CSPDT cheat sheet

PPE for decontamination: fluid-resistant gown, gloves, mask with eye protection or face shield, shoe covers, and hair cover; remove all PPE before leaving the area.

Cleaning is the first and most critical step - residual soil protects microorganisms and can inactivate disinfectants and sterilants.

Point-of-use treatment: keep contaminated items moist with approved gel, foam, or water; never let blood or saline dry on the device.

Manual cleaning: brush instruments while submerged below the water surface to prevent aerosol generation; use a brush sized to the lumen.

Ultrasonic cleaner: degas the solution, fully submerge items, and open hinges and box locks; cavitation removes soil but does not sterilize.

Decontamination area is held at negative air pressure relative to adjacent spaces, with a minimum of 10 air exchanges per hour.

Final rinse water in washer-disassemblers should be treated (RO/DI) to reduce mineral and pyrogen residue on instruments.

Washer-disassembler verification each load: check spray arms for blockage, detergent level, and the recorded time-temperature printout.

Disassemble multi-part instruments per the manufacturer's instructions; open box locks and remove all detachable parts before cleaning.

Every instrument is inspected for cleanliness, function, alignment, sharpness, corrosion, and cracked or frayed insulation before packaging.

Hinged instruments are opened to the first ratchet notch or fully open so sterilant contacts all surfaces.

Instrument lubricants must be water-based, steam-permeable, and approved by the device manufacturer; oil-based lubricants are not used.

An internal chemical indicator goes inside every package and an external indicator (tape or label) on every package; neither proves sterility.

Weight limits: instrument sets about 25 lb, textile packs about 12 lb, and textile density about 7.2 lb/ft3 to allow penetration and drying.

Peel pouch loading: the item should occupy no more than about three-quarters of the pouch and must not touch or stress the seals.

Label each package with sterilizer identifier, cycle or load number, date of sterilization, preparer's initials, and expiration or event-related date.

Nested basin sets: separate basins with absorbent material and position them so condensate can drain; avoid tightly nested configurations.

Use only FDA-cleared packaging validated for that specific sterilization method; inspect wraps for tears and punctures after the cycle.

Steam cycles (AAMI-referenced): 121-123 C (250-252 F) gravity for 30 min; 132-135 C (270-275 F) prevacuum for 3-4 min; the device IFU always governs.

Biological indicator organisms: Geobacillus stearothermophilus for steam, ethylene oxide, and hydrogen peroxide plasma; Bacillus atrophaeus for dry heat and EO.

Bowie-Dick test: prevacuum steam only, run daily in an empty warmed chamber; it detects air removal and steam penetration failure, not sterility.

Chemical indicator classes: 1 process indicator, 2 Bowie-Dick, 3 single parameter, 4 multi-parameter, 5 integrating, 6 emulator.

Implant loads are quarantined until the biological indicator is negative; a rapid-read BI may permit earlier release only if facility policy allows.

Positive biological indicator: recall all items processed in that sterilizer back to the last negative BI and do not release new loads until the cause is resolved.

Dry heat parameters: 160 C (320 F) for 2 hours or 170 C (340 F) for 1 hour, used for powders, oils, and items that cannot tolerate moisture.

EO parameters are typically 55-60 C, 40-80% relative humidity, 450-1200 mg/L concentration, 1-6 hours exposure, followed by required aeration.

Load configuration: do not overload; stand paper-plastic pouches on edge, place rigid containers flat, and tilt basins so condensate drains.

Storage environment: approximately 20-24 C (68-75 F) and 30-60% relative humidity, with temperature and humidity documented.

Clearances: at least 8-10 inches above the floor, 18-20 inches below the ceiling, and 2 inches from exterior walls; nothing stored under sinks or water pipes.

Event-related sterility: shelf life depends on storage and handling events rather than elapsed time alone.

Store paper-plastic pouches on edge rather than flat or folded; store rigid containers per the container manufacturer's instructions.

Transport sterile items in closed or covered carts; never carry them against the body or set them on the floor.

Issuance check before distribution: package integrity, correct label, correct item, and valid event-related status.

Rotate stock first in, first out (FIFO); segregate recalled or compromised packages and return them for reprocessing.

Traffic control: separate clean from contaminated flow and minimize personnel traffic in the sterile storage area.

Spaulding classification: critical devices require sterilization, semicritical devices require at least high-level disinfection, noncritical devices require low-level disinfection.

OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030): exposure control plan, hepatitis B vaccination offered within 10 working days of assignment, PPE, training, and sharps injury log.

OSHA Hazard Communication (29 CFR 1910.1200): chemical inventory, accessible safety data sheets, labeled containers, and staff training.

AAMI ST79 covers steam sterilization and sterility assurance; ST91 covers flexible endoscope processing; ST58 covers chemical sterilization and high-level disinfection.

FDA clears sterilizers, biological indicators, chemical indicators, and sterilization packaging as medical devices before marketing.

The CDC Guideline for Disinfection and Sterilization in Healthcare Facilities sets device processing levels; Joint Commission and CMS survey compliance against them.

Device, sterilizer, and packaging manufacturer instructions for use must all be compatible; where they conflict, the most restrictive instruction governs.

Records must be legible and traceable to the load and patient recall; retention periods follow facility policy and regulatory requirements.

CSPDT certification requires passing the CBSPD examination and maintaining continuing education as required for recertification.