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CNOR 2024 Zander Notes Questions And Answers With Latest Solutions

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What is the dose and preparation of Dantrolene? - ** 2.5mg/kg ** 2-3mg/kg - Mix with PF STERILE WATER ONLY - Pull 60ml PF Sterile water out, add to Dantrolene vial - Pull back out of vial and administer Decontamination processes - -Disassemble everything -Brush lumens/channels using a brush ba...

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  • September 16, 2024
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  • 2024/2025
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  • CNOR 2024 Zander Notes
  • CNOR 2024 Zander Notes
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CNOR 2024 Zander Notes
What is the dose and preparation of Dantrolene? - ** 2.5mg/kg ** 2-3mg/kg



- Mix with PF STERILE WATER ONLY



- Pull 60ml PF Sterile water out, add to Dantrolene vial

- Pull back out of vial and administer



Decontamination processes - -Disassemble everything

-Brush lumens/channels using a brush based on mfr instruction for correct diameter and length of lumen

-Brush lumens/channels/crevices/joints UNDER WATER

-Automated (washers/ultrasonic) more effective than manual cleaning.



Meaning of Non Critical Spaulding Classification System - -Will be in contact with INTACT SKIN

-Intermediate or Low Level Disinfection or Cleaning.

-Disinfect with an FDA approved disinfectant that's effective against HEP B.




Meaning of Critical Spaulding Classification System - Items MUST be sterile.

Items will enter -sterile tissue- or -vascular system-



Examples of items in Critical Spaulding Classification System - -Instruments-

-Laparoscopes- -Arthroscopes-

-*Cutting endoscope accessories for biopsy*-

-Cardiac Caths-

-IV caths- - Needles-

-*Urinary Caths-

,Meaning of Semi-Critical Spaulding Classification System - Items SHOULD be sterile.

Items will contact -broken skin- or -MM-



If the manufacturers instructions say it WON'T tolerate sterilization, they CAN be HLD (but only IF MF
SAYS).

-Spores survive HLD-



Examples of items in Semi-Critical Spaulding Classification System - -Bronchoscopes

-GI Scopes/GI endoscopes

-RT equipment (laryngoscope blades)

-Anesthesia equipment




Examples of items in Non Critical Spaulding Classification System - -Furniture

-Laundry/Linens

-OR bed

-BP Cuff/Leads/Monitors/Stethoscopes

-Tourniquets



Name the 3 Spaulding Classification Systems - Critical

Semi-Critical

Non-Critical



Requirement for decontamination area: - -Must have a physical WALL or SEPARATION between
decontam and processing areas.

-This includes Immediate Use Areas.

-Why: Because decontam requires NEGATIVE PRESSURE

,Sterile Processing Workflow - Decontamination (always 1st) --> Prep&Pack -->Sterilization

-->Distribute/Store



Most important step to prevent infection: - Cleaning and Pre-treating with a non-drying enzymatic
solution in order to avoid biofilm, which encapsulates spores.




Two Types of Steam Sterilization - -Pre-Vac Autoclave/Dynamic Air Removal

-Gravity Displacement



PreVac settings - 270-276



3 min (NON porous instruments/regular instruments)



4 min (POROUS or LUMEN instruments, heavy plastic, rubber, wooden handles, poole suction)



PreVac/Dynamic Air Removal setting for porous (heavy plastic, rubber, wood handels) or lumen
instruments (poole suction/channels) - 270-276 for 4 min



PreVac/Dynamic Air Removal setting for Non Porous instruments - 270-276 for 3 min



How does PreVac/Dynamic Air Removal autoclave work? - -Sucks air out of chamber with a
VACCUM then steam is released and snaps down onto inst/trays.

-DRAINS MUST BE CLEAN

-Most common. Most effective.



Gravity Displacement Autoclave settings - 270-276



3 min: NonPorous/reg instruments

, 10 min: Porous/Lumens



Gravity Displacement autoclave settings for porous/lumens - 270-276 10 min



Gravity Displacement autoclave settings for NonPorous/reg inst - 270-276 3 min



How does Gravity Displacement autoclave work? - Steam pushes air down to a thermometer in
the drain, the air exits the chamber, drain closes, cycle starts.



-Not great for trays or packages.



-Rarely used.



Both PreVac/Dynamic Air Removal and Gravity time and temperature requirements are for the
instrument and autoclave only.

For certain containers/systems such as One Tray system or containers with lids: - I will follow the
manufacturers instructions!



3 ways to avoid condensation with steam sterilization items: - - Allow airflow between trays and
pkgs and all the way around.

-Remove loads immediately (don't crack the door to cool).

-Don't place items on cooling racks or solid surfaces (can place on lined surfaces).



How many classes of Chemical Integrators? - 6



What kind of chemical integrators react to heat? - Class 1 Chemical Indicator

-Reacts to HEAT only. Verifies exposure only.

-Tape-Locks-Filter dots

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