Free tool · CRCST exam topic
Spaulding classification
Pick what the item touches and see its Spaulding category and the minimum reprocessing CDC requires — sterilization, high-level disinfection or low-level disinfection.
Spaulding category
Critical
Minimum reprocessing
Sterilization
Steam sterilization when the item is heat-tolerant; ethylene oxide, hydrogen peroxide gas plasma or liquid chemical sterilants for heat-sensitive items.
Examples
Surgical instruments · Cardiac catheters · Urinary catheters · Implants · Ultrasound probes used in sterile body cavities
Spaulding category
Semicritical
Minimum reprocessing
High-level disinfection (at minimum)
The item must be free of all microorganisms, although small numbers of bacterial spores are allowed.
Examples
Respiratory therapy equipment · Anesthesia equipment · Some endoscopes · Laryngoscope blades · Esophageal manometry probes · Cystoscopes · Anorectal manometry catheters · Diaphragm fitting rings
Spaulding category
Noncritical
Minimum reprocessing
Low-level disinfection
Intact skin is an effective barrier to most microorganisms, so items that touch only intact skin need cleaning and low-level disinfection.
Examples
Bedpans · Blood pressure cuffs · Crutches · Computers · Bed rails · Some food utensils · Bedside tables · Patient furniture · Floors
The Spaulding classification
Earle Spaulding’s scheme, used in CDC’s Guideline for Disinfection and Sterilization, classifies patient-care items by the risk of infection from their use — and that decides how they must be reprocessed.
| Category | Contact | Reprocessing |
|---|---|---|
| Critical | Enters sterile tissue or the vascular system | Sterilization |
| Semicritical | Contacts mucous membranes or nonintact skin | High-level disinfection (at minimum) |
| Noncritical | Contacts intact skin only (not mucous membranes) | Low-level disinfection |
Critical items
Critical items carry a high risk of infection if contaminated with any microorganism, including bacterial spores.
- Surgical instruments
- Cardiac catheters
- Urinary catheters
- Implants
- Ultrasound probes used in sterile body cavities
Semicritical items
Intact mucous membranes generally resist common bacterial spores but are susceptible to other organisms such as mycobacteria and viruses.
- Respiratory therapy equipment
- Anesthesia equipment
- Some endoscopes
- Laryngoscope blades
- Esophageal manometry probes
- Cystoscopes
- Anorectal manometry catheters
- Diaphragm fitting rings
Noncritical items
Noncritical items have a low risk of transmitting infection directly, but can spread organisms on hands and equipment.
- Bedpans
- Blood pressure cuffs
- Crutches
- Computers
- Bed rails
- Some food utensils
- Bedside tables
- Patient furniture
- Floors
Cleaning always comes first: organic material left on an item can stop a disinfectant or sterilant from working.
Spaulding on the CRCST exam
HSPA’s CRCST content outline names the three levels of the Spaulding classification under Cleaning, Decontamination and Disinfection, the section with 21% of the exam. Expect questions that give you an item and ask what level of reprocessing it needs, and questions on the disinfectant types (quats, halogens, aldehydes) used for each level. For sterilization parameters, see thesteam sterilization cycle times.
Test yourself: a CRCST-style question
A laryngoscope blade contacts the patient’s mucous membranes. Under the Spaulding classification, what is the minimum reprocessing it needs?
- Cleaning only
- Low-level disinfection
- High-level disinfection
- Sterilization is always required
Show answer
C. High-level disinfection
Items that contact mucous membranes or nonintact skin are semicritical and need at least high-level disinfection. Sterilization is required for critical items, which enter sterile tissue or the vascular system.
Questions like this come up in the Cleaning, Decontamination and Disinfection section of the CRCST exam. The 901 questions in the app each come with a written explanation.
FAQ
- What are the three Spaulding categories?
- Critical (enters sterile tissue or the vascular system — sterilize), semicritical (contacts mucous membranes or nonintact skin — at least high-level disinfection) and noncritical (contacts intact skin only — low-level disinfection).
- Is an endoscope critical or semicritical?
- It depends on where it goes. Most gastrointestinal endoscopes contact mucous membranes and are semicritical, needing at least high-level disinfection. Endoscopes that enter sterile tissue or body cavities are critical and should be sterilized.
- What does the Spaulding classification not cover?
- It does not by itself address prions, or the cleaning that must come before any disinfection or sterilization. Always clean first, and follow the device manufacturer’s instructions for use.
Sources
- CDC. Guideline for Disinfection and Sterilization in Healthcare Facilities (2008): A Rational Approach to Disinfection and Sterilization
- HSPA. CRCST Exam Content Outline (revised November 2023)
Checked against these sources on November 13, 2026. For education and CRCST exam preparation only — not a substitute for your facility’s policies, the device and sterilizer manufacturers’ instructions for use (IFU), or ANSI/AAMI standards. Everything