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Chapter 14 Surgical Room Skills 269

FIGURE 14.30 Autoclave indicator strips.

through the autoclave. The minimum requirement for
sterilization is 15 psi of pressure, for 15 minutes at 250 F.
o
Thicker packages will take more time for the pressure
and temperature to penetrate to the center of the pack.
It will also make a difference if you pack the autoclave
tightly. Leaving a bit of space around each pack will
ensure that the pressure and temperature get to the
center of each item. If your test pack indicators come out
lighter in color, you may have to increase the time to
achieve sterilization. Remember to place the indicators
in the middle of the packs to be sure the entire package
has been sterilized.

Reflection

Discuss the differences between autoclave tape
and autoclave sterilization indicators, include
what they tell you and how they should be used.

Cold Sterilization
FIGURE 14.31 Cold sterilization trays and transfer forceps.
Some clinics like to put their sharp instruments, like
scissors and needles, into cold sterilization solutions. completely at least once a week and if they are contami-
Some clinics will also use cold sterilization for extra instru- nated. In the background of Figure 14.31 you can see a
ments in case one is dropped or contaminated during a transfer forceps. This allows non‐sterile personnel to
surgery. The cold sterilization solutions vary but most are supply an instrument without touching the solution.
quaternary ammonia compounds and are time sensitive Some clinics may use gas sterilization for items that
to achieve sterilization, often up to or over 24 hours of may be damaged in the autoclave. This method of steril-
exposure. The instruments are cleaned and rinsed in the ization utilizes ethylene oxide gas. This is an extremely
same manner but are not lubricated. The instruments are toxic gas and must be handled with care. Items that are
then immersed in special containers that have trays that sterilized in this manner need to be “aired” for 12–24
can be lifted out of the solution without touching it with hours before use, so usually they are sterilized well in
your bare hands (Figure 14.31). This is important as most advance of being required. They too have a type of ster-
of these cold sterilization solutions are deactivated by ilization indicator and often the individual packaging
organic material and time. They should be changed out will have a strip on it that will turn pink when exposed to