# Sanitizing Trauma Shears



## bburnette252 (Oct 3, 2014)

Best way to sanitize trauma shears (that aren't throw aways) after a bloody mess?

I sprayed the germ away we keep on the truck on them but I'd like to clean them a little better


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## teedubbyaw (Oct 3, 2014)

Death wipes or soap and water. You're not going to sanitize  them.


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## DesertMedic66 (Oct 3, 2014)

Dishwasher?

I honestly have no clue. The one time use ones are my friend


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## OnceAnEMT (Oct 4, 2014)

I clean my AT scissors (basically bandage scissors) with alcohol to get the adhesive off then death wipes to really disinfect. Trauma shears just with death wipes.

I suppose a warm bleach bath if you want to get picky...


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## jlw (Oct 4, 2014)

I generally use throw aways.


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## Akulahawk (Oct 4, 2014)

Normally I use commercially available death wipes to get the shears as clean as I can and then soak them in a commercially available death bath or very strong bleach bath, if I wanted to get the shears as disinfected/sanitized as possible. Now if I had access to an autoclave...


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## Underoath87 (Oct 4, 2014)

If any of you have a pressure canner/cooker capable of 15 psi, you have an autoclave. 
Or you can just soak it in bleach.  That'll kill anything.


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## Carlos Danger (Oct 4, 2014)

Underoath87 said:


> If any of you have a pressure canner/cooker capable of 15 psi, you have an autoclave.
> Or you can just soak it in bleach.  That'll kill anything.



I think there's a little more to an autoclave that that.....and I'm not sure I'd want my nasty shears cleaned in the very same device that I use to cook my sunday dinners, anyway.


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## Underoath87 (Oct 4, 2014)

Remi said:


> I think there's a little more to an autoclave that that.....and I'm not sure I'd want my nasty shears cleaned in the very same device that I use to cook my sunday dinners, anyway.



The only difference lies in ease of use, safety, electonic options, and design, but standard autoclaving procedure uses 15psi above 1atm (121 C/ 250 F).  The pathogens can't tell the difference between the two machines, so long as the pressure/temp is the same.


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## samiam (Oct 9, 2014)

My black flouride prestige medical shears (friggin awesome) specifically say you can autoclave them on the handles. I made friends with the autoclave tech and toss them in from time to time. Honestly that must be a horrible job to just sit there and put things in and out. No TV no computer just staring at the machine all day. She is one of the happiest employees I have met at the hospital though. In between I use the industrial strength bleach wipes. If you do want to give autoclaving a shot make sure the plastic can handle it. Most of the cheap ones will melt.


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## samiam (Oct 9, 2014)

Underoath87 said:


> Or you can just soak it in bleach.  That'll kill anything.


Not Prions.


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## STXmedic (Oct 9, 2014)

So please refrain from dissecting brains with your trauma shears...


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## samiam (Oct 9, 2014)

STXmedic said:


> So please refrain from dissecting brains with your trauma shears...


Once had a doc grab the shears out of my hand and used them to get thru the ribs for a thoracotomy. Couldn't find the wire saw. I never really thought about it but I should probably not use my cadaver lab tools for anything else.


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## Underoath87 (Oct 9, 2014)

samiam said:


> Not Prions.



Granted...



"(Adapted from www.cdc.gov 11,12)
Table 10. Prion Inactivation Methods for Reusable Instruments
and Surfaces

1. Immerse in 1 N NaOH, heat in a gravity displacement autoclave at 121ºC for 30 minutes. Clean
and sterilize by conventional means.
2. Immerse in 1 N NaOH or sodium hypochlorite (20,000 ppm) for 1 hours. Transfer into water and
autoclave (gravity displacement) at 121ºC for 1 hour. Clean and sterilize by conventional means.
3. Immerse in 1N NaOH or sodium hypochlorite (20,000) for 1 hour. Rinse instruments with water,
transfer to open pan and autoclave at 121ºC (gravity displacement) or 134ºC (porous load) for 1
hour. Clean and sterilize by conventional means.
4. Surfaces or heat-sensitive instruments can be treated with 2N NaOH or sodium hypochlorite
(20,000 ppm) for 1 hour. Ensure surfaces remain wet for entire period, then rinse well with water.
Before chemical treatment, it is strongly recommended that gross contamination of surfaces
be reduced because the presence of excess organic material will reduce the strength of either
NaOH or sodium hypochlorite solutions.
5. Environ LpH (EPA Reg. No. 1043-118) may be used on washable, hard, non-porous surfaces
(such as floors, tables, equipment, and counters), items (such as non-disposable instruments,
sharps, and sharp containers), and/or laboratory waste solutions (such as formalin or other
liquids). This product is currently being used under FIFRA Section 18 exemptions in a number of
states. Users should consult with the state environmental protection office prior to use.


Working Solutions 1 N NaOH equals 40 grams of NaOH per liter of water.
Solution should be prepared daily. A stock solution of 10 N NaOH can be prepared
and fresh 1:10 dilutions (1 part 10 N NaOH plus 9 parts water) used daily.
20,000 ppm sodium hypochlorite equals a 2% solution. Most commercial
household bleach contains 5.25% sodium hypochlorite, therefore, make a 1:2.5
dilution (1 part 5.25% bleach plus 1.5 parts water) to produce a 20,000 ppm
solution. This ratio can also be stated as two parts 5.25% bleach to three parts
water. Working solutions should be prepared daily.
CAUTION: Above solutions are corrosive and require suitable personal
protective equipment and proper secondary containment. These strong corrosive
solutions require careful disposal in accordance with local regulations.
Precautions in using NaOH or sodium hypochlorite solutions in autoclaves:
NaOH spills or gas may damage the autoclave if proper containers are not used.
The use of containers with a rim and lid designed for condensation to collect and
drip back into the pan is recommended. Persons who use this procedure should
be cautious in handling hot NaOH solution (post-autoclave) and in avoiding
potential exposure to gaseous NaOH; exercise caution during all sterilization
steps; and allow the autoclave, instruments, and solutions to cool down before
removal. Immersion in sodium hypochlorite bleach can cause severe damage to some instruments."


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## samiam (Oct 9, 2014)

True but these are NOT the standard methods employed by most hospitals for sterilizing instruments or surfaces. So if there was unkown contamination it would likely slip thru and has. While back there was a brain surgery that exposed like 13 people


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## STXmedic (Oct 9, 2014)

samiam said:


> Once had a doc grab the shears out of my hand and used them to get thru the ribs for a thoracotomy. Couldn't find the wire saw. I never really thought about it but I should probably not use my cadaver lab tools for anything else.


Well that's one way to do it... 

Wait... He was going to use a gigli saw to crack a chest??


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## samiam (Oct 10, 2014)

STXmedic said:


> Wait... He was going to use a gigli saw to crack a chest??



Yeah apparently it was supposed to be a wire saw that loops under the ribs to cut thru them.

Actually these guidelines say use a gigli saw or "large trauma shears" to cut thru the sternum. Must be more common then we thought. 
****Slightly Graphic****
http://www.trauma.org/archive/thoracic/EDToperative.html


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## JPINFV (Oct 10, 2014)

samiam said:


> Not Prions.



1. Are you seriously concerned about mad cow disease?

2. Do prions qualify as being "alive"?


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## samiam (Oct 10, 2014)

JPINFV said:


> 1. Are you seriously concerned about mad cow disease?
> 
> 2. Do prions qualify as being "alive"?


Assumimg they were not used for brain tissue/spinal tissue then no. However I deffinitly think it could be a possibility though very very very remote that one of the 20 cadavers in cadaver lab could have had CJD and tools could potentially be contaminated.  I have deffinitly cut myself on a scapel once or twice in lab. Again very un-likely however not out of the realm of possibilities.  I dont plan on using thoose tools for anything w/o really sterilizing them or just getting rid of them. 

As for prions being "alive" no they are not alive however they are very strong and resistant proteins that remain infectious until denatured which is not easy to do.


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## STXmedic (Oct 10, 2014)

samiam said:


> Yeah apparently it was supposed to be a wire saw that loops under the ribs to cut thru them.
> 
> Actually these guidelines say use a gigli saw or "large trauma shears" to cut thru the sternum. Must be more common then we thought.
> ****Slightly Graphic****
> http://www.trauma.org/archive/thoracic/EDToperative.html


Yeah, I'm familiar with them. They suck when held at sharp angles like I was envisioning would be needed, but I guess they could be held a little wider than I thought. That, and I guess a rib and sternum would be much easier to cut through than a mid-shaft femur...  Lol


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## MackTheKnife (Oct 10, 2014)

teedubbyaw said:


> Death wipes or soap and water. You're not going to sanitize  them.





Underoath87 said:


> If any of you have a pressure canner/cooker capable of 15 psi, you have an autoclave.
> Or you can just soak it in bleach.  That'll kill anything.


Soap and water to do an initial clean, then bleach. It'll kill anything. The pressure cooker is an option.


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