CSFA Aseptic Technique and Sterilization 4 — Questions and Answers
Question 1: When pouring sterile solutions onto the sterile field, the scrub person should hold the basin:
- At the edge of the sterile field so the circulator can pour from any height
- Near the edge of the sterile field to minimize splashing risk (Correct answer)
- Well away from the field so the circulator pours from a safe distance
- Away from the field and return it after pouring is complete
Correct answer: Near the edge of the sterile field to minimize splashing risk
Holding the basin near the edge of the sterile field allows the circulator to pour without reaching over sterile items and minimizes splashing.
Question 2: What is the standard minimum wrap count for peel pouches used with steam sterilization?
- Single-layer peel pouch is sufficient for steam sterilization
- Double-layer peel pouch (pouch within a pouch) is required
- Triple-layer wrap is mandated by AAMI standards
- Manufacturer instructions determine the wrap count (Correct answer)
Correct answer: Manufacturer instructions determine the wrap count
AAMI and AORN guidelines require adherence to manufacturer's instructions for use (IFU), which define pouch and wrap requirements for each device.
Question 3: Immediate-use steam sterilization (IUSS), formerly called 'flash sterilization,' should be used:
- Routinely to speed turnover between cases
- Only as a last resort for an item needed immediately that cannot be processed otherwise (Correct answer)
- Whenever a sterile item is dropped during a procedure
- At the beginning of each surgical day for all instrument trays
Correct answer: Only as a last resort for an item needed immediately that cannot be processed otherwise
IUSS is intended only as a last resort when no sterile alternative is available, not as routine practice due to the lack of full quality controls.
Question 4: During a procedure, an instrument falls below the level of the sterile drapes onto the floor. This instrument is:
- Still sterile if it did not touch the floor directly
- Considered contaminated and must be removed from the sterile field (Correct answer)
- Sterile if retrieved within 10 seconds
- Sterile if the floor was cleaned before the case
Correct answer: Considered contaminated and must be removed from the sterile field
Any item that falls below the sterile field level is considered contaminated regardless of whether it visibly contacts the floor.
Question 5: Which of the following is the correct technique when a scrubbed person must turn their back to pass behind another scrubbed person?
- Face the sterile field while sidestepping behind the other person
- Pass back-to-back with the other scrubbed person (Correct answer)
- Ask the circulator to move the other scrubbed person first
- Pass face-to-face with the other scrubbed person
Correct answer: Pass back-to-back with the other scrubbed person
Scrubbed personnel pass back-to-back to keep their sterile fronts away from each other's backs, which are considered non-sterile.
Question 6: A steam sterilization load fails a Bowie-Dick test. What is the correct response?
- Run the load again and use if the second test passes
- Use instruments from the load since chemical indicators still changed color
- Remove the load from service, investigate the autoclave, and notify biomedical engineering (Correct answer)
- Quarantine only items at the center of the load
Correct answer: Remove the load from service, investigate the autoclave, and notify biomedical engineering
A failed Bowie-Dick test indicates inadequate steam penetration or air removal; all items in the load must be quarantined and the autoclave taken out of service for investigation.
Question 7: Which personal protective equipment (PPE) is required when handling items soiled with blood prior to decontamination?
- Sterile gloves only
- Utility gloves, moisture-resistant gown, eye protection, and mask (Correct answer)
- Standard examination gloves and a gown
- N95 respirator and sterile gown
Correct answer: Utility gloves, moisture-resistant gown, eye protection, and mask
Decontamination of soiled items requires utility (heavy-duty) gloves, a moisture-resistant gown, and face protection to guard against splashing of blood and body fluids.
CSFA Aseptic Technique and Sterilization 4
When pouring sterile solutions onto the sterile field, the scrub person should hold the basin: