DAANCE Infection Control and Sterilization in the Anesthesia Setting — Questions and Answers
Question 1: According to OSHA's Bloodborne Pathogen Standard, which item must be placed in a puncture-resistant container immediately after use in the anesthesia setting?
- Used syringes with needles still attached (Correct answer)
- Contaminated gauze pads
- Single-use breathing circuit tubing
- Disposable gloves
Correct answer: Used syringes with needles still attached
OSHA requires that sharps—including needles attached to syringes—be discarded immediately into an approved puncture-resistant sharps container without recapping by hand. Gauze, tubing, and gloves go into standard biohazard waste, not sharps containers.
Question 2: Which sterilization method is considered the gold standard for heat-stable dental anesthesia instruments such as metal laryngoscope blades?
- Cold chemical (glutaraldehyde) soaking
- Dry heat oven at 160°C
- Steam autoclave (moist heat) sterilization (Correct answer)
- UV light cabinet
Correct answer: Steam autoclave (moist heat) sterilization
Steam autoclave (moist heat) sterilization at 121–134°C is the CDC and OSAP gold standard for heat-stable instruments. It reliably destroys all microorganisms including spores. Cold chemical soaking and UV cabinets are lower-level disinfection methods, not sterilization.
Question 3: After removing gloves during post-anesthesia cleanup, the dental anesthesia assistant should:
- Apply hand sanitizer only if hands appear visibly soiled
- Perform hand hygiene with soap and water or an alcohol-based hand rub (Correct answer)
- Rinse hands with cold water for 5 seconds
- Don a new pair of gloves without washing hands
Correct answer: Perform hand hygiene with soap and water or an alcohol-based hand rub
CDC hand hygiene guidelines require hand hygiene with soap and water or an alcohol-based hand rub after glove removal, because gloves can have microscopic defects and hands become contaminated during removal. Hand sanitizer alone is appropriate only when hands are not visibly soiled.
Question 4: Which of the following is the correct sequence for reprocessing a reusable anesthesia mask?
- Sterilize → clean → inspect → store
- Clean → disinfect or sterilize → inspect → store (Correct answer)
- Rinse → sterilize → clean → package
- Disinfect → rinse → clean → sterilize
Correct answer: Clean → disinfect or sterilize → inspect → store
Proper reprocessing always begins with cleaning (removing gross debris), followed by appropriate disinfection or sterilization, then inspection for defects, and finally storage in a clean/sterile package. Sterilizing a visibly soiled instrument first is ineffective because bioburden protects organisms from the sterilant.
Question 5: Personal protective equipment (PPE) required for the dental anesthesia assistant during IV placement includes:
- Gloves only, since the oral cavity is not entered
- Gloves and a face shield or mask with protective eyewear (Correct answer)
- A full face respirator and a gown
- No PPE is required for IV access procedures
Correct answer: Gloves and a face shield or mask with protective eyewear
OSHA's standard precautions require gloves plus eye and face protection (mask and protective eyewear, or a face shield) during any procedure where splash or splatter of blood or body fluids is possible—including IV catheter placement. A full respirator is not required unless aerosol-generating procedures are performed.
Question 6: Which of the following best describes the concept of 'zone control' in the dental anesthesia operatory?
- Separating sterile instrument zones from contaminated zones to prevent cross-contamination (Correct answer)
- Designating separate zones for patients of different ASA classifications
- Controlling temperature zones to preserve anesthetic agents
- Marking floor zones to guide patient traffic flow
Correct answer: Separating sterile instrument zones from contaminated zones to prevent cross-contamination
Zone control refers to establishing and maintaining clearly defined sterile and contaminated areas within the operatory so that clean/sterile items are never placed in or near contaminated zones, preventing cross-contamination of instruments, supplies, and surfaces.
DAANCE Infection Control and Sterilization in the Anesthesia Setting
According to OSHA's Bloodborne Pathogen Standard, which item must be placed in a puncture-resistant container immediately after use in the anesthesia setting?