Your FREE CRCST Flashcards 2026 – 200+ Cards

Enter sterile tissue or the vascular system — must be STERILIZED (surgical instruments, implants).

Contact mucous membranes or non-intact skin — high-level disinfection minimum (flexible endoscopes).

Contact intact skin only — low/intermediate-level disinfection (BP cuffs, stethoscopes).

Clean FIRST — soil shields microbes. 'If it is not clean, it cannot be sterilized.'

A system that ranks devices by infection risk (critical, semicritical, noncritical) to set the reprocessing level.

Destroys all microbes EXCEPT small numbers of bacterial spores (glutaraldehyde, OPA, peracetic acid).

Kills mycobacteria, most viruses and bacteria — but NOT spores (alcohols, chlorine, iodophors).

Kills most bacteria, some viruses and fungi — not mycobacteria or spores (quats).

A process that destroys ALL microbial life, including bacterial spores.

Cavitation — imploding microscopic bubbles dislodge fine soil from hinges, box locks, and lumens.

AFTER gross soil is removed — never as the first or only cleaning step.

Automated wash plus thermal or chemical disinfection of instruments (thermal rinse often ≥ 90°C).

Utility = tap water for flushing/early cleaning. Critical = purified (RO/DI) for the final rinse.

A protective layer of microbes and soil that forms when soil dries on instruments; resists cleaning.

Point-of-use treatment and prompt cleaning — keep instruments moist so soil never dries.

Keep soil moist and start removing it right after use, so it cannot dry into biofilm.

Breaks down organic matter — blood, protein, fat — in the pre-cleaning phase.

To prevent aerosols (splash/spray) that could spread contamination.

Controlled per IFU — typically warm, not hot, so protein soil does not coagulate onto the instrument.

The linked conditions (agent, reservoir, exit, transmission, entry, host) that let infection spread.

Transfer of microbes from a contaminated item or surface to a clean one.

Creutzfeldt-Jakob Disease — prion disease; prions resist normal sterilization and need enhanced processing.

Special enhanced steam exposure (e.g., prevacuum 134°C extended); prions resist routine cycles.

Toxic Anterior Segment Syndrome — sterile eye inflammation from residues; prevented by thorough rinsing.

Minimum Effective Concentration — the lowest concentration that still works; checked with test strips.

Quaternary ammonium compounds — low-level disinfectants for noncritical surfaces.

High-level disinfectants (aldehydes) used for semicritical items like endoscopes.

Fluid-resistant gown, gloves, mask, and face/eye protection (full barrier in the dirty area).

Automated Endoscope Reprocessor — cleans and high-level-disinfects flexible endoscopes.

A correctly sized brush contacts the inner walls to remove soil; a loose one misses it.

Automated cleaning of carts, large containers, and bulky items.

Detects holes/tears in the scope before immersion; a leaking scope is removed from service.

Enzymatic, neutral, and alkaline — matched to the soil and the IFU.

ANSI/AAMI ST108 — defines utility and critical water categories.

The agent must stay wet on the surface for the full labeled contact time to work.

Safely containing and neutralizing a hazardous-chemical spill per the SDS.

Negative relative to clean areas, so contaminated air does not flow toward sterile items.

The process that removes or reduces contamination so an item is safe to handle (cleaning + disinfection).

Cleaning removes soil; decontamination makes the item safe to handle by cleaning plus disinfection.

The number of microorganisms on a contaminated item before reprocessing.

Too little is ineffective; too much wastes product and can leave residue — follow the IFU exactly.

Flushing soil from lumens and channels that brushes cannot fully reach.

Manual = hand cleaning at the sink; mechanical = automated (ultrasonic, washer-disinfector, cart washer).

To confirm no visible soil remains before the item moves to the clean side.

Keep point-down, never recap by hand, and dispose in a puncture-resistant sharps container.

Registers surface disinfectants and their tuberculocidal and other label claims.

A high-level disinfectant/sterilant for immersible instruments and endoscopes (e.g., automated systems).

To remove chemical residue that could harm patients or instruments (e.g., TASS prevention).

To contain soiled items and prevent exposure and spills during transport to decontamination.

Galvanic action can pit or corrode the instruments.

