≥100㎝2.
Sampling method: use a standard sterilised specification plate of 5 x 5 cm2, place it on the surface of the object to be inspected, use a cotton swab with sterile saline sampling, apply it five times in each of the horizontal and vertical columns within the specification, and turn the cotton swab accordingly, sample the area of four consecutive specification plates, cut off the hand contact part, put the cotton swab into a test tube with 10 ml of sampling solution and send it for inspection, for door handles etc., the object is directly coated with the cotton swab. method of sampling.
XIIII How is hand monitoring carried out for health care workers?
Sampling time: sampling before contact with patients engaged in medical activities
Sampling area and method: The subject's five fingers are brought together and a cotton swab containing sterile saline sampling solution is applied twice back and forth from the root to the end of the finger on the curved surface of both fingers, and the cotton swab is subsequently rotated to maintain the swab, the hand contact area is clipped and the cotton swab is placed in a test tube containing 10ml of sampling solution and sent for testing.
XV What should I pay attention to when using UV light?
1 The surface of the UV lamp should be kept clean and swabbed with a 5% alcohol cotton block once a week, and the surface of the lamp should be wiped whenever dust and oil are found.
2 UV lamps are irritating to the eyes and should not be looked at directly to prevent conjunctivitis.
3 Do not expose the UV light source directly to people to prevent skin erythema.
4 Ultraviolet light emits ozone, too much ozone can cause poisoning, and the concentration of ozone in a working environment should not exceed 0.3mg/m3.
XVI Factors that can affect the effectiveness of chemical disinfection are
1The surface cleaning solution of the object
2The structure of the object to be disinfected
3Concentration and duration of action of the disinfectant solution
4 Ambient wet temperature and pH value
5Type and number of pathogenic microorganisms
