Infection Control Manual, Guidelines

Sterilization Guidelines
	Introduction
	Equipment Classification
	Levels of Disinfection
	Cleaning/Reprocessing of GI Endoscopes
	Glutaraldehyde
	Methods of Sterilization and Disinfection

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Yale New Haven Hospital
QISS
GB 325
New Haven, CT
06504 USA

Dr. Jeff Topal
688-4634


Equipment Classification, pg2

2) Determine the level of disinfection which is indicated:

Instruments	Level of Disinfection	Procedure
CLASS I - CRITICAL All invasive instruments (e.g., surgical instruments, IV catheters, implanted devices, etc.)	Sterility required	Moist heat, dry heat, or ethylene oxide.
CLASS II - SEMI-CRITICAL. All instruments which contact mucous membranes (e.g., endoscopes, airways, anesthesia masks, etc).	High level disinfection required between patients.	Moist heat, 100 C for 30 min.; aqueous 2% glutaraldehyde for 30-40 mins.; 1:10 dilution of bleach for 20 mins. A sterile water rinse after disinfection is required to prevent contamination from tap water.
CLASS III - NON-CRITICAL	Low level required	Chemical disinfectants include ethyl or isopropyl alcohol (70-90%), phenolic disinfectant solutions, iodophors and quartenernary ammonium compounds. An exposure (contact) time of at least 10 mins. is required.

3) Prior to disinfection a thorough mechanical cleansing with enzymatic cleanser is required.

4) Following the disinfection process the item must be thoroughly rinsed with sterile water and dried aseptically.

5) When using a disinfectant agent for reprocessing of medical devices/instruments, the manufacturer's instructions for dilution, activation, temperature, contact time, and appropriate use must be strictly followed.

Last modified: March 12, 2001.