High-level disinfection/sterilization of heat-sensitive devices: Which of the following are processed effectively with glutaraldehyde solutions (per manufacturer instructions)?
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AClinical thermometers (heat-sensitive types)
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BBronchoscopes (flexible endoscopes)
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CCystoscopes (endoscopic urologic instruments)
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DAll of these
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ESurgical towels
Answer
Correct Answer: All of these
Explanation
Introduction:Glutaraldehyde is a high-level disinfectant/chemical sterilant used for heat-sensitive medical devices that cannot be autoclaved. Knowing which devices are appropriate for immersion processing is essential for reprocessing protocols.
Given Data / Assumptions:
- Devices listed (thermometers, bronchoscopes, cystoscopes) are heat-sensitive and have lumens or surfaces requiring liquid contact.
- Exposure time and concentration determine high-level disinfection versus sterilization claims.
Concept / Approach:Glutaraldehyde solutions (e.g., 2% activated) provide broad antimicrobial activity, including mycobacteria and many spores with prolonged exposure. They are widely used (historically) for endoscopes and delicate instruments, alongside modern alternatives (ortho-phthalaldehyde, peracetic acid). Fabric items like surgical towels are not immersed in glutaraldehyde for routine processing; they are laundered and heat-sterilized instead.
Step-by-Step Solution: Identify heat-sensitive, immersible devices among the options. Confirm that thermometers and flexible endoscopes are standard use-cases. Select the inclusive option covering all listed devices.
Verification / Alternative check:Reprocessing guidelines historically include glutaraldehyde immersion for endoscopes with proper cleaning, contact time, and rinsing steps.
Why Other Options Are Wrong:
- Any single device alone: Incomplete; glutaraldehyde is used across these categories.
- Surgical towels: Typically processed by laundry/steam, not glutaraldehyde immersion.
Common Pitfalls:Skipping meticulous pre-cleaning; organic soil reduces efficacy of liquid chemical disinfectants.
Final Answer:All of these devices are commonly processed with glutaraldehyde when heat-sensitive.