Sterilization Methods in Microbiology

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Questions and Answers

What is the primary method used in steam sterilization at sub-atmospheric pressure?

Hydrogen peroxide

Chlorine gas

Formaldehyde vapour (correct)

Ozone

At what temperature does water boil when placed under increased pressure?

108°C (correct)

75°C

100°C

147°C

Which of the following methods is NOT recommended for sterilizing surgical instruments?

Gamma radiation

Ultraviolet radiation

Steam sterilization

Boiling at 100°C (correct)

What is the major target for most radiation methods of sterilization?

Microbial DNA Signup and view all the answers

What type of radiation causes ionization in microbial cells?

Gamma rays Signup and view all the answers

Which of the following items can be sterilized using radiation methods?

Dressings and instruments Signup and view all the answers

What is a limitation of boiling water as a sterilization method?

It requires prolonged periods for vegetative bacteria. Signup and view all the answers

Why are prions a concern in sterilization processes?

They can survive certain sterilization methods. Signup and view all the answers

What is the first step in the open-glove technique?

Place the glove’s rolled cuff edge at the palm Signup and view all the answers

Which hand should be used to hold the rolled cuff of the glove in the open method?

The opposite hand Signup and view all the answers

What should be done after grasping the glove firmly?

Stretch the cuff over the hand Signup and view all the answers

How should the gown cuff be positioned when donning gloves?

It should be secured and covered completely by the glove cuff Signup and view all the answers

What is a necessary adjustment step for the gloves after donning?

Wiggle fingers to ensure proper fit Signup and view all the answers

Which of the following should NOT be done while putting on the gloves?

Pull the glove sleeve excessively over the arms Signup and view all the answers

During the gloving process, what should you do with any excessive glove sleeve?

Pull it underneath the cuff of the glove Signup and view all the answers

What is the overall goal of the open-glove technique?

To ensure a perfect fit of the gloves over the hands Signup and view all the answers

Which surgical blade is most commonly used for incisions of the abdomen?

No. 10 Signup and view all the answers

Which blade is best suited for incision and drainage procedures?

No. 11 Signup and view all the answers

What distinguishes Metzenbaum scissors from Mayo scissors?

Mayo scissors are bigger and stouter. Signup and view all the answers

Why are No. 15 blades preferred in very delicate areas such as the face?

They allow for more control during incision. Signup and view all the answers

Which of the following details is true regarding the availability of blades No. 21, 22, and 23?

They are not commonly available, found in some hospitals. Signup and view all the answers

What is the main purpose of Iris scissors?

For sutures with hooks or beaks. Signup and view all the answers

Which surgical blade is specifically noted as 'not very common'?

No. 12 Signup and view all the answers

What differentiates Mayo scissors from Metzenbaum scissors in their usage?

Mayo scissors are used for general purpose cutting. Signup and view all the answers

What is the primary purpose of antisepsis in a surgical context?

To decrease microorganisms on skin or mucous membranes Signup and view all the answers

Which chemical is commonly used as a throat antiseptic?

Dequalinium Signup and view all the answers

Surgical hand antisepsis is designed to minimize the risk of what?

Developing a surgical site infection (SSI) Signup and view all the answers

What does an aqueous scrub contain?

A water-based solution with active ingredients Signup and view all the answers

What is one common application of antiseptic techniques?

Invasive procedures at the bedside Signup and view all the answers

Which statement about surgical site infections (SSIs) is true?

SSIs are common healthcare-associated infections Signup and view all the answers

Which practice is a part of medical asepsis?

Isolation precautions Signup and view all the answers

In what areas is antisepsis commonly practiced?

In operating rooms and burn units Signup and view all the answers

What type of procedure is best associated with Level 2 barrier protection?

Suturing Signup and view all the answers

What is the primary characteristic of Level 4 barrier protection?

Prevents all fluid penetration for up to 1 hour Signup and view all the answers

Which situation would require Level 3 barrier protection?

IV insertion Signup and view all the answers

What tests are conducted to assess barrier protection performance?

Water impact and pressurizing the material Signup and view all the answers

What kind of exposure does Level 2 barrier protection specifically guard against?

Larger amounts of fluid penetration Signup and view all the answers

Which of the following is a characteristic of the environments that require Level 3 protection?

Presence of splatter and soaking exposure Signup and view all the answers

In which level can you expect to prevent virus penetration for up to one hour?

Level 4 Signup and view all the answers

What is the key aspect of Level 1 barrier protection?

Limited to minor blood draws Signup and view all the answers

What distinguishes the critical zones of a surgical gown?

They include the fabric construction and seams in specified areas. Signup and view all the answers

Why have cotton fabrics almost disappeared from operating rooms?

