9
SECTION 2
PREPARATIONS FOR STERILIZATION
B. Cleaning
5. With the increasing concern for asepsis, offices are using more disinfectants and instrument soaks. If
any of the disinfectants are introduced into the autoclave during the cycle (either directly or by incom-
plete rinsing after soaks), corrosion of the stainless steel chamber, instruments and trays or baskets
may occur. There are several chemicals commonly used as disinfectants which may break down under
temperature and pressure to cause corrosion to the stainless steel trays and instruments, even in a
properly passivated 304 stainless steel chamber. These chemicals include:
"
Any disinfectant containing Zephiran Chloride (Benzalkonium Chloride), a quaternary ammonium
compound. (A number of practices still use quaternary ammonium com pounds, although this is no
longer recommended by professional organizations.)
"
Any Amine based disinfectant containing quaternary amine hydrochlorides.
"
Any disinfectants containing sulfite products.
"
Any disinfectants containing phenolic products. Some disinfectants commonly used in practices
containing phenols are:
"
Any disinfectants containing active hydrogen halide group.
"
Sporicidin@, Lysol@, and Omni II@.
II. SPECIAL PREPARATION GUIDE FOR CARBON STEEL INSTRUMENTS
A. Handling
1.
Handle and thoroughly clean instruments as outlined above. (Refer to Section 2-1.)
B. Cleaning
1.
Prepare a 2% solution of sodium nitrite (one tablespoon per quart of water). Immerse instruments in
the solution and allow them to remain for three minutes.
C. Sterilization Preparation
1.
Remove instruments and prepare for sterilization. (Refer to Section 2-Ill.) Do not rinse or wipe instru-
ments prior to sterilization.
NOTE: Do not place carbon steel instruments directly on the MagnaClave’s stainless steel tray. Before
placing instruments on the tray, line the tray with a towel or paper wrap.
D. Instrument Wrapping
1.
Instruments which will be wrapped for sterilization should be packaged in a material which promotes
drying.
NOTE: Instruments in packages may not dry well and may require use of an atmosphere reducer
(Vapor Phase, Lorvic Corporation, St. Louis, MO,) for best drying results.
III. TRAY PREPARATION AND LOADING
A. General Guidelines for Tray Preparations
•
An internal process indicator strip should be in-
cluded with each sterilizer load to verify gross
heat penetration.
•
A biological spore test indicator should be used
weekly in a representative sterilizer load for ster-
ilization assurance.
•
Date packages and re-sterilize after one month,
or according to packaging manufacturers’ speci-
fications.
•
Sterilization indicators/monitors should be placed
in the front bottom area of the sterilizer.
•
DO NOT mix or cause contact of dissimilar met-
als (i.e. metals such as carbon steel and stain-
less steel) during sterilization or storage.
•
Make sure that all instruments are sterilized in an
open position. (Refer to AORN guidelines.)
•
Place all sharps (scissors, knives, skin hooks) so
they do not touch during autoclaving. Cotton or gauze
may be used to isolate and protect the sharp edges
and the smaller instruments.
•
Do not place metal instruments, other than stainless
steel, directly on stainless steel autoclave trays. The
trays should be lined with thin cloth or paper liners.
•
Any item which might hold water should be placed so
the water will drain out.
•
Use small packs to separate larger ones. See instruc-
tions for preparing wrapped trays.
•
Never stack trays on top of one another. At least one
inch should separate trays.
•
Wrapped trays and packs must not touch the sides
of the sterilizer.
•
Do not overload trays. Overloading may cause steril-
ization failure.
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