sterilization and cleaning of ot table and light.pptx

Sterlization

1. STERILIZATION AND CLEANING OF OT TABLE, OT LIGHT,CAUTERY MACHINE ETC. SUBMITED BY:- JP SIRAJ GAUTAM

2. Sterilization:- the process by which an article is made free of all living either in vegetative or in spore state. DISINFECTION:- the destruction or removal of all pathogenic organism/organisms capable of giving rise to infection. Sterilization and Asepsis

3. Antiseptic:- A chemical that is applied to living tissue , such as mucous membrane or skin to reduce the number of organisms present , thoroughly inhibition of their activity or destruction. Disinfection:- A chemical used on non-vital objects to kill surface vegetative pathogenic organism but not necessary spore form/viruses. Antiseptic and Disinfectants

4. Scrubbing with detergents and rinsing with water Spot cleaning of walls and ceiling daily For open shelves-clean daily For closed cabinets-clean weekly For furniture , light , equipments-clean end of the day with Lysol Lights and other equipments -steamed weekly The floor should be scrubbed with warm water and detergents and dried . No disinfectant is necessary . The OT table , OT light, cautery machine and other non clinical equipments must be wiped to remove all visible dirt and left to dry. GENERAL CLEANING:-

5. Weekly cleaning of all the areas inside the operating theatre complex should be done thoroughly with warm water and detergent and dried. The storage shelves must be emptied and wiped over , allowed to dry and restacked.

6. Frequency of cleaning: Operation rooms- daily Entire theatre complex – once a week Schedule for cleaning of the ots – Before first case i.e beginning of the day During the surgery Between the surgery End of the day Weekly/monthly Cleaning in operation theatres

7. Prior to first case:- Wipe all furniture ,equipment ,lights , cautery machine , suction points ,ot table ,slabs ,etc with a detergent /soap and water Complete at least one hour before start of surgery During surgery:- Spills /blood splashes in the vicinity of the sterile field absorbed with a cloth and covered with freshly prepared sodium hypochlorite for at least 30 minutes. Clean the area with soap and water In between surgeries:- Gather all soiled linens in the receptacles and place them in trolleys to be taken for sorting. The dirty linen is then sent to the laundry. Use gloves while handling dirty linen.

8. Used instruments- Disinfect- wash in adjacent room by scrubbing with brush ,liquid soap and vim-send for sterilization. In septic theatres – autoclave first-then clean manually-pack and autoclave. 2. Furnitures ,operating lights ,suction canisters and other equipment used-wiped with a detergent. Patient transport vehicles are wiped. Floor- mop 3-4 feet area of the floor around the table

9. Days end:- Repeat same procedures as earlier. Wipe over head lights ,cabinets ,waste receptacles ,equipment ,furniture with soap / detergent and water. Wash floor with soap and water followed by disinfectant solution (0.1% hypochlorite solution /1% bacillocid solution/ 7%lysol). Disinfect the operating room ,scrub utility ,corridor ,furnishing and equipment . WEEKLY (deep cleaning):- staff undertaking cleaning must wear appropriate personal protective equipment ( ppe ) . The patients must be vacated from the area to be cleaned. Pre cleaning culture swabs must be taken by ICN . Disposable /opened items discarded; the area is cleared of all personal effects,

10. Equipment (once cleaned ),linen and biomedical waste. Remove the curtains prior to cleaning and send for laundering . Housekeeping services are responsible for cleaning the entire environment including en- suit facilities /patient lockers / tables /underside of bed frame with bacillocid 1% . Clean the wall and ceiling with bacillocid 1% . AC ducts /vents should be cleaned . Mop the beds and mattress with bacillocid 1% . Mopping should be done for air beds unless contraindicated by manufacturer’s instruction .

11. 7 floor should be scrubbed with detergent and then mopped with bacillocid 1% from inside to outside. Suction jars and humidifiers should be cleaned with soap and water, korsolex and dipped in sodium hypochlorite 1% for 45 minutes or send for ETO. All equipments clinical and nonclinical mopped with disinfection. Biomedical staff is responsible for cleaning of all electronic equipment with bacillol 25. All equipment in the area must be decontaminated prior to transferring to a clean area. The cleaning culture swabs to be taken by ICN. The ward /area can resume its normal activities after taking the culture swabs.

