Patient Care · Infection control3 min read5-question check
Sterile Technique and Hazardous Materials
Only sterile touches sterile, anything below the table edge is contaminated, and the SDS tells you how to handle a chemical.
Clean vs sterile
Medical asepsis, or clean technique, reduces the number and spread of microbes. Hand hygiene, clean gloves, and wiping the table and detector between patients are medical asepsis. Surgical asepsis, or sterile technique, removes all microbes from an object or area and keeps them out. It is used for arthrograms, myelograms, line placement, and any time skin is broken or a body cavity is entered. Disinfection uses chemicals to kill most pathogens on surfaces, but not always spores. Sterilization kills every microorganism, spores included, with steam under pressure in an autoclave, ethylene oxide gas, dry heat, or chemical sterilants.
The sterile field
Only sterile touches sterile. A sterile field is sterile only at and above the table top. Anything below the waist or the table edge, and the outer inch of a drape, is considered contaminated. Never reach across a sterile field and never turn your back to it. A sterile gown is sterile in front from chest to waist and on the sleeves from about two inches above the elbow to the cuff. Moisture that soaks through a drape, called strike-through, contaminates it. Open a sterile pack with the first flap away from you so you do not reach over it. If you are not sure something is sterile, consider it contaminated and replace it.
Sharps and IV supplies
Used needles go straight into a puncture-resistant sharps container without recapping, bending, or breaking. Replace the container when it is about three-fourths full. Used IV supplies go in the right container too: the catheter stylet and any needle go to sharps, and tubing or dressings soaked with blood go into a red biohazard bag. Report any needlestick at once, wash the site with soap and water, and follow facility policy for testing and follow-up.
Hazardous materials
OSHA's Hazard Communication Standard requires a safety data sheet, or SDS, for every hazardous chemical, including disinfectants and contrast cleanup agents. The SDS lists the hazards, protective equipment, first aid, and spill response. Read it before using a new product and keep it where staff can reach it. Chemotherapy drugs are hazardous to staff. Body fluids from a patient who received chemotherapy are treated as hazardous for a period after the dose, commonly about 48 hours, so wear chemotherapy-rated gloves and a gown when handling them. Ventilate when using strong disinfectants and never mix cleaning chemicals.
Clinical Example
During a knee arthrogram, the radiologist's sterile glove brushes the edge of the C-arm, which is not draped. The radiographer points it out at once. The radiologist changes gloves before touching the needle or the sterile tray, and the exam continues without contamination.
Common Mistakes
- Treating disinfection and sterilization as the same thing.
- Counting the area below the table edge as part of the sterile field.
- Recapping a used needle before discarding it.
- Handling a chemotherapy patient's urine or emesis with standard gloves only.
Why It Matters
The 2027 outline names asepsis, disposal of IV supplies, and hazardous materials directly. You will help with sterile procedures and handle chemicals every week, and the registry tests the rules that keep patients and staff safe.
Key Relationships
- Medical asepsis → reduce microbes; surgical asepsis → eliminate them
- Disinfection → most pathogens; sterilization → all, including spores
- Below table level or outer inch → contaminated
- Needle or stylet → sharps; bloody tubing → biohazard bag
- Chemical question → read the SDS