Spaulding Classification, Autoclave Sterilization, Chemical Indicators, Debris Removal, And Safety Data Sheets

In your own words, describe the Spaulding classification.  List and describe the three categories as devised by Spaulding as well as the level of risk, application, and processes associated with each category.List at least three examples each of critical, non-critical, and semi critical items that you use in the dental surgery.

List how used items are prepared for strerilisation in an autoclave.  Your response should include preparation of critical and semi-critical instruments using trays and/or cassettes and batch control identification measures.   Be sure to provide the required BCI information that is recorded for each cycle as well as the importance of accurate record keeping.  

There is a range of chemical indicators that can be stored inside packages or attached to the outside of the wrapped package prior to sterilisation.  What are chemical indicators?  List and describe the intended uses for the six chemical indicator types.  

List three possible reasons why a pouch that has just been removed from a completed autoclave tray would be considered unsterile and needs to be reprocessed.  In the event of the autoclave not functioning within regulation, how and to whom would you report and document the fault/malfunction

Explain why you need to completely remove all blood, saliva, and other debris from instruments before sterilisation can take effect.  Describe the methods that may be used in removing all debris prior to sterilisation, including the advantages and disadvantages of each.  Which method/s lessen the chance of contamination via aerosol or splatter

There are many different types of chemical waste produced at the dental workspace.  These vary between types of equipment and specific cleaning product in use.  Safety Data Sheets should be always be referred to when assessing risks.  What information do SDS sheets contain.

Understanding Spaulding Classification

Spaulding Classification system is given by Dr.E.H. The medical devices are divided into categories which are based on the risk of infection involved with their use. The three categories which are based on device usage are :

1) Critical Items:  It covers a high risk of infection if they are entering the vascular system so it should be sterile because any microbial contamination can be a cause of transmit diseases. It includes the medical devices like implants, Invasive catheters or any device that touch sterile body cavities.

2) Semi Critical Items: The items contact non intact skin. Metabolic process, medical cares, medical instrument blades, Body part are included in this process. These devices are free from mucous membrane. These items need high level medical care to make chemical disinfectants.

3) Non critical items: This device only touches or focus on intact skin and not on mucous membrane and it does not directly touch the patient.critical Items: The examples of critical items are

1. a)  Forceps: It is used for holding and grasping the object. It is used when fingers are large to grasp small objects and also when there are many objects to be handled at the same time. Forceps is used mainly in medical field.
2. b) Scalpels: It is small in size and a sharp bladed instrument which is used for surgery and for many art and crafts.
3. c) Bone Chisels: It is an instrument which is used to cut or remove bones. It is an instrument with the feature to cut the edge of the blade for cutting. These items should be sterilized on daily use by steam under pressure, dry heat.

2) Semi critical items:  It is an instrument which do not enter in soft tissues like :

1. a) Dental mouth Mirror: It is the main instrument which is used by dentist. The head of the mirror is small and round. The mirror comes in many sizes which are used by dentist. This mirror helps to reflect light where the lightning is difficult.
2. b) Amalgam condensers: It is an instrument which is used for compact the silver amalgam, used for restoring teeth to a natural contour.
3. c) Dental handpieces: It is a surgical instrument which is used at the time of operation.  Used in the operation middle ear, dissecting bone etc.

3) Non critical items: It is an instrument that only comes in contact with intact skin.

1. a) Blood pressure:   It is  machine that is used to measure the high and low blood pressure of the human body
2. b) Stethoscope:  It is a medical device which is used to listens internal sound of human body.
3. c) Hospital beds and furniture: It is used in the hospital to give separate place to the patients.

The used items is prepared by using sterilization techniques using saturated steam under hot air it is the most reliable and useful method. By this all the bacteria, fungi are inactivated. The tray and cassettes should be used in date order with the oldest date item. It should be kept clean to prevent contamination and should only store sterilised instruments only. There is a particular way by which cassettes are wrapped. The instrument needs to be wrapped properly. If the packing of instrument is not done properly then it is not done

the equipment has not been fully sterilised. Correct packing should be that only a single layer of tray on each rack should be there. The autoclave should not be overfilled and also to arrange the item in such a way that the steam can fully circulate easily. Also the instruction of manufacturer should be followed. Accurate records supports clinically to solve the record effectively. If accurate record keeping takes place it can be easy to take decisions. 

Chemical indicator is a substance that gives visibility by change in colour or by concentration of chemical species like an acid in a solution. Methyl yellow is the example of this. It imparts the yellow colour to a solution of alkaline. The change in colour takes places in the process.

Preparation of Used Items for Sterilization in an Autoclave

1) It provides maximum use of product and also the item is used to its effectively.

2) It gives security that the package is sealed and the item is secure to use. It gives sense of security that the item it safe to use.

3) It performs as a reliable item to use and also a reliable barrier to microorganisms.

4) It allows the air to be completely removed from the product.

5) It does not degrade easily when sterile packages are stored.

6) It also removes the sterilizing agent at the end of the process.

) The strip which was sterile did not change its colour like the user did not remember to place it in the pouch.

2) The air entered the bag because the bag was not sealed properly so the contents of the bag got unsterile.

3) During the entire process the sharp object or item punctured a hole in the pouch. It is important to double pouch the heavy instruments so if any damage or tear happens in the bag it can only affect the inner area of the bag. So that it is assumed that the pouch is properly sealed.

The report should be given to the supervisor immediately and also to doctors and surgical techs. In writing and with date and time document the malfunction. You should also give a Cleaning can precede all the disinfection. If blood, saliva and other debris is not removed it will give interference in microbial inactivation and can compromise the sterilization process. It reduces bio burden and also if all these are not removed then microbes can survive the sterilization process.

The method which can be used to remove all the debris are Rinsing Rinse the instrument under hot water by this all the debris can be removed. If there is proper rinsing of the instrument then debris can be removed easily without any struggle. Advantage can be that all the debris can be removed easily with easy process and the disadvantage is that in small amount the infection remains in the instrument.

By screening and analyzing the patient before conducting the dental surgery can lessen the contamination via aerosol or splatter and also dentist should maintain personal and health hygiene by using gloves, face mask.

Safety data sheet is the most important component of safety and health. Its format can vary from source to source within country. It is used for the information on chemicals and mixtures of chemicals. It covers the instructions for safe use and hazards which are related with a particular product. It contain the information hazards like fire, health and environmental. It also covers the methods that how to work safely with chemical products. It is a plan for safety and development of complete health structure. There are number of information   that is present in Sds sheets. It covers the information about the products or items that are considered as hazardous substance or dangerous goods. It include the information about the product, Physical data, First aid measures, Preventive measures,  explosion or Fire hazard data, Reactivity data in which the information is of chemical. 

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