Spaulding classification for sterile processing

Three classes, three minimums

Earle Spaulding sorted patient-care items by infection risk. The CDC guideline still uses that sort. Critical items enter sterile tissue or the vascular system: surgical instruments, implants, cardiac and urinary catheters, ultrasound probes used in sterile body cavities. They must be sterile. Steam is preferred when the device can take heat and moisture.

Semicritical items contact mucous membranes or nonintact skin: some endoscopes, respiratory and anesthesia equipment, laryngoscope blades, cystoscopes. They need high-level disinfection at a minimum. Small numbers of bacterial spores are tolerated; bacteria, mycobacteria, and viruses are not. Noncritical items contact intact skin only, such as bedpans and blood-pressure cuffs, and they receive low-level disinfection.

The class follows the use

The same object can move categories if the use changes. A thermometer that touches intact skin is noncritical. One that touches nonintact skin is not. When you are unsure, read the IFU and ask infection prevention. Do not downgrade a critical instrument to a disinfectant wipe because the schedule is tight.