The information below details specific steps in the process
for cleaning and sterilizing surgical instruments, as well as
the point at which hydraulic fluid was accidentally introduced
into the cleaning systems in late 2004. The process varies
somewhat from hospital to hospital.
- Dirty instruments come from operating rooms and other
areas throughout the hospital to the decontamination
area.
- Instruments are cleaned manually and/or
mechanically.
- Instruments are inserted into a tunnel-like or
single-chamber unit washing machine. The multi-step washing
and rinsing process takes 16 or more minutes. Detergent is
introduced in the second and third steps, in which the
instruments are washed with a small amount of the detergent
diluted into several gallons of hot water. This is the stage
in which hydraulic fluid was introduced.
- As part of the cleaning process, a lubricant is applied
to the clean instruments to prevent rust and ensure the
instruments do not lock up during use.
- Instruments are removed by hand from the washing machine
in the next room and manually sorted on tables into bundled
sets prior to sterilization.
- Instruments are then placed into another machine for
sterilization. In the 50-minute sterilization process,
instruments are conditioned and sterilized in very
high-temperature steam (the equivalent of pressure-cooking in
a 270-degree Fahrenheit oven-like chamber) to destroy any
possible organisms.
- Instruments are then sent to the operating rooms or other
areas throughout the hospital.