They have low resistance to liquid penetration and high porosity. Signup and view all the answers

What is the required barrier performance level for the entire gown, excluding cuffs, hems, and bindings?

Level 1 Signup and view all the answers

What area of the surgical gown is referred to as the neckline?

Area C Signup and view all the answers

What material is primarily used in single-use surgical gowns?

Nonwoven materials Signup and view all the answers

Which area of the surgical gown is considered sterile?

The front exterior of the gown Signup and view all the answers

How are the operators expected to interact regarding faults that may occur?

They should point out faults in a non-threatening way. Signup and view all the answers

What is the primary advantage of tightly woven textiles for surgical gowns?

They exhibit relatively good barrier performance with water repellent finishes. Signup and view all the answers

Study Notes

Endotracheal Intubation

Involves placing a tube into the trachea
Commonly used for altered mental status, poor ventilation, and poor oxygenation
Emergency setting goal is to secure airway and achieve first-pass success
Requires teamwork
Connects to ventilator for breathing assistance

Anatomy and Physiology

Upper airway includes oral cavity, pharynx (nasopharynx, oropharynx, hypopharynx), and larynx
Warms and humidifies inspired air
Pharynx connects nasal/oral cavities to larynx and esophagus
Cricothyroid ligament: Important for emergent cricothyrotomy (emergency airway access)
Heimlich Maneuver: Used for upper airway obstruction, involving abdominal thrusts

Brief History

Early airway interventions described by Vesalius (1543)
Trendelenburg performed successful tracheal intubation in 1896

Indications and Contraindications

Indications include altered mental status/loss of consciousness, loss of airway protective reflexes, respiratory issues, and risks of pulmonary aspiration
Contraindications include severe trauma, anatomic distortions, cervical spine injuries, difficult airway access, ineffective mask ventilation, limited mouth opening, or severe kyphosis.

Equipment for Intubation

Laryngoscope (Macintosh-curved or Miller-straight)
Nasal/oral airways
Bag-valve-mask
Endotracheal tube with stylet
12-mL syringe
Yankauer suction
Bougie

Pediatric Considerations

Children's larger heads naturally place them in sniffing position, making intubation easier
Infants' large heads can result in posterior positioning of larynx
A towel under infant's shoulders should correct this

Post-Procedure Care

Important to stabilize patient's breathing before removing the tube
Visual reconfirmation of Correct tube placement (capnography)
Aspirate air from cuff before removing tube

NGT Intubation

Process of inserting a flexible plastic tube through the nose or mouth into the stomach
Diagnostic or therapeutic procedures, include removal of gastric contents, lavage, administering medications or feeding, or bowel rest

Nasogastric Tube Size and Types

Large bore (12-18F) - recommended for gastric decompression in adults
Smaller size (8-12F) suitable for medication administration, feeding, or other less demanding purposes
Pediatric patients use smaller sizes (8-10F for less demanding purposes)

Endotracheal Tube Placement Confirmation

Equal breath sounds bilaterally in chest wall
Absence of breath sounds over epigastrium
Visible condensation in endotracheal tube
Appropriate reservoir bag compliance during ventilation

Esophagogastroscopy (EGD)

Diagnostic procedure visualizing the esophagus, stomach, and duodenum
Utilizes a long, thin, flexible tube with a camera (endoscope).
Enables tissue biopsy if needed
Common procedure for evaluating upper GI issues.

Esophagus Anatomy and Physiology

Extends from cricoid cartilage to the cardiac orifice of the stomach.
Lies posterior to trachea
Ranges in diameter and length depending on patient age.

Gastric Anatomy and Physiology

Located beneath the diaphragm in the upper abdomen
Divided into sections (cardia, fundus, body, antrum, pylorus).
Cardia is the top part where the esophagus connects
Pylorus separates the stomach from the small intestine

Duodenum Anatomy and Physiology

C-shaped section of the small intestine.
Extends from the pylorus to the duodenojejunal junction.
Important part of digestive system

Proctosigmoidoscopy

Procedure to directly visualize the rectum and sigmoid colon using a flexible endoscope
Aids in early detection of colorectal cancer and diagnosis of rectal ailments.

Bowel Preparation

Procedure to cleanse the colon and rectum before examination/procedure
Uses cathartics or osmotic agents to remove solid stool
Essential for colonoscopy or other surgical procedures

Lumbar Puncture

Procedure of removing cerebrospinal fluid (CSF) from the subarachnoid space
Diagnosed for various conditions (like meningitis).
Done in lower back between lumbar bones (lumbar space), between L3-L4 or L4-L5
Procedure generally uses a long, hollow, thin needle.

