Free CSPDT Exam Flashcards

Items move in one direction only: decontamination (soiled) → preparation and packaging → sterilization → sterile storage and distribution. Clean and sterile items never travel back toward the dirty side, which prevents cross-contamination.

Every sterilizer load is documented with a load/lot number, sterilizer ID, cycle, date, operator, contents, and monitoring results. This record lets the department trace and recall specific items if a sterilization failure is later discovered.

If a biological indicator turns positive (spore growth), recall every load processed since the last negative BI, quarantine those items, re-sterilize them, and notify the supervisor and infection prevention per policy.

A count sheet lists every instrument and quantity for a specific tray. Technicians use it during assembly to build the set correctly and confirm all instruments are present and functional before packaging.

ST79 covers steam sterilization; ST91 covers flexible and semi-rigid endoscope reprocessing; ST58 covers chemical/low-temperature sterilization and high-level disinfection; ST108 covers water quality for processing medical devices.

CBSPD certification is valid for five years. To recertify, a technician must earn 100 approved continuing-education points within that period and submit the recertification packet and fee before the credential expires.

The technician must inspect each instrument and remove any that is damaged, dull, misaligned, or malfunctioning from service, tag it, and route it for repair or replacement rather than assembling it into a set.

The number and type of viable microorganisms on an item before decontamination or sterilization. Higher bioburden and dried organic soil make sterilization harder to achieve, which is why thorough cleaning must always come first.

The most resistant form of microbial life. Spores of Geobacillus stearothermophilus and Bacillus atrophaeus resist heat and chemicals, so they are used in biological indicators—if a process kills these spores, it kills everything less resistant.

The probability that a single viable microorganism survives on an item after sterilization. The accepted standard for medical devices is a SAL of 10⁻⁶—no more than one chance in one million of a surviving organism.

Cleaning removes visible soil and organic material; disinfection destroys most pathogens but not all spores; sterilization destroys ALL microbial life, including spores. An item cannot be reliably disinfected or sterilized unless it is cleaned first.

Items that enter sterile tissue or the vascular system—surgical instruments, implants, needles. They pose the highest infection risk and must be STERILIZED.

Items that contact mucous membranes or non-intact skin—flexible endoscopes, respiratory therapy equipment, laryngoscope blades. They require at minimum HIGH-LEVEL DISINFECTION (HLD).

Items that contact only intact skin—blood pressure cuffs, stethoscopes, bedpans. They require LOW- or INTERMEDIATE-LEVEL disinfection, because intact skin is an effective barrier to most organisms.

At the end of a procedure, the OR team removes gross soil and keeps instruments moist (with water or an approved pretreatment product—not saline) so blood and debris do not dry on, which would make later cleaning far harder.

Because all items are treated as contaminated, staff wear a fluid-resistant gown, gloves, a mask, and eye protection or a face shield; hair and shoe covers are added per policy. PPE guards against splashes and aerosols.

A cleaning agent containing enzymes (such as protease) that break down and dissolve organic soil—blood, protein, and tissue. It loosens debris from surfaces and lumens so it can be rinsed away before disinfection or sterilization.

An ultrasonic cleaner uses high-frequency sound waves to form microscopic bubbles that implode (cavitation), dislodging fine soil from hinges, box locks, and hard-to-reach areas. It is used after gross soil is removed, and items are rinsed afterward.

Automated equipment that cleans and then thermally disinfects instruments through wash, rinse, and a heated (thermal) rinse phase. It provides consistent, validated cleaning and reduces staff handling of contaminated items.

Utility (tap) water is acceptable for flushing, washing, and initial rinsing. Critical water—highly treated with low mineral and endotoxin content (e.g., deionized/RO)—is required for final rinsing so residues and contaminants are not left on devices.

Common high-level disinfectants include glutaraldehyde, ortho-phthalaldehyde (OPA), and peracetic acid. They destroy vegetative bacteria, fungi, and viruses and—with sufficient contact time—spores. Contact time and temperature per the IFU are critical.

Each instrument is checked for cleanliness, function, sharpness, alignment, and damage—often with a lighted magnifier. Instruments must be visibly clean and dry; any that are soiled or defective are removed from the set.

Hinged instruments are lubricated with a water-soluble, steam-permeable lubricant ('instrument milk'). Oil-based or mineral-oil lubricants are NEVER used because they block steam and sterilant contact and prevent sterilization.

Instruments with hinges, box locks, or ratchets are packaged OPEN and unlocked so the sterilant reaches every surface. Closed jaws trap air and block steam contact, causing sterilization failure.

Load peel pouches so instruments fit without stressing the seal, and place a chemical indicator inside. When double-pouching, orient paper-to-paper and plastic-to-plastic, and stand pouches on edge in the sterilizer for drainage and steam contact.

Packaging must allow the sterilant to penetrate during processing and then maintain a sterile barrier during storage and handling. A package is presumed sterile until its integrity is compromised (event-related sterility).

