Which antiseptic is used for disinfection or sterilization of instruments in the O.T. that cannot be disinfected by autoclave?

Appeared in: HSSC Staff Nurse - 2015

Explanation

Cidex is a brand name for a glutaraldehyde-based solution, which is a high-level disinfectant and chemical sterilant.
It is specifically designed for medical instruments that are sensitive to heat and would be damaged by the high temperatures of an autoclave, such as flexible endoscopes.
Glutaraldehyde works by alkylating essential components of microorganisms, including proteins and nucleic acids, leading to their death.
Depending on the immersion time, it can achieve either high-level disinfection (killing most microbes) or complete sterilization (killing all microbes, including spores).

Option A: Savlon is an antiseptic containing chlorhexidine and cetrimide, intended for topical use on skin and for first aid. It is not potent enough to sterilize surgical instruments.
Option B: Sodium chloride is normal saline, an isotonic solution. It is used for cleaning and irrigation but has no antimicrobial or disinfectant properties.
Option D: Phenol is a corrosive chemical used as a surface disinfectant for things like floors and countertops. It is too harsh and toxic for disinfecting delicate medical instruments.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Chemical sterilization and high-level disinfection of heat-sensitive medical instruments as background academic context rather than a clinical decision trigger.
Correctly identifying and using the appropriate level of decontamination is a fundamental patient safety responsibility for nurses to prevent healthcare-associated infections (HAIs).
Nurses handling chemical sterilants like Cidex must be trained in safety protocols, including the use of PPE and ensuring adequate ventilation, to protect themselves from exposure to toxic fumes.
Failure to properly pre-clean, immerse, or rinse instruments can lead to disinfection failure and patient harm.

How to Approach the Question

First, identify the core requirement of the question: finding a disinfectant for instruments that 'cannot be disinfected by autoclave'.
This key phrase tells you the instruments are heat-sensitive, so you must look for a chemical method of high-level disinfection or sterilization.
Next, evaluate each option based on its primary use in a clinical setting.
Eliminate Savlon, as it is a skin antiseptic.
Eliminate Sodium chloride, as it is saline for irrigation and has no germicidal properties.
Eliminate Phenol, as it is a harsh surface disinfectant, not suitable for instruments.

Concept Tested & Keywords

Concept Tested: Chemical sterilization and high-level disinfection of heat-sensitive medical instruments.
Stem keywords: antiseptic, disinfection, sterilization, instruments, O.T., cannot be disinfected by autoclave
Lead-in keywords: Which
Clinical cues: The phrase 'cannot be disinfected by autoclave' is the key clinical cue, indicating the need for a low-temperature sterilization or disinfection method for heat-sensitive equipment.

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E6 Pharmacology Katzung 16e p. 1396-1398

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

Practise the full HSSC Staff Nurse - 2015

Attempt every question from this paper in a timed mock, then review the full solution for each one.