Equipment Application and Cleanliness

1. Equipment Application and Cleanliness Ensure Infection Control

2. CRT exam includes some areas of infection control that you may not be regularly involved in • Equipment disinfection • Infection control guidelines • Protocols to • Decrease incidence of VAP • Combat spread of emerging infections such as SARS

3. Common Errors to Avoid on the Exam • Don’t pasteurize or immerse any electrically powered equipment in liquid disinfectants; use gas sterilization instead • Don’t confuse sterilization (which kills all microorganisms, including bacterial spores) with high-level disinfection (which kills all microorganisms except bacterial spores) • Don’t select steam autoclaving for any heat-sensitive items needing sterilization. • Don’t routinely change ventilator circuits; change these components only if visibly soiled or malfunctioning

4. More Common Errors to Avoid on the Exam • Don’t recap, bend, break, or otherwise manipulate used needles with your hands • Don’t intubate a patient if noninvasive ventilation will suffice; this will minimize ventilator-associated pneumonia • When wearing PPE, avoid touching surfaces, objects, and your face with contaminated gloves

5. Exam Sure Bets • Always disassemble and inspect nondisposable equipment before cleaning • Always ensure that all equipment that has been cleaned via washing is dried properly before further processing • Always ensure that all nondisposable critical items (devices introduced in the blood stream or other parts of the body) are sterilized before reuse • Always treat any nondisposable equipment that comes in contact with a patient’s airway as semicritical and in need of either high-level disinfection or pasteurization before use.

6. More Exam Sure Bets • Always recognize that among semicritical respiratory therapy equipment, nebulizers and aerosol generators pose the greatest infection risk • Always use sterile solutions to fill nebulizers and aerosol generators • Always use low-resistance HEPA filters to isolate bedside and laboratory pulmonary function equipment from the patient

7. More Exam Sure Bets • Always wear a mask and maintain good hand hygiene when examining or caring for patients with signs and symptoms of a respiratory infection • Always perform a user-seal check each time you use an N-95 respirator for airborne precautions

8. Reference: Certified Respiratory Therapist Exam Review Guide, Craig Scanlon, Albert Heuer, and Louis Sinopoli Jones and Bartlett Publishers