Question

Dr. McKinney scheduled a craniotomy for biopsy of possible Creutzfeldt-Jacob Disease. The patient has a history of having lived in the United KIngdom for 5 years prior to his return to the UNited States 10 years ago. His current mental status is declining and he is no longer ambulatory.

1)How will the instruments used be handled post-operatively?

2) How is the room cleaned post-operatively?

Answer 1

Decontamination od instruments

Use one of the following method to reprocess heat-resistant instruments

1.Immerse in a pan containing 1N sodium hydroxide (NaOH) and heat in a gravity displacement autoclave at 121°C for 30 min; clean; rinse in water; and subject to routine sterilization.

2.Immerse in 1N NaOH or sodium hypochlorite (20,000 ppm available chlorine) for 1 hour; transfer instruments to water; heat in a gravity displacement autoclave at 121°C for 1 hour; clean; and subject to routine sterilization.

3.Immerse in 1N NaOH or sodium hypochlorite (20,000 ppm available chlorine) for 1 hour; remove and rinse in water, and then transfer to open pan and heat in a gravity displacement (121°C) or porous load (134°C) autoclave for 1 hour; clean; and subject to routine sterilization.

All instruments contaminated with higher-infectivity tissue (eg.brain) should be immersed in sterile water in a special container after surgery and it will prevent drying prior to reprocessing.

Heat-sensitive Instruments or Materials can be decontaminated by

• Flooding with or soaking in 2N NaOH or undiluted sodium hypochlorite for 1 hour and rinsed with water.

Post-operatively, the room is cleaned by

• Exposing area with freshly prepared solution (1M sodium hydroxide (NaOH) or 20,000ppm (free chlorine) sodium hypochlorite) for 1 hour and then rinse with water.
• Surfaces that cannot tolerate NaOH or sodium hypochlorite should be cleaned using anionic detergent.E.g.Sodium n-dodecyl benzene sulphonate and Sodium Lauryl Sulphate.