been used or contaminated is not a mere function but an obligation for patient and
personnel safety. The preliminary steps in processing equipment through CMS must be
b. Sorting. Sorting of used items is performed first in the cleanup area. It is
essential for efficient processing since items are cleaned differently and with various
cleaning agents. It is much easier and faster to clean many like-items at one time than
to process a few of a variety of items. The instruments are carefully removed from the
bags and sorted as follows:
Heat-resistant, submergible (can be put in water).
Heat-sensitive, not submergible.
Like items are put together for further processing.
a. The Cleaning of Items. After supplies and equipment are sorted, cleaning
the items is the next step. Cleaning procedures depend on whether the items are soiled
b. Contaminated Items. Decontaminating reduces the microbial count on an
item to a level where personnel can safely handle the item. Contaminated items must
be terminally sterilized (see para 1-14gg) before further processing. Cleaning is a form
of decontamination; disinfecting is another. In order to prevent the spread of bacteria
from contaminated articles, you must take these actions prior to cleaning and further
(1) To decontaminate, place (submerge) in a detergent solution and steam
sterilize all items that can withstand moisture and heat. Use a washer-sterilizer-
decontaminator for decontaminating whenever possible.
(2) Gas sterilize, using double the exposure time, items that cannot be
submerged and that are heat-sensitive.
(3) Soak in a detergent-disinfectant all items that are heat-sensitive if gas
sterilization is not available.
Personnel working in the decontaminating area must change clothes and
thoroughly wash arms and hands before leaving the area. Gloves must be
worn while handling contaminated items.