Treat all blood and body fluids as potentially infectious — full PPE in decontamination.

The decontamination area where contaminated items are received and cleaned.

Geobacillus stearothermophilus — used for steam, ozone, and hydrogen peroxide gas plasma sterilization.

Bacillus atrophaeus — used for ethylene oxide and dry heat.

About 4 minutes at 132–135°C (270–275°F); a vacuum pump removes air before steam.

About 30 min at 121°C (250°F) or 15 min at 132°C (270°F); steam pushes air out the drain.

Actual kill of resistant spores — the only DIRECT proof of sterilization.

The sterilant contacted the item (a PROCESS check) — not that the item is sterile.

Moist heat denatures and coagulates microbial proteins and enzymes.

Oxidation of cell constituents; slow to penetrate, so longer times are needed.

Steam pushes air out by gravity through a drain; slower air removal, longer exposure.

A vacuum pump removes air BEFORE steam, giving fast, reliable penetration and shorter cycles.

A daily air-removal test for prevacuum sterilizers; uniform color = pass, a spot = trapped air = fail.

Daily, before the first processed load, in an otherwise empty chamber.

121°C (250°F) and 132°C (270°F) are the two common temperatures.

Conditioning (air removal/heat-up), exposure (sterilize at temp/time), and exhaust/drying.

Trapped air — it blocks steam contact, so air removal is closely monitored.

Heat- and moisture-sensitive devices and lumened items, at low temperature.

Gas concentration, temperature, humidity, and exposure time.

EO residual is toxic and carcinogenic; aeration (8–12 hr at 50–60°C) drives off the gas.

Toxic, flammable, explosive, and a known human carcinogen.

1.0 ppm as an 8-hour time-weighted average (TWA).

Low temperature, about 37–44°C — for heat-sensitive devices.

No — by-products are water vapor and oxygen, so items are safe to handle immediately.

No moisture (wet items abort the cycle); cellulose/linen and long narrow lumens are restricted.

Low temperature (30–35°C); made in-machine from oxygen and water; reverts to oxygen and water.

About 170°C for 60 min, 160°C for 120 min, or 150°C for 150 min.

Powders, oils, and anhydrous items that steam cannot penetrate or that moisture would damage.

Immediate Use Steam Sterilization — for items needed right away; e.g., 132°C, 3 min, gravity, unwrapped.

Not routinely — only in a documented emergency, with a Class 5 integrator.

A device that changes color when a sterilization condition is met — a process check, not sterility.

External = on the outside (processed vs not). Internal = inside the pack at the hardest-to-reach spot.

Process indicator (e.g., autoclave tape) — shows the pack was exposed, not that it is sterile.

A specific-use test, such as the Bowie-Dick air-removal test.

Integrating indicator — reacts to all critical parameters and correlates to BI performance.

Emulating indicator — cycle-verification, tied to a specific cycle's parameters.

Contains resistant spores; after incubation it proves whether the cycle killed them.

Process Challenge Device — a hard-to-sterilize challenge pack holding the BI/CI to test the cycle.

Recall loads back to the last negative BI, quarantine them, remove the sterilizer, document, investigate.

Hold implants until the BI result is read; release early only in a documented emergency.

An identifier linking every item to a specific sterilizer, load, and date — enables recall and traceability.

That the cycle reached and held time, temperature, and pressure (printout/gauge).

The operator — accountability that the cycle parameters were verified.

Moisture inside or on a package after the cycle; it can wick microbes in — the load is not sterile.

Hot packs must cool on a rack/cart before handling; handling warm packs can cause condensation and wet packs.

High-temp = steam and dry heat. Low-temp = EO, H₂O₂ gas plasma, ozone, liquid chemical.

Peracetic acid systems — low-temperature sterilization of immersible instruments and endoscopes.

Jacket, door gasket, and drain/strainer — inspected and maintained per IFU.

Sterility Assurance Level — the probability of a surviving microbe, target 10⁻⁶ (one in a million).

The first phase — air removal and heat-up before exposure.

The time the load is held at the set temperature to sterilize.

To remove condensate and prevent wet packs that could wick microbes in.

A steam cycle that alternates flush and pressure pulses to remove air; air leaks do not affect it.

In the area hardest for the sterilant to reach, per IFU and AAMI guidance.

