What are the sterilization preparations for doctors?

Physical methods, chemical methods and biological methods, but biological methods using biological factors to remove pathogens, the role of slow, and sterilization is not complete, generally not used for disinfection of infectious diseases, so the main application of physical and chemical methods of disinfection. (A) physical disinfection method 1. mechanical disinfection general application of soap scrubbing, running water, can eliminate most or even all of the bacteria on the hands, the use of multi-layer masks can prevent pathogens from the respiratory tract or invasion. Application of ventilation device filters can make the operating room, laboratory and isolation room air, to protect the sterility of the state. 2. Thermal disinfection, including fire, boiling, flowing steam, high heat steam, dry heat sterilization. Can make the pathogen protein coagulation denaturation, loss of normal metabolic functions. (1) fire where the economic value of small pollutants, metal instruments and corpses can be used in this way. Simple and economical, stable results. (2) Boiling boil-resistant goods and general metal instruments are used in this method, 100 ℃ 1 ~ 2 minutes to complete the disinfection, but the germ cells need a longer period of time. Bacillus anthracis germ cells should be boiled for 30 minutes, tetanus germ cells need 3 hours, botulism germ cells need 6 hours. To sterilize metal instruments, add 1~2% sodium carbonate or 0.5% soft soap and other alkaline agents, which can dissolve fat and enhance the bactericidal power. Cotton fabrics with 1% soapy water 15l/kg, disinfection and decontamination effect. When sterilizing items by boiling, do not exceed 3/4 of the volume, should be immersed in the water under the surface. Pay attention to leave a gap, in order to facilitate convection. (3) flow steam disinfection Relative humidity 80 ~ 100%, the temperature of nearly 100 ℃, the use of water vapor in the object and so on the surface cohesion, the release of heat energy, kill pathogens. And when the steam cohesion contraction produces negative pressure, promote the outer layer of hot steam into the supplementary, penetrate into the depth of the goods, accelerate the heat, promote sterilization. (4) High-pressure steam sterilization Usually the pressure is 98.066kPa, temperature 121 ~ 126 ℃, 15 ~ 20 minutes that can completely kill the bacterial germs, applicable to heat-resistant, damp items. (5) dry heat sterilization dry heat air conduction is poor, small heat capacity, weak penetration, the object is heated more slowly. Need 160 ~ 170 ℃, 1 ~ 2 hours to sterilize. Applicable to glass containers that can not take water, metal instruments and so on. Heat tolerance of different pathogens, expressed in heat death time. 3. Radiation sterilization There are two kinds of non-ionizing radiation and ionizing radiation. The former includes ultraviolet, infrared and microwave radiation, while the latter includes high-energy electron beams (cathode rays) of C-rays. Infrared and microwave mainly rely on heat sterilization. Ionizing radiation equipment is expensive, the object and the human body has a certain degree of harm, so the use of less. At present, the most widely used is ultraviolet light, which can cause changes in cellular components, especially nucleic acids, plasma proteins and acids, leading to the death of microorganisms. Ultraviolet wavelength range of 2100 ~ 3280A, kill microorganisms at wavelengths of 2000 ~ 3000A, with 2500 ~ 2650A the strongest effect. Fungal spores are the most resistant to UV light, followed by bacterial germ cells, and bacterial propagules are the weakest, with a few exceptions. UV penetration is poor, below 3000A can not pass through 2mm thick ordinary glass. Dust in the air and relative humidity can reduce its sterilization effect. The penetration of water decreases with depth and turbidity. However, it is widely used to sterilize the air and the surface of general articles because it is easy to use and does not damage the medicines. Irradiation of human body can occur skin erythema, UV ophthalmia and ozone poisoning. Therefore, people should be avoided when using or use the appropriate protective measures. Sunlight exposure also relies on the ultraviolet radiation, but due to scattering and absorption in the atmosphere, only 39% of the use of the ground, so only for microorganisms with low endurance, and must be exposed for a long time. In addition, filtration sterilization in addition to laboratory applications, only the ventilation of the building, air filtration can be used, so it is difficult to apply the general disinfection. (B) chemical disinfection according to the role of pathogen proteins, divided into the following categories. 