Steps of HLD by Chemicals

Step 1: Decontaminate, clean, and thoroughly dry all instruments and other items to be processed. Water from wet items will dilute the chemical solution, thereby reducing its effectiveness.

Step 2: When using a glutaraldehyde-containing solution: Prepare the solution according to the manufacturer's instructions. Ideally, an indicator strip should be used each time the solution is used to determine if the solution is still effective. After preparing the solution, put it in a clean container with a lid. Mark the container with the date the solution was prepared and the date it expires.; When using a chlorine solution: Prepare the 0.5% chlorine solution as described for decontamination. Fresh solution should be made each day, or more often if the solution becomes cloudy. Put the solution in a clean container with a lid.

Step 3: Open all hinged items and disassemble those with sliding or multiple parts. The solution must contact all surfaces in order for HLD to be achieved. Completely submerge all items in the solution. All parts of the items should be under the surface of the solution. Place any bowls and containers upright, not upside-down, and fill with the solution.

Step 4: Cover the container, and allow the items to soak for 20 minutes. Do not add or remove any instruments or other items once timing has begun.

Step 5: Remove the items from the solution using dry, HLD pickups (lifters, cheatle forceps).

Step 6: Rinse thoroughly with boiled water to remove the residue that chemical sterilants leave on items. This residue is toxic to skin and tissue.

Step 7: Place the items on an HLD tray on in an HLD container and allow to air-dry before use or storage. Use items immediately or keep in a covered, dry, HLD container and use within one week.; Note: An HLD tray or container can be prepared by boiling it for 20 minutes or by filling it with a 0.5% chlorine solution and letting it soak for 20 minutes, then draining the chlorine solution and rinsing thoroughly with boiled water.

Tips for chemical HLD:

Items must be completely covered with solution. Open all hinged instruments and disassemble items with sliding or multiple parts.
Soak for 20 minutes. If you forget to start timing, start at the point at which you remember.
Do not add or remove anything once timing begins.
Rinse items thoroughly with boiled water.

Antiseptics should never be used for HLD.

Formaldehyde is potentially cancer-causing and extremely irritating to the skin, eyes, and respiratory tract. Therefore it is not recommended.

Disinfectants should always be stored in a cool, dark place. Never store them in direct light or near excessive heat.