General Medical Information

Sterilization of Equipment

James A. Duncavage
John R. Coleman, Jr.

Another facet in the prevention of occupational transmission of disease is sterilization of the work environment and instruments used. Numerous articles have been published that discuss the merits of different disinfectants in the elimination of bacterial and viral vectors. Other articles have examined the potential for cross-contamination of reusable equipment. One article of particular interest examined the risk of cross-infection with a multiuse nasal atomizer. These authors were able to document the contamination of the atomizer tip, nozzle, and reservoir with bacteria isolated from the nasal vestibule. Other groups examining dental and gastrointestinal endoscope sterilization found removal of lubricants and organic debris before the process to be the central facet in ensuring effective sterilization.

Recommendations for the office, therefore, include effective cleaning of all equipment and surfaces to remove particulate matter after each patient care contact. Disinfection of all surfaces with an antibacterial/antiviral agent should be performed. Instruments that can be heat sterilized should be; those that cannot tolerate heat sterilization should be immersed in antibacterial/antiviral solution for an appropriate period based on the manufacturer’s recommendation. Two percent glutaraldehyde has proved particularly effective for the disactivation of the HIV virus. Finally, when possible, disposable equipment should be used. An excellent example of this in our practice is the use of disposable sheaths for our flexible nasopharyngoscopes.