Bowel Irrigation

Medical process using polyethylene glycol solution for rapid administration.
Empties the gastrointestinal tract.
Used after toxic ingestions.

Central Venous Catheterization

Insertion of a catheter into a large vein near the heart for providing long-term vascular access(like a permanent IV in chest).
Types: Triple-lumen, tunneled CVCs, Peripherally inserted central catheters (PICCs), Totally implantable ports

Subclavian Vein Technique

Subclavian vein is commonly used for CVC insertion.
Approaches include supraclavicular and infraclavicular.
Infraclavicular approach is considered safer and more comfortable for the patient
The technique benefits from clear landmarks and less risk of complications like pneumothorax, compared to other techniques.

Arterial Cannulation

Procedure of inserting a catheter into an artery for various reasons.
Commonly used approaches include the anterior and axillary approaches.
Requires proper technique and care including the use of an image guidance and proper monitoring for complications during procedures.

Wound Management

Processes of cleaning, dressing, and closure of wounds
Aims to promote healing, prevent infection, and reduce scar formation

Types of Wounds

Clean : Clean wounds are minimally infected, do not contain foreign matter and don't have significant inflammation.
Clean-contaminated : Clean-contaminated wounds have the possible entry of microorganisms from the gastrointestinal tract and respiratory, urinary, and genital tracts.
Contaminated : Contaminated wounds present extensive contamination and risk of infection.
Dirty : Dirty wounds present infection and likely devitalized tissue, requiring special attention.

Common Wound Dressings

Types: Adhesive dressings
Types: Gauze dressings
Types: Hydrogels
Types: Hydrocolloids (used for chronic wounds and burns)

Wound Closure Methods

Surgical closure - use of sutures (stitches) to close a wound
Tissue adhesives, like glue, are used for minor wounds.
Staples
Skin adhesives
Skin closure plays a critical role in wound healing and aesthetic outcomes.

Procedures for Wound Treatment

Debridement: Removal of dead/damaged tissue
Irrigation: Cleaning the wound with saline solutions
Dressing: Covering, protecting, and maintaining a healthy environment for healing
Closure: Using sutures, staples, or dressings to close the wound

Sutures and Staplers

Used to close wounded/injured tissues (or organs).
Categorized as Absorbable sutures and Non-absorbable sutures, dependent on body absorption rates
Different sutures are best suited for various cases and wound types.
Types: Simple, mattress, horizontal mattress and staplers.

Fine Needle Aspiration Biopsy

Procedure to remove a small amount of cells from a suspicious lump or mass, usually for diagnostic purposes.
Involves inserting a thin needle into the abnormal tissue and extracting cellular samples
Can be used on almost any part of the body to sample fluid or tissues.

Core Needle Biopsy

Procedure to remove a small cylindrical piece (core) of tissue from a suspicious lump or mass
Used for better assessment of its structure/tissue composition.
More detailed analysis than FNAB, usually involves a larger needle and a different procedure.

Incision and Drainage of Abscesses

An abscess is a localized collection of pus (purulent fluid) in soft tissue
I&D involves the surgical incision and drainage of the abscess to remove the pus and prevent spreading infection.
Common procedures include Hilton's method and Blairs method in abscesses.

Paracentesis

Procedure used to drain fluid (often ascites) from the peritoneal cavity
Performed as a diagnostic procedure or to relieve pressure/resolve symptoms related to ascites
Performed under local or possibly regional and general anesthesia and using ultrasound guidance.

Thoracentesis

Procedure for removing fluid from the pleural space (the space between the lungs and the chest wall)
Used primarily to diagnose or treat pleural effusions (abnormal collections of fluid in the pleural space).
The procedure involves inserting a needle into the pleural space to remove fluid under direct ultrasound guidance in patients.

Pericardiocentesis

Insertion of a needle into the pericardial space to drain excess fluid.
Performed to relieve pressure (cardiac tamponade) caused by large pericardial effusions.
Can only be performed by specially trained physicians or medical personnel.

Manual Artificial Respiration and Cardiopulmonary Resuscitation (CPR)

Methods for restoring breathing and circulation in patients who have stopped breathing or whose hearts have stopped functioning.
Techniques: Mouth-to-mouth respiration, prone pressure method, arm lift chest pressure methods
The sequence is crucial for successful resuscitation (especially the ratio for compressions and rescue breaths, 30:2).

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Description

Test your knowledge of sterilization techniques used in microbiology. This quiz covers steam sterilization, radiation methods, and the challenges associated with sterilizing various instruments. Explore various concepts related to temperature, pressure, and the implications of prions in sterilization processes.