12. For mopping of floor 3 bucket system should be preferred. 1 st bucket with water : - dirty mop is rinsed . 2 nd bucket with fresh water for rinsing: - mop rinsed again in this water. 3 rd bucket with low level disinfectant: - mop is immersed in the solution and the mopped liberally. -Wash the used mop with disinfectant after use and dry thoroughly before reuse. 3 bucket system

13. High:- kills all the organisms except spores , E.g.- glutaraldehyde . Intermediate:- kills mycobacteria ,most viruses and bacteria. Low :- kills some viruses and bacteria. Levels of disinfection:-

14. Do not waste the chemicals. Only remove the dust with cloth wetted with clean water, Don’t use chemical/disinfectants as a habit, Use only when contaminated with blood or body fluids. Environmental cleaning of operation theatres:-

15. Disinfectant Purpose Sodium hypochlorite contaminated with blood and body fluids Bleaching powder Toilets , Bathrooms 9 grams/lit. Environmental cleaning of hospital with chlorinated compounds .

16. Fumigation

17. Low temp. Heating produce vapour Vapour phase decontaminates the air /environment. Kills vegetative bacteria / spores When formaldehyde mixed with water and exposed to elevated temperature Gaseous formaldehyde is generated time x temp. Fumigation

18. To sterilize the operation theatre formaldehyde gas (bactericidal & sporicidal , viricidal ) is widely employed as it is cheaper for sterilization of huge areas like operation theatres. Formaldehyde kills the microbes by alkylating the amino acids and sulfydral group of proteins and purine bases. In spite of the gas being hazardous continues to be used in several developing countries. Fumigation usually involves the following phases:- First the area to be fumigated is usually covered to create a sealed environment; fumigation Fumigation

19. Next the fumigant is released into the space to be fumigated; Then, the space is held for a set period while the fumigant gas percolates through the space and acts on and kills any infestation in the product, next the space is ventilated so that the poisonous gases are allowed to escape from the space ,and render it safe for humans to enter.

20. Thoroughly clean windows ,doors ,floor ,walls and all washable equipments with soap and water. Close windows and ventilations tightly. If any opening found seal it with cellophane tape or other material. Switch off all lights ,AC and other electrical & electronic items Calculate the room size in cubic feet (LxBxH) and calculate the required amount of formaldehyde as given in Procedure of fumigation

21. Adequate care must be taken by wearing cap ,mask cover ,spectacle., Formaldehyde is irritant to eye & nose; and it has been recognized as a potential carcinogen . So the fumigation employee must be provided with the personal protective equipments . Creating the formaldehyde gas Electric boiler fumigation method:- For each 1000 cubic . feet of the volume of the operation theatre 500 ml of formaldehyde (40% solution) added in 1000 ml of water in an electric boiler. Personal care during fumigation

22. Switch on the boiler ,leave the room and seal the door . After 45 minutes (variable depending to volume present in the boils apparatus ) switch off the boiler without entering in to the room.

23. In principle we have to generate formaldehyde gas. Can be done by most easier way to mix the needed quantity of formalin to water and heating at 80-90°c can done also with addition of formalin to potassium permanganate Method on Fumigation

24. Potassium permanganate method:- for every 1000 cubic feet add 450 gm of potassium permanganate (KMnO4) to 500 ml of formaldehyde (40% SOLUTION). Take about 5 to 8 bowls (heat resistant place it in various locations) with equally divided parts of formaldehyde and add equally divided KMnO4 to each bowel. This will cause auto boiling and generate fume. After the initiation of formaldehyde vapour, immediately leave the room and seal it for at least 48 hours. Adding potassium permanganate to formaldehyde

25. Neutralize residual formalin gas with ammonia by exposing 250 ml of ammonia per letter of formaldehyde used. Place the ammonia solution in the centre of the room and leave it for 3 hours to neutralize the formalin vapour An example is set as... Operation theatre volume= lxBxH=20x15x10 =300 cubic feet Formaldehyde required for fumigation=500 ml for 1000 cubic feet Fumigation to be neutralised

26. So 1500 ml of formaldehyde required Ammonia required for neutralization=150 ml of 10% ammonia for 500 ml of formaldehyde so 450ml of 10% ammonia required.

27. Ultraviolet radiation:- Daily U.V irradiation for 12-16 hrs To be switched off 2 hrs before. Disinfection by radiation