At least daily, and with every load containing an implant.

An unprocessed BI from the same lot, incubated to confirm the spores were viable.

To verify it works before clinical use — run BI/PCD and qualification cycles after major repair.

Preconditioning/humidification, gas introduction, exposure, evacuation, and air washes.

Moisture carries EO to reactive sites and is required for the gas to be effective.

Vaporized hydrogen peroxide, energized into a plasma of microbicidal free radicals.

Oxygen and water vapor at the end of the cycle — no toxic residue.

Static-air (gravity convection) is slower; forced-air (mechanical convection) heats faster.

Air is a poor conductor, so heat penetrates slowly — long times at high temperatures are needed.

Saturated steam (about 97–100% dryness) with minimal non-condensable gases.

Moisture or cellulose in the load — both are not permitted.

Hold the load until the BI is read; early release only in a documented emergency with a Class 5 integrator.

Back to the last NEGATIVE biological indicator result for that sterilizer.

Identify, recall, quarantine, document, notify, investigate, and retest before returning to service.

To verify cleanliness and function — a soiled or broken instrument cannot be sterilized or used safely.

Water-soluble, steam-penetrable instrument 'milk' per IFU — never petroleum/oil-based.

Oil coats the surface and blocks the sterilant from contacting the metal.

Checking electrosurgical instrument coatings for breaks that could burn tissue; defects are removed.

A list of every item in a tray, used to assemble and verify the set correctly.

AAMI recommends about 25 lb (≈11.3 kg) per tray, with even weight distribution.

So the sterilant reaches all surfaces, including the box lock and jaws.

In the area of the pack most challenging for the sterilant to reach.

Sterilization wrap, peel pouches, and rigid containers.

Square fold and envelope fold.

The clear plastic side — never the paper (Tyvek), which the sterilant passes through.

On the indicator tape or label — never on the sterilization wrapper itself.

Intact filters, gaskets, valves, and latches before each use.

Contents, load/lot number, sterilizer, date, and the technician's initials.

Protecting delicate or sharp instrument tips and must be steam/sterilant-permeable.

Sharpness, alignment, ratchets, box locks, hinges, and signs of staining or corrosion.

Document it and remove it for repair — do not assemble it into a set.

To detect residual soil, cracks, pitting, and damage during inspection.

The sterilization method — high-temp packaging vs low-temp-compatible packaging.

Small, lightweight single items; the clear side lets you see the contents.

Excess weight and density block sterilant penetration and cause wet packs.

A Class 5 chemical indicator that reacts to all critical parameters; placed inside the pack.

To prevent wet packs and ensure the sterilant penetrates the whole set.

Holding hinged instruments open and organized so the sterilant reaches all surfaces.

Self-seal has an adhesive strip; heat-seal is closed with a heat sealer — both must seal fully.

A weak or incomplete seal can fail and compromise sterility; seals are checked routinely.

Check for holes, tears, and stains; a compromised wrapper cannot maintain sterility.

Obtain the IFU and count sheet, then clean, inspect, assemble, and sterilize per the manufacturer.

To correctly identify instruments and assemble sets accurately.

Implant, loaned, and the sterilization method/cycle used.

Protecting instruments and absorbing moisture while allowing sterilant penetration.

Soil and defects must be visible; the clean side is kept separate from decontamination.

Items move dirty → clean → sterile and never back, preventing contamination of clean instruments.

A physical barrier (wall/partition) with separate ventilation and pressure.

ASHRAE (and AAMI ST79) define the environmental requirements per area.

Safety Data Sheet — OSHA-required document of a chemical's hazards, handling, PPE, first aid, and disposal.

Instructions For Use — the manufacturer's validated, FDA-cleared method for reprocessing a device.

It is the validated, FDA-cleared method; following it is how a device is ensured safe and sterile.

Surgical attire, hand hygiene, hair covered, no artificial nails or jewelry.

Quality assurance — monitoring processes (tray audits, turnaround, case-cart accuracy) to ensure quality.

TQI/CQI, Six Sigma, and LEAN.

Sterilization records are legal documents and enable recall and traceability.

Immediate flushing of the eyes after a chemical splash; required where chemicals are used.

