Correct use of autoclave
High-pressure steam sterilization has the advantages of fast sterilization speed, reliable effect, high temperature, strong penetrating power, etc. Improper use can lead to sterilization failure. Points to note during sterilization:
1. Preliminary treatment of disinfected items. All medical equipment, sheets, clothing, etc. that have been exposed to pathogenic microorganisms should be disinfected with chemical disinfectants first, and then cleaned as usual. In particular, all kinds of items after use in infectious wards should be strictly checked, first strictly disinfected, and then cleaned and disinfected. In routine cleaning, first soak and scrub with detergent solution to remove oily dirt, blood stains and other dirt on items, and then rinse with running water. Instruments and other items such as shaft joints, tooth slots and gaps should be opened or disassembled as much as possible and thoroughly washed. The washed items should be wiped dry, and packed according to the clinical needs to avoid re-contamination. Containers and transportation tools for items before and after contamination should be strictly separated and clearly marked to prevent cross-infection.
2. The packaging and containers of sterilized items should be appropriate. The packaging adopts double-wrapped white cotton cloth. The new wrapper should be washed and dessized before use. The packaging of the items should be tied with string, so that it should not be loosened and should not be too tight. When the container is used for storage, the choice can not only block the intrusion of external microorganisms, but also has better steam penetration. Such as special syringe sterilization box, storage tank for dressing, etc. Civil aluminum boxes are difficult to enter due to steam, and the air in the box is not easy to escape, and the sterilization effect is often not achieved according to conventional sterilization. Test comparison shows that its pollution rate is much higher than that of medical aluminum boxes. Therefore, it is not possible to use civilian aluminum boxed syringes or instruments for sterilization.
3. The disinfection items should be placed reasonably. Too many items to be disinfected or improperly placed can affect the sterilization effect. The contents of the sterilization pot should not be over-squeezed, and should not exceed the content of the pot. Try to sterilize similar items in a pot. If there are different types of items packed together, the temperature and time required for the items that are difficult to be sterilized should be the standard. When loading items, they should be staggered up, down, left, and right, leaving gaps so that the steam can easily penetrate. The large disinfection bag should be placed on the upper layer, and the small bag should be placed on the lower layer. The large enamel boxes and storage tanks should also be placed on the bottom layer. Cloth and metal items should be placed on the lower layer to make the two heat basically the same. And prevent the condensed water generated in the sterilization of metal objects from wetting the wrapping cloth.
4. exhaust the air. When using a high-pressure steam sterilizer, the most important thing is to exhaust the air in the pot. If there is air in the pot, the pressure pointed by the air pressure needle is not the pressure produced by saturated steam. At the same pressure, the temperature of steam mixed with air is lower than that of saturated steam.
5. Calculate the sterilization time reasonably. Sterilization time includes: ①Penetration time, calculated from the time the pot reaches the sterilization temperature, and the time until the most difficult-to-reach part of the pot also reaches this temperature; ②Maintenance time, that is, the time required to kill microorganisms, generally based on The time required to kill the spores of Stearothermophilus is expressed; ③Safety time is the time required to ensure the sterilization is exactly guaranteed. It is generally half of the heat death time, and its length depends on the sterilized items. No safe time is required for the sterilization of heat-conducting metal equipment. During the sterilization time, pay attention to the pressure gauge and time to adjust the air volume to maintain the pressure at the sterilization time. During the sterilization process, if the pressure or temperature drops, the temperature should be increased again and the timing should be restarted.
6. After sterilization. After the sterilized items are dried, check that the indicator meets the sterilization requirements and can be out of the pot. When taking aseptic items, strictly aseptic operation is required. First, cover the uncapped items and close the vents in the storage tank. At the same time, it should be placed in categories and issued in order. Exceeding the validity period, generally no more than seven days in the hot and humid season.
7. Prevent superheated steam. Although the temperature of superheated steam is high, like air, it cannot condense into water and release latent heat when it encounters disinfected items, so it is not good for sterilization. The way to prevent overheating is to use an external steam killer, do not make the temperature of the interlayer higher than the temperature of the sterilization room, and the two should be similar. Do not let the steam with too high pressure enter the sterilization room; do not use high pressure steam during sterilization. Heat to the required temperature, and then reduce the pressure.
8. Pay attention to safety. Before each sterilization, check whether the sterilizer is in good working condition, especially whether the safety valve is in good condition. After disinfection, the pressure should not be too strong or too fast. You should wait for the pressure gauge to return to the "0" position before opening the pot door. If there is a bottled solution in the sterilization pot and the pot is suddenly opened, the glass will burst when it encounters cold air suddenly. It must be noted that if the pot door is suddenly opened too large, a large amount of cold air will enter, which will easily cause the steam around the cloth to condense into water spots. Blocking the holes of the wrapper prevents the steam in the wrapper from exhausting and makes the article damp.
9. Do not use a high-pressure steam sterilizer to sterilize any destructive materials and substances containing alkali metal components. Disinfecting these items will cause explosion or corrosion of the inner tank and internal pipes, as well as damage to gaskets. List of dangerous goods:
1. Explosive substances ethylene glycol dinitrate (nitroglycol), nitroglycerin, nitrocellulose (nitrocellulose filter) and all nitrate-containing esters. Trinitrobenzene, yellow explosive, picric acid and all flammable and explosive nitro groups, peroxyacetic acid, methyl group, ethyl group, methanol, hydrogen peroxide, peroxide, benzoyl, benzoyl and organic peroxide Oxide.
2. Flammable substances: Metal lithium, potassium, sodium, yellow phosphorus, phosphorus, sulfide, red phosphorus. Gelatin, calcium carbide (calcium carbide), calcium oxide (lime), magnesium powder, sodium dithionite (sodium hydroxide).
3. Oxidizers potassium chloride, sodium chloride, ammonium chloride and other chlorides. (Powder) Potassium perchlorate, sodium perchlorate, ammonium perchlorate and other high chlorides. Potassium nitrate, sodium nitrate, ammonium nitrate and other nitrates. Potassium peroxide, sodium peroxide, barium peroxide and other inorganic peroxides. Sodium chlorite and other hypochlorite, calcium hypochlorite and other hypochlorous acid.
4. Two flammable substances, ether, gasoline, acetaldehyde (acetaldehyde), propylene oxide, propylene oxide, carbon disulfide and other substances whose ignition point is between -30°C and 0°C. Methanol, ethanol, xylene, benzyl, benzyl acetate, and other substances (alcohols) whose ignition point is between 0°C and 30°C. Lamp oil, kerosene, gasoline, isoamyl alcohol, acetic acid (acetic acid), and other similar substances whose ignition point is between 30°C and 65°C.
5. Flammable gases (hydrogen, acetylene, ethylene, methane), ethane, propane, butane and other gases at 15°C and one atmosphere.
6. When the liquid containing salt leaks or overflows, it must be wiped clean in time, and the sealing ring along the lid must be thoroughly wiped dry, otherwise it will corrode the container and pipeline.
7. Before opening the lid, confirm that the pressure has fallen below "0/npa".
8. Do not use the instrument near explosive gases.
