Notes

Autoclave
Sterilization is the highest level of asepsis, killing all microorganisms, including viruses and spores. Sterilization is used on instruments and equipment, not on people. The most common piece of equipment used for sterilization in a medical office is an autoclave. The autoclave uses pressurized steam to kill microorganisms. In an autoclave, there is under 15 pounds of pressure per square inch and the boiling point of water increases from 212°F (100°C) to 250°F (121°C). At this temperature, items can be sterilized in 15 to 30 minutes
The sterilization of equipment and instruments is highly regulated and requires extensive training and documentation. It is performed by properly trained staff.

Wrapping Items
Items must be wrapped before autoclaving to maintain their sterility afterward. More specifically, after autoclaving, the outer wrapper of a package is considered contaminated while the item inside remains sterile. Items must be wrapped firmly so as to prevent movement but not so tightly as to prevent steam from circulating around them. Items may be wrapped in the materials below.
-Muslin is a cloth wrap. It has the benefit of being economical. On the other hand, the content of a package cannot be viewed, and the muslin must be laundered and inspected for tears and deterioration.
-Autoclave paper is disposable. Like muslin, though, the content of a package cannot be viewed.
-Autoclave bags are easy to use because items do not have to be wrapped. Autoclave bags are also disposable. In addition, some
bags are made of plastic, so the content of a package is visible. Autoclave bags, however, are expensive.
Items may be double-wrapped. In other words, they are wrapped and then they are wrapped again, creating a package inside a package. This results in additional supplies and labor, but it provides more protection.

Sterility Indicators
Sterility indicators are used to ensure that items have been sterilized properly. They are chemically-treated strips that change appearance when exposed to the high temperature of an autoclave for a specific amount of time. Sterility indicators are placed in the center of a wrapped package.

Autoclave Tape
Autoclave tape is used to seal wrapped items before autoclaving. It has chemically-treated stripes that change color when exposed to a high temperature. It is important to note that a change in color does not ensure that an item is sterile, only that it has been inside a heated autoclave.

Labeling Items
Items wrapped for autoclaving must be labeled properly. This includes the name of the item in the package, the date of sterilization, and the initials of the person who performed the sterilization. Labeling should be done on autoclave tape. Autoclave bags usually have a specific place for labeling. Labels should be written with a permanent marker, and care must be taken to not puncture the package. Sterilized items remain sterile for 30 days.

Loading Items
Items must be loaded properly in an autoclave so that steam can circulate and penetrate them. There must be space between the items as well as between the items and the sides and top of the autoclave. In addition, items should be placed on their sides. This is especially important for jars and bowls.

Cleaning Autoclave
Autoclaves must be cleaned according to the manufacturer's instructions. Light cleaning should be done daily. The inside and outside of an autoclave should be washed with cloth and mild detergent. Heavier cleaning should be done weekly or monthly, depending on how often the autoclave is used. The autoclave should be drained of water, filled with a cleaning solution, run through a cycle, drained of the solution, filled with distilled water, run through another cycle, drained of the rinse water, and filled with distilled water again.