FDA, CMS, CDC, OSHA, EPA, The Joint Commission, plus AAMI/ANSI and AORN standards.

The comprehensive guide to steam sterilization and sterility assurance — the primary SPD standard.

Designing tasks and workstations to reduce strain and injury (lifting, repetitive motion).

Immediate-use steam sterilization is monitored and minimized because it has higher risk.

Accredits hospitals and surveys SPD practices, IFU adherence, and the environment.

Regulates medical devices, sterilizers, and sterilants; device IFUs are legally binding.

Conditions of Participation tied to Medicare/Medicaid reimbursement.

Per AAMI/ASHRAE, frequent air exchanges with negative pressure relative to clean areas.

Document it and take corrective action; sterility and package integrity can be affected.

Documentation of injuries or events, retained as legal records and for QA review.

Sets perioperative nursing standards that overlap with the sterile field and instrument handling.

Tracking tray accuracy and errors as a quality metric.

They are legal records and support recall, traceability, and process improvement.

Performed on entry, between tasks, and when changing areas; part of the dress code.

A quality method that reduces waste and improves workflow efficiency.

A package stays sterile until an EVENT compromises it (tear, wet, dropped) — not until a date.

Time-related used expiration dates; event-related (current standard) uses package integrity.

First In, First Out — use the oldest stock first to rotate inventory and avoid expiration.

About 8–10 in. off the floor and 18 in. below the ceiling/sprinklers, away from outside walls.

Clean, dry, controlled temperature/humidity, restricted access, with covered or solid shelving.

In closed/covered carts with dust covers to maintain sterility during distribution.

Integrity (no tears/holes), dryness, intact seal, and the chemical indicator.

Periodic Automated Replenishment — the set stock level that triggers reordering.

A cart assembled with all instruments and supplies for a specific surgical case.

Unique Device Identifier — used to identify and track a specific device.

Radio-frequency tracking of instruments, trays, and equipment location and status.

Identify affected lots via load-control records, remove items from use, and document/notify.

Just-in-time delivers supplies as needed; exchange carts swap a full cart for a used one.

Vendor-owned trays that must be cleaned, inspected, and sterilized per IFU before use.

Where external shipping cartons are removed before supplies enter the clean storage area.

Cartons carry dust and pests; they are broken down in a separate break-out area.

Over sterile packs in storage/transport to protect them from contamination.

Each, box, or case — must match so quantities are ordered correctly.

A par-stocked cart swapped on a schedule to replenish a unit's supplies.

Code carts, C-section carts, and procedure-specific carts kept ready.

Vendor-owned stock kept on site and paid for only when used (e.g., implants).

So items with printed expiration dates are used before they expire.

Protect patient information on case carts, count sheets, and implant records; share only on need-to-know.

Resolving a complaint or error to restore a customer's (OR/unit) confidence.

To communicate accurately about cases, sets, and instruments with the OR and other staff.

Maintaining certification and staying current with standards and technology.

A group from different roles/departments working together on a shared goal (e.g., OR and SPD).

Courteous, clear telephone and in-person communication, including service recovery and respect (DEI).

It helps a technician understand how instruments are used and assemble sets correctly.

On-the-job training on new equipment, instruments, or procedures.

Diversity, equity, and inclusion — respectful, fair treatment of all coworkers and customers.

Each member understands their responsibilities and is accountable for their part of the workflow.

Clear, courteous communication with the OR/units prevents errors and delays.

Personal and professional development within the human-relations content area.

Scheduled inspection, testing, and servicing of patient care equipment to keep it safe and working.

Remove the equipment from service and send it to Biomedical Engineering before issuing it.

Frayed cords, cracks, damage, and proper function per the IFU before distribution.

Biomedical Engineering (Clinical Engineering).

SCD pumps/sleeves, suction units, feeding pumps, and IV poles handled by the SPD.

Manual logs, computerized systems, or RFID record where each item is and its status.

To the OR, ED, L&D, and patient units after testing, cleaning, and inspection per IFU.

Sequential compression device — pumps that help prevent blood clots in the legs.

To confirm it functions safely for patient use.

Documented in manual, computer, RFID, or hybrid systems for location and return.

Tag it out of service and route it to Biomedical Engineering for repair.