CHS MED-RX Series 사용 지침
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페이지 인쇄CLEANING AND MAINTENANCE
A) Rinsing
Directly after surgery, rinse instruments under hot
running water, removing all body fluids and debris.
B) Disinfecting (the protection for medical personnel
from accidental contamination during cleaning)
To avoid blood and other proteins from sticking to
instrument surfaces, an enzymatic cleaner bath (soaking)
should be used on all instruments. After soaking for a
minimum of 10 minutes, rinse all instruments in running
tap water.
Immerse instruments completely in hospital approved
disinfectant for an additional 10 minutes then rinse again
under running water.
DO NOT USE BLEACH. Exposure to bleach will damage
instruments.
C) Cleaning
Instruments should be submerged in a solution of water
and neutral pH (7) detergent.
Ultrasonic Cleaning
Place instruments in an open position into the ultrasonic
cleaner. Make sure all "sharp" (i.e. scissors, knives,
blades, etc.) do not touch other instruments. All
instruments
must
be
completely
Instruments should be processed in the ultrasonic
cleaner for the full recommended cycle time, which is
typically 5‐10 minutes. A lid should cover the ultrasonic
cleaner during the operation to avoid splashing. Never
place different metals in the same cleaning cycle. For
example, stainless steel and copper, etc.
Change
solution
frequently
per
recommendations. Rinse all instruments after an
ultrasonic cleaning with water to remove the excess
cleaning solution.
Automatic Washing Sterilization
Follow all manufacturers' recommendations. Ensure all
instruments are lubricated after and before the
sterilization cycle.
Manual Cleaning
Ultrasonic cleaning is the preferred method of cleaning
and strongly recommended to ensure all dirt, debris and
are fully removed – particularly with instruments with
hinges, locks, and other moving parts. If ultrasonic
cleaning is not available, follow the below instructions.
a) Use stiff nylon cleaning brushes. Do not use steel
wool or wire brushes unless specifically recommended
for cleaning brushes for instrument‐serrated areas or on
bone files, burs or on stained areas in knurled handles.
Recommended Cleaning Procedure for Cleaning
Maintenance and Sterilization of Surgical Instruments
b) Use only neutral pH (7) detergents, low pH (acidic less
than 6 pH) detergents will cause breakdown of stainless
steel protective surface (pitting) and black staining.
Higher pH detergents (alkaline – more than 8 pH) will
cause a surface deposit of a brown stain (phosphates),
which will also interfere with a smooth operation of the
instrument. Most brown stains are not rust, but merely a
high pH surface (phosphate) deposit and can easily be
removed with a stain remover.
c) Brush delicate instruments carefully. These should be
handled separately from all other general instruments.
d) Make sure all instrument surfaces are visibly clean
and free from stains and tissue. The stain remover will
aid in the elimination of residue stains.
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Instruments – Instructions for Use
*French instructions to follow/* Mode d'emploi en français à suivre
Each instrument should be inspected for functionality
and general condition, this would include, but is not
limited to:
Forceps have properly aligned tips.
Hemostats and needle holders should not show light
between the jaws, when closed in the first ratchet
position (hemostats may show a small open space
halfway in from the closed tips), lock and unlock easily
at joints and make sure they are not too loose. Check
needle holders for wear on jaw surfaces.
Check suction tubes to ensure they are clean inside.
Ensure biopsy punches are clean by punching a hole
into tissue paper.
Check working functions of all retractors.
Make sure that all cutting instruments and knives
have sharp undamaged blades.
e) After scrubbing, rinse all instruments thoroughly
under running water. While rinsing, open and close
scissors, hemostats, needle holders and other hinged
instruments to make sure the hinged areas are rinsed
out, as well as the outside of the instruments.
D) After Cleaning
If instruments are to be stored, let them air dry then
store them in a clean and dry area.
submerged.
E) Autoclaving
Lubricate all instruments that have any "metal to metal"
action (i.e. scissors, hemostats, etc.). Non‐silicone,
water‐soluble surgical lubricants, such as spray lube is
recommended. Do not sure industrial lubricants. Put
instruments up for sterilization either individually or in
sets.
manufacturer
For Individual Instruments
Disposable paper or plastic pouches are ideal. Make sure
you use a wide enough pouch (4 inches or wider) for
instruments with ratchet locks (i.e. hemostats and
needle holders, etc.) so the instrument can be sterilized
in an open (unlocked) position. Locking instruments
during autoclaving will result in cracked hinges and other
defects because of heat expansion. If you wrap
instruments, make sure your towels do not contain
detergent residue, which can stain your instruments.
Make sure that the towels used in sterilization of
instruments have no detergent residue and are neutral
pH (7) if immersed in water. This can be a problem, as
laundries will frequently use inexpensive but high pH (9‐
13) detergents and do not properly rinse out or
neutralize those detergents in the final wash or rinse
cycle. Also, sometimes bleaches are added and are not
neutralized. Hospitals use a "sour" rinse cycle to
neutralize all detergent residue.
For Instrument Sets
Unlock all instruments and sterilize them in an open
position. Place the heavier instruments on the bottom of
the set, when two layers are required. Never lock an
instrument during autoclaving. Steam cannot penetrate
contacting surfaces and this will compromise the sterility
of the instruments. The instrument will develop cracks in
hinges (lock box) areas because of the heat expansion
during sterilization. Do not overload autoclave chambers
as pockets may form and will not permit steam to
penetrate. Place a towel on the bottom of the pan to
absorb the excess moisture during autoclaving.
CAUTION: With most portable, tabletop autoclaves, at
the end of the autoclave cycle – before drying cycle –
unlock the door and open it no more than a crack
(approximately 1/4"). Then run dry cycle for the period
recommended by the autoclave manufacturer. If the
autoclave door is opened fully before the drying cycle,
cold room air will rush into the chamber, causing
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Canadian Hospital Specialties Ltd.
condensation on the instruments. This will result in water
stains on the instruments and also cause wet packs.
Make sure the autoclave filters and chambers are
cleaned periodically. A stain remover will remove stains
and clean the autoclave chamber.
F) Cold Sterilization
Most cold sterilization solutions render instruments
sterile only after 10‐hour immersions. This prolonged
chemical action can be more detrimental to surgical
instruments than the usual 20‐minute autoclave cycle. If
the instrument needs to be, "disinfected" only, a cold
sterilization soak is okay, as disinfecting will take place in
10‐minutes or more. Check the manufacturer's
specifications. Also, see the warning sign on using bleach
(section B).
Keep in mind the difference between:
STERILE – No living microorganisms
DISINFECTED – Kills most but not all microorganisms
CAUTION: For instruments with Tungsten Carbide inserts
(hemostats, scissors, needle holders – also identified by
a gold handle), we do not recommend cold sterilization
or solutions containing Benzyl Ammonium Chloride,
which will deteriorate the Tungsten Carbide, inserts.
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