What is the difference between critical and semi-critical instruments?
Reply: Critical instruments are referred to those instruments that are in contact with sterile tissues of the body but semi-critical instruments are the instruments that contact mucus and damaged skin. It is realized from these definitions that critical instruments are more sensitive and therefore need stronger decontamination,process. Thus, they should be made sterile (after cleaning procedures) and semi-critical instruments should be in the category of high-level disinfection.
To what category (Critical or semi-critical) does Laryngoscope belong?
Reply: Laryngoscope’s fiber optic, depending on its use could be classified as critical or semi-critical. If it is used for tissue sampling, it is critical and should be sterilized and in case its use is only for opening breathing way, it should be disinfected high-level.
How is the correct process for surgical scrub?
Reply: Surgical scrub steps are as follows:
  • Fingernails should be cut short and no artificial fingernail should be used.
  • Nail polish should be wiped.
  • All jewelries and hand watch should be taken off.
  • First wash your hands completely (fingertips, wrists, forearms up to elbow) with water and soap to eliminate any visible contamination (It is not necessary to do so between surgery procedures unless visible contaminations are observed).
  • Clean under your fingernails with a brush that is disposable or capable of being used in autoclave. Brushing is only necessary for the first scrub of the day and it is not required for steps between surgery procedures.
  • After above steps first dry your hands by a clean cloth (not necessarily sterile) or paper tissues and rub your hands with alcoholic hand solutions. Hand rubbing should be done three times from fingertips up to elbows and 3-5 ml of the solutions should be applied every time. The whole duration for this step is 3 to 5 minutes.
  • Hands should not be wet or moist. Then, make use of sterile, suitable hand coverings.
What types of solutions should be used for endoscopes?
Reply: Endoscopes fall in semi-critical instrument category and thus should be disinfected high-level. High-level disinfecting solutions should hence be applied to them. Glutaraldehyde-, peracetic acid-, and hydrogen peroxide-based solutions are useful for this purpose.
What properties should a good hand disinfectant have?
Reply: Alcoholic hand disinfectants are the best solutions in health-care centers. However, such disinfectants should be in a way that is most effective and least harmful. Propanol-based solutions are the best. On the other hand, emollients and moisturizers should also be used in such alcoholic solutions (their amount should not exceed an allowed quantity). In addition, these solutions should have two specified standards, i.e. EN 1500 and EN 12791. The first indicates that the alcoholic product can be used for hand disinfection at health-care settings and the second standard allows its use for surgical scrub in operation rooms.
How long should hand-rub and hand-wash processes last?
Reply: Appropriate duration for alcoholic hand-rub is 20 to 30 seconds while hand wash should last for 40 to 60 seconds.
What are high- and intermediate-level disinfectants? (Give some examples)
Reply: High-level disinfection pertains to those solutions that are known to have sporicidal activity (not necessarily completely) and, those solutions that are not sporicidal but have tuberculocidal property (TB-cidal) are called intermediate-level. High-level examples are solutions based on glutaraldehyde, formaldehyde (which are not used anymore), peracetic acid, hydrogen peroxide, and some other compounds. Alcohol-, Quaternary ammonium compounds-, chlorine-, and iodide-based solutions have intermediate-level disinfection activity. 54 SPORCIDE and HLDPA solutions are high-level whereas 53 PLUS, decosept, and 53 INSTRUMENT are intermediate-level.