1. Coagulation of protein disinfectants, including phenols, acids and alcohols. (1) Phenols, mainly phenol, Lysol, hexachlorophenol and so on. With a special odor, limited bactericidal power. Can make the textile discoloration, rubber articles become brittle, skin has a certain degree of irritation, so in addition to Lysol less applications. Phenol (carbolic acid) (carbolic acid): colorless crystals, has a special odor, moisture pink, but the disinfectant power is not reduced. For cellular plasma poison, on the bacterial reproduction type 1:80 ~ 1:110 solution, 20 ℃ for 30 minutes can kill, but can not kill germ cells and strong resistance to the virus. Add soap can saponify fat, dissolve proteins, promote its penetration, enhance the disinfection effect, but more toxic, skin irritation, with a bad smell, can not be used for skin disinfection. Lysol (coal phenol soap) (lysol): 47.5% cresol and potassium soap. Reddish-brown, soluble in water, has a decontamination effect, bactericidal force is stronger than the stone phenol 2 to 5 times. Commonly used for 2-5% aqueous solution, can be used for spraying, rubbing, soaking containers and hand washing. Bacterial reproduction can be killed in 10-15 minutes, but the effect on germ cells is poor. Hexachlorophenol (hexochlorophane): bisphenol compounds, slightly soluble in water, soluble in alcohols, esters, ethers, plus alkali or soap can promote dissolution, less toxic and irritating, but stronger bactericidal force. Mainly used for skin disinfection. With 2.5 ~ 3% hexachlorophenol soap hand washing can reduce skin bacteria 80 ~ 90%, there are reports of neurological damage, so it is advisable to use long-term. (2) Acids have killing effect on bacterial propagules and germ cells. But easy to damage the goods, so generally not used for room disinfection. 5% hydrochloric acid can be disinfected washing utensils, fruits, plus 15% salt in 2.5% solution can be disinfected fur and leather, 10l/kg heating 30 ℃ soak for 40 hours. Lactic acid is often used in air disinfection, 100m3 space with 10g of lactic acid fumigation for 30 minutes, can kill staphylococcus and influenza virus. (3) Alcohol ethanol (alcohol) 75% concentration can quickly kill bacterial reproduction, the general effect of viruses slower, the role of hepatitis virus is not certain, the fungal spores have a certain effect on killing, no effect on germ cells. Used for skin disinfection and thermometer immersion disinfection. It can not be used to sterilize surgical instruments because it can not kill germ cells. Isopropyl alcohol (isopropylalcohol) on the bacterial killing ability is greater than 2. Protein solubilization disinfectants are mainly alkaline drugs, commonly used sodium hydroxide, lime, etc. (1) sodium chlorine oxide white crystal, soluble in water, strong bactericidal force, 2 ~ 4% solution can kill viruses and bacterial reproduction, 10% solution can kill tuberculosis bacilli, 30% solution can kill germ cells in 10 minutes, due to corrosive, so rarely used, only for the elimination of anthrax germ cells. (2) Lime can produce high temperature and dissolve proteins in contact with water to kill pathogens. Commonly used 10～20% lime milk to disinfect excreta, the dosage must be twice as much as the excreta, and the effect is 4～5 hours after mixing. 20% lime milk is used to disinfect anthrax contaminated places, spraying every 4～6 hours, 2～3 times in a row. It can kill bacillus of tuberculosis by brushing the wall for 2 times. Because of its unstable nature, it should be freshly prepared when applying. 3. Oxidizing protein disinfectants, including chlorine disinfectants and peroxide disinfectants. Because of the strong disinfecting power, it is currently the most widely used in the medical epidemic prevention work. (1) Bleach is the most widely used. The main component is calcium hypochlorite [Ca(OCl)2], containing 25-30% of the effective, unstable nature, can be light, heat, moisture and CO2 decomposition. Therefore, it should be kept in a dark and dry place in a closed container for not more than 1 year. Hypochlorous acid, the active ingredient, can penetrate into the cell, oxidize the hydrogen sulfide group of cell enzymes and destroy the cytoplasmic metabolism. It has strong and rapid bactericidal power in acidic environment, and can kill germ cells in high concentration. It is used for disinfecting feces, sputum, pus, etc. in powder form. Add 200g of dry powder per liter, mix well and leave it for 1~2 leaves, add 5g of dry powder per liter of urine and leave it for 10 minutes. 10~20% emulsion can be used to disinfect excreta and secretion, but also can be used to spray toilets and polluted vehicles, etc. If it is stored for a long time, it should be used for disinfection. If it is stored for a long time, the actual effective chlorine content should be measured and the dosage should be corrected. The powder and tablet of bleaching powder can contain 60-70% of effective chlorine, and the amount can be reduced proportionally. (2) Chloramine-T is an organochlorine disinfectant, containing 24-26% effective chlorine, stable in nature, only 0.1% effective chlorine is lost when it is kept closed for 1 year. Slightly soluble in water (12%), less irritating and corrosive, the role of hypochlorous acid is slower than 0.2% 1 hour can kill bacterial reproduction, 5% 2 hours can kill tuberculosis bacilli, kill germ cells need more than 10 hours. All kinds of ammonium salts can promote its bactericidal effect. 1~2.5% solution also has effect on hepatitis virus. Active liquid must be used 1 ~ 2 hours before preparation, too long, the bactericidal effect is reduced. (3) Sodium dichloroisocyanurate, also known as Euchlorine, is a widely used organochlorine disinfectant, containing 60-64.5% chlorine. It has the advantages of high efficiency, broad-spectrum, stability, high solubility and low toxicity. Aqueous solution can be used for spraying, soaking, rubbing foam, can also be used to disinfect pollutants directly with dry powder, treatment of feces and other excreta, the use of the same bleach. Spray directly on the ground, the dose of 10 to 20g/m2. Mixed with paraformaldehyde powder ignition, the gas can be fumigated disinfection, can be mixed with No. 92 coagulant (hydroxyaluminum chloride as the basis for iron powder, sulfuric acid, hydrogen peroxide and other synthesis) to 1:4 to become a "water clear", for drinking water disinfection. It can be mixed with sodium sulfonate to form various disinfectant detergents, such as "Tetramet", "Euchlorine", and so on. It can kill hepatitis virus. In addition, there are trisodium chlorophosphate, chlorobromodicyanuric acid and so on with the same effect. (4) Peroxyacetic acid, also known as peroxyacetic acid, is a colorless transparent liquid, volatile and irritating acidic smell, is a kind of same-effect quick-acting disinfectant, easily soluble in water and ethanol and other organic solvents, has a bleaching corrosive effect, volatile and irritating acidic smell, is a kind of high-efficiency and quick-acting disinfectant, easily soluble in water and ethanol and other organic solvents, has a bleaching and corrosive effect, is unstable, in contact with heat, organics, heavy metals, powerful and alkali, etc., easily decomposed. 0.01 ~ 0.5%, 0.5 ~ 10 minutes to kill bacterial propagules, 1% 5 minutes to kill germ cells, commonly used concentration of 0.5 ~ 2%, can be disinfected by soaking, spraying, rubbing and other methods, in closed conditions for aerosol (5% concentration, 2.5 ml / m2) and fumigation (0.75 ~ 1.0 g / m3) disinfection. (5) Chlorine peroxide 3 ~ 6% solution, 10 minutes can be disinfected. 10 ~ 25% for 60 minutes, can be sterilized, used for heat-resistant plastic products, tableware, clothing and other disinfection. 10% hydrogen peroxide gas deep gel spray disinfection of indoor polluted surfaces; 180 ~ 200 ml / m3, 30 minutes can kill the bacterial propagules; 400 ml / m3, 60 minutes can be killed germ cell ethanol, absorbed by lungs Can cause anesthesia, but no damage to the skin, can be used instead of ethanol. (6) Potassium permanganate 1-5% concentration of immersion for 15 minutes, can kill the bacterial propagation body, commonly used in food utensils, fruits and melons disinfection. (4) Cationic surfactants, mainly quaternary ammonium salts, high concentration of protein coagulation, low concentration of inhibition of bacterial metabolism. Bactericidal concentration, toxicity and irritation, no bleaching and corrosion, odorless, stable, water-soluble and so on. But the bactericidal power is not strong, especially for germ cells, the effect of organic matter is greater, more contraindications for its shortcomings. Domestic production of new jerricide, disinfecting Ning (Dumicang) and disinfecting net to disinfecting Ning stronger bactericidal power, commonly used concentration of 0.5 ~ 1.0 ‰, can be used for disinfection of skin, metal instruments, tableware and other disinfection. Not suitable for excreta and secretion disinfection. Alkylated disinfectants (1) formalin 34 ~ 40% formaldehyde solution, has a strong bactericidal effect. 1 ~ 3% solution can kill the bacterial reproduction type, 5% solution for 90 minutes or to kill the germ cells, indoor fumigation disinfection is generally used 20ml / m3 plus an equal amount of water for 10 hours to eliminate the contamination of the germ cells, you need to be 80 ml / m3 24 hours, applicable to the fur, synthetic fibers, silk and other items that are not heat resistant. It is suitable for fur, artificial fiber, silk fabrics and other non-heat-resistant articles. Because of its poor penetration, irritation, so the disinfection of goods should be spread out, the house must be closed. (2) Glutaraldehyde acts like formaldehyde. In the acidic solution is more stable, but the bactericidal effect is poor, in the alkaline solution can be maintained for 2 weeks, but strong to improve the bactericidal effect, so usually 2% glutaraldehyde with 0.3% sodium bicarbonate, corrected pH for compounds (bactericidal effect is enhanced, and can maintain the stability of 18 months. Non-corrosive, broad-spectrum, fast-acting, high heat, low toxicity and other advantages, can be widely used to kill bacteria, germ cells and viruses disinfection. It is not suitable for skin and mucous membrane disinfection. (3) Ethylene oxide is a colorless liquid at low temperature, boiling point 10.8 ℃, so it is a gas sterilizer at room temperature. Its role is to destroy the microbial protein by alkylation. The general application is 0.4～0.7kg/m2 at 15℃ for 12～48 hours. If the temperature is increased by 10℃, the bactericidal power can be increased by more than 1 times, and the sterilization effect is best when the relative humidity is 30%. It has the advantages of high activity, strong penetration, no damage to articles, no residual poison, etc. It can be used to disinfect paper, books, cloth, fur, plastic, artificial fiber, metal products. Because of the strong penetrating power, it is necessary to disinfect in closed containers. Avoid open flame to prevent explosion. Ventilate after disinfection to prevent inhalation. (1) Iodine interferes with protein metabolism through halogenation. It has a rapid and long-lasting effect, is non-toxic, and is little affected by organic substances. It is often used in the form of sulfonated wine and sulfonated vapors (sulfonated and surfactants are indeterminate conjugates). Commonly used in skin and mucous membrane disinfection, medical equipment emergency treatment. (2) Chlorhexidine is a biguanide compound. It has strong disinfecting effect on bacteria. Can be used for hand, skin, medical equipment, clothing and other disinfection, commonly used concentration of 0.2 ~ 1 ‰