Wrapping an item in two barrier layers—two sheets wrapped sequentially or a bonded double-ply wrap—creates a package that can be opened aseptically and protects the contents. The wrap must still permit sterilant penetration and air removal.

AAMI ST79 recommends that a wrapped instrument set not exceed 25 pounds (about 11.3 kg). Overweight sets are hard to dry, promote wet packs and condensate, and strain staff—risking sterilization failure and injury.

An internal chemical indicator (commonly a Type 5 integrating indicator) is placed inside every package or tray in the location considered hardest for the sterilant to reach, verifying that conditions were met inside the pack.

Typical gravity cycles for wrapped instruments: 121°C (250°F) for 30 minutes, or 132°C (270°F) for 15 minutes, plus a drying time. Gravity cycles rely on incoming steam pushing air down and out of the chamber.

Prevacuum sterilizers actively pump air out first, so exposure is shorter: 132°C (270°F) for 4 minutes, or 135°C (275°F) for 3 minutes, plus drying. Better air removal allows faster, more reliable steam penetration.

A low-temperature GAS process for heat- and moisture-sensitive devices. EO is toxic, flammable, and carcinogenic and requires a lengthy AERATION phase to remove residual gas before items are safe to handle. Biological indicator: Bacillus atrophaeus.

A low-temperature process (e.g., Sterrad) for heat- and moisture-sensitive items with NO aeration needed. It CANNOT process cellulose materials (paper, linens, cotton), liquids, or long/narrow lumens beyond stated limits. Biological indicator: Geobacillus stearothermophilus.

A low-temperature method that uses ozone gas (oxygen converted to O₃) to oxidize and destroy microorganisms, then breaks back down to oxygen and water. Biological indicator: Geobacillus stearothermophilus.

Geobacillus stearothermophilus spores monitor STEAM, hydrogen peroxide, and ozone. Bacillus atrophaeus spores monitor ETHYLENE OXIDE and DRY HEAT. A BI is the only monitor that directly proves the process killed resistant spores.

A daily AIR-REMOVAL test run in an empty prevacuum steam sterilizer, usually as the first cycle of the day. It is a Type 2 chemical indicator test that detects air leaks and inadequate air removal that would block steam penetration.

Type 1 = process indicator (external, shows exposure, e.g., autoclave tape); Type 2 = specific-use test (e.g., Bowie-Dick); Types 3–4 = single/multi-variable; Type 5 = integrating indicator (responds to all critical variables); Type 6 = emulating (cycle-specific).

Formerly called 'flash' sterilization—used only for an urgently needed, already-cleaned item, not for routine processing and (except in emergencies) not for implants. A typical cycle is 132°C (270°F) for 3–4 minutes, and the item is used right away because it is not packaged for storage.

Sterile storage is kept cool, dry, and controlled: commonly temperature not exceeding 75°F (24°C), relative humidity not exceeding 70%, positive air pressure relative to adjacent areas, and a minimum of 4 air changes per hour.

Store sterile items 8–10 inches (about 20–25 cm) above the floor, 18 inches (about 45 cm) below the ceiling or sprinkler heads, and at least 2 inches (5 cm) from outside walls to protect packages and allow air circulation.

A sterilized package stays sterile until an EVENT compromises its barrier—getting wet, torn, crushed, dropped, or having a broken seal—rather than expiring on a set date. Judge sterility by package integrity, not just a printed date.

Sterile supplies are rotated 'first in, first out': older stock is placed in front and used first. This minimizes prolonged storage and reduces the chance that packaging integrity degrades before an item is used.

Before an item leaves storage or is opened at the point of use, staff verify the package is intact, dry, and sealed and that the external chemical indicator changed. A wet, torn, or dropped package is considered contaminated and must be reprocessed.

Before manual cleaning and immersion, a flexible endoscope undergoes a leak test to detect holes or damage in its channels and outer sheath. Skipping it lets fluid invade and damage the scope and can leave a device impossible to clean, endangering patients (AAMI ST91).

Order: point-of-use precleaning → leak test → thorough manual cleaning with brushing and flushing of ALL channels → high-level disinfection or sterilization → rinsing, drying, and proper storage—each step performed per the manufacturer's IFU.

Powered (pneumatic or electric) surgical instruments generally must NOT be immersed or run through automated washers unless the IFU permits it, because water can ruin the motor. They are cleaned, lubricated, and sterilized strictly per the manufacturer's instructions.

Technicians must reprocess every device according to its written Instructions for Use (IFU). Skipping steps or shortening cycle or contact times to save time is an ethical and patient-safety violation, even when the department is busy.

If a biological indicator is positive or a chemical indicator did not change correctly, the load must be quarantined and reprocessed—never dispensed. Patient safety always outweighs turnaround time or pressure from the OR.

Sterilization and monitoring records must be accurate and complete. Falsifying cycle records, indicator results, or load contents is a serious ethical breach that can directly cause patient harm and legal liability.

A technician is obligated to speak up and report unsafe conditions or shortcuts—such as sending incompletely processed or contaminated instruments to the OR—rather than stay silent. Professional accountability protects patients above workplace convenience.