The antiseptic used for disinfection or sterilization of instruments in O.T. that cannot be disinfected by au… - NHM UP Staff Nurse - 2019

NHM UP Staff Nurse - 2019

Applied Microbiology & Infection control

Easy

Appeared in: NHM UP Staff Nurse - 2019

Explanation

Cidex is a trade name for a solution containing glutaraldehyde, a high-level disinfectant capable of chemical sterilization.
It is the standard choice for instruments that are sensitive to the high heat and pressure of autoclaving, such as flexible endoscopes, cameras, and certain plastic or rubber items.
Glutaraldehyde works by denaturing proteins in microorganisms, including tough bacterial spores, although achieving a sporicidal effect (sterilization) requires a prolonged immersion time of several hours.
The process of using chemical agents to sterilize equipment is often referred to as 'cold sterilization'.

Option A: Savlon contains chlorhexidine and cetrimide. It is an antiseptic intended for topical use on skin for wound cleaning and is not strong enough or formulated for sterilizing surgical instruments.
Option B: Sodium chloride is sterile saline. It is an isotonic solution used for cleaning, irrigation, and as a vehicle for medications. It has no antimicrobial or disinfectant properties.
Option D: Phenol (carbolic acid) is a powerful, corrosive disinfectant used for environmental surfaces like floors and laboratory benches. It is too toxic and damaging to be used on medical instruments that come into contact with patients.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Chemical sterilization for heat-sensitive medical instruments as background academic context rather than a clinical decision trigger.
Proper sterilization of medical equipment is a cornerstone of infection control, directly preventing healthcare-associated infections (HAIs). Using the wrong method can lead to instrument damage or, more critically, patient infection.
Nurses must be vigilant about the contact time required for Cidex. A shorter time provides high-level disinfection, while a much longer time is needed for sterilization. This distinction is critical based on the instrument's intended use (e.g., entering sterile vs. non-sterile body cavities).
What if the instrument was a simple stainless steel hemostat? In that case, autoclaving (steam sterilization) would be the preferred method as it is faster, cheaper, more reliable, and does not leave toxic residues. Cidex is reserved for when heat cannot be used.

How to Approach the Question

First, analyze the question to identify the key requirements. The keywords are 'sterilization', 'instruments', and crucially, 'cannot be disinfected by autoclave'.
This immediately tells you the answer must be a method of 'cold sterilization' or chemical sterilization suitable for heat-sensitive items.
Next, evaluate each option based on its primary clinical application.
Eliminate Sodium chloride, as it's saline for irrigation, not disinfection.
Eliminate Savlon, recognizing it as a skin antiseptic, not an instrument sterilant.
Eliminate Phenol, recalling it's a harsh environmental disinfectant, not for delicate medical instruments.

Concept Tested & Keywords

Concept Tested: Chemical sterilization for heat-sensitive medical instruments
Stem keywords: antiseptic, disinfection, sterilization, instruments, O.T., cannot be autoclaved
Lead-in keywords: The antiseptic used for
Negative lead-in flag: false

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E6 Pharmacology Katzung 16e p. 1395-1397

E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart A (pp 26-201 of 604) pp. 128-130, 127-129