Treatment of dirty treatment tray - Aftercare and maintenance
Treatment of dirty treatment tray
Work safely and use sturdy disposable gloves (for example Biogel®) when cleaning the trays, but in any case always when washing (if applicable)!
A Approved needle container. B Using an approved needle container, remove the needle from the anesthetic syringe
A Safely remove scalpel blade. B The Quicksmart: a handy device to safely remove scalpel blades
Instruments loaded in thermodesinfector
Clean treatment tray
- Deposit sharp objects in containers, if not already in the treatment room. Note that it must always be traceable for which patient the relevant tray has been used, because that is of great importance in the case of a puncture incident. For logistics it is useful to provide instruments with a ring with a certain color, so that it can be traced from which treatment room they originate.
Work safely with an approved container or device for sharp waste.
Always remove scalpel blades with tweezers from the handle.
Preferably use disposable scalpel blades.
- Put all the voluminous waste in the hands-free refuse bin.
- Instruments and tools from category C (not critical) are laid separately for further processing. Prints are also placed separately for disinfection as well as the used dynamic instruments.
- Place all hand instruments in the thermodisinfector for cleaning and disinfection.
- Collect all the 'small stuff', such as small drills and endoviles (small sizes, end sleeves up to and including thickness 20), disposing of extrusion needles and lentilone needles after use). Remove visible contamination with a drilling brush. Place it in order. Drill the brush daily in 80% alcohol.
A Wire baskets for small objects. B Drill brush for removing visible contamination on drill bits. c Drilling blocks start drilling and already in the thermodisinfector
- Remove the remaining small disposables including traypaper or disposable insert and also place the tray itself in the thermodisinfector.
Load thermodesinfector with stainless steel treatment trays
Dispose of thermodesinfector
The use of a thermodesinfector is part of the preferred route.
A large number of points for attention when cleaning up the thermodisinfector require:
- When cleaning in, make sure that the water from the sprinklers has to be able to reach everywhere. Instrument racks with a partly closed bottom cause a so-called bobbin shade. Therefore, no effective parts of instruments can be placed just above the closed bottom.
Load thermodesinfector with stainless steel treatment trays
Rinse shadow can also be caused by stacking, for example, instrument cassettes or cleaning trays in the thermodisinfector without the use of the appropriate inserts.
2. Suction pipes must be placed on the specially designed attachments to clean the inside. If this device is not present in the thermodisinfector then place the extraction tubes upright in every case!
Suction tubes correctly placed on attachments
3. Aluminum treatment trays and aluminum drill bits can not enter the thermodisinfector due to deterioration of the detergent. Chromed or steel instruments also cause problems due to rust formation. Always consult the product sheet of the used agents before cleaning various materials in the thermodisinfector.
In principle, only stainless steel and plastic materials are suitable for thermal disinfection.
4. The thermodisinfector must not be too full, because then the cleaning and disinfection are insufficiently guaranteed.
5. Pliers, scissors and tweezers must be open for proper cleaning.
6. The program button should preferably be set to vario-TD. (Also read the study material!) This program is first rinsed, then cleaned with new water with soap at 45° C and finally with the last (clean) rinsing water the required high temperature for thermal disinfection is reached.
Cleaning at low temperatures has the advantage that existing blood residues on instruments and materials can not burn. Blood residues will frequently, if not almost always, be present on dental instruments.
Note that with existing settings it is not possible to change programs just like that. Always consult the manufacturer of your thermodesinfector before changing programs.
7. The used soap can be added as a powder or in liquid form from a connected automatic dosing system. Liquid soap is preferred because the distribution takes place quickly and evenly. With powder, a lot of time is needed before the whole is dissolved (can last up to 15 minutes!) And that makes the cleaning unreliable than with liquid soap.
The dosing of powder is also 'people's work' and not reproducible. Liquid agents are dosed in a controlled manner by the vending machine and are therefore reproducible, making the process reliable.
8. There can never be a change of program just like that. The manufacturer must always be consulted first. The 93-10 program is often set for older vending machines and powder dosing. At new vending machines the vario-TD.
Preference setting, read the floor material!
Advice is: if there are no problems or complaints, programs will not be changed or modified.
For a machine with rotary knob programming to know which preference setting has ever been entered when the machine is installed, the display on the display when the additional neutralizing program is switched on offers a solution:
- appears 45, then the machine runs an adjusted vario TD run;
- If 93 appears on the display when A is switched on, then the acid supplemented Special 93-10 program is run under that program. In the thermodisinfectors with liquid soap installation, a mild acid (citric acid) is used, so that acid can be added to each run automatically, without instruments and materials suffering too much from the acid.
In that case, the additional neutralizing program will never have to be run temporarily separately, because the machine and the instruments can never strike, rust or discolour.
It is possible that programs are disabled. Then the foregoing does not apply. A point appears in the display.
9. When using soap powder and the subsequent manual addition of this detergent, the following must be known:
- For the Special 93-10 program, the powder must be applied on the inside of the door according to the manufacturer's instructions, because cleaning and disinfecting are carried out without separate pre-flushing with the first ingested water at high temperature.
- With the vario TD program soap powder should never be deposited loose in the machine (on the inside of the door), because it will then wash away during the pre-wash and then be cleaned without soap powder...
So put the soap powder in the soap dish and close it well. The machine opens it automatically at the right time.
Note: the upper basket must have a recess to open the lid of the soap dish. Older machines have upper racks that offer no room for this.
In these cases, a new top rack can be purchased or the Special 93-10 program is maintained.
There is always a possibility to switch to liquid dosing by purchasing a dosing pump. This must of course be profitable compared to the age and condition of the machine.
To go through the second choice route, the following steps apply:
- Put on sturdy disposable gloves.
- Place the instruments in the handle basket in the ultrasonic cleaning device. The instruments must be completely submerged and there must not be any instruments against the bottom, because this will considerably shorten the life of the device! For thin hollow instruments, when they are vibrated lying down in the ultrasonic cleaning device, the dirt can not escape. Preferably, such objects must be vibrated upright in a rack. Note: rubber and soft plastic absorb the ultrasonic vibrations, so that they are not sufficiently cleaned. Also, due to the reduced vibration, all the other instruments will be insufficiently vibrated effectively.
- Place the lid on the ultrasonic cleaning device to prevent aerosol formation in the sterilization area. Vibration time is at least 20 minutes at room temperature or 3 minutes at 45 ° C. (Warmer is not allowed due to the denaturation of proteins.) The addition of a disinfectant to the ultrasonic cleaning device can also considerably reduce the basic vibrations. Ultrasonic equipment is only intended for cleaning! For example, for drills, hollow and hinged instruments that are difficult to clean in a thermodesinfector. After that, disinfection of the instruments must always be followed separately.
- Put the instruments in a container (with loose colander-like insert), which is filled with disinfectant; use the ultrasonic cleaning device according to the manufacturer's instructions.
- After at least 20 minutes, take the instrument insert and hold it under the tap to wash away the remains of the disinfectant and coarse dirt.
- Next, deposit the instruments handsfree in a dishwashing machine with clean rinsing water by turning the basket.
- Now inspect the instruments for contamination such as cement residues or other debris. Clean with a (nail) brush and reinsert the relevant instrument in the bin with disinfectant (duration according to the manufacturer's instructions) and then inspect the location that was under the contamination. Then rinse well again.
- Dry the instruments and arrange them in autoclave racks. Not too much on a rack, because the steam must be able to reach all surfaces. Re-usable extraction tubes require extra attention in the absence of a thermodesinfector. Sometimes, unfortunately, an ultrasonic cleaning device is also missing... Just 'soaking' in a container with disinfectant, rinsing and subsequent autoclaving is absolutely insufficient to recondition the inside of these extraction tubes! The inside of the exhaust pipes must be cleaned with a well-fitting brush after disinfection.
- Process the empty treatment trays by treating them with alcohol-free disinfectant that is applied in the form of foam. Rinse with a solid instrument tissue soaked in disinfectant and allow to air dry. Second possibility is cleaning them with an instrument tissue and disinfecting them by immersing them for 10 minutes in 80% alcohol.
Process instruments from category C
- Wash mixers and mixers with hot soapy water until all of the media has disappeared.
- Disinfect spatulas, mixing cups, cofferdam goose tongs and, for example, orthotangen, preferably in the thermodisinfector! Thermal disinfection always goes beyond chemical disinfection. So: everything that can do in the thermodisinfector has to be!
- If materials from category C are not sufficiently heat-resistant or so large that the capacity of the thermodisinfector for other instruments is compromised, then chemical disinfection is chosen by immersing them in an 80% sealed container with alcohol.
- Leave for 10 minutes.
- Put on clean gloves and take the stuff out of the alcohol. Place them on the worktop on the clean side of the sterilization area and allow the alcohol to evaporate in the air
Category C: second choice: chemical disinfection by immersing for 10 minutes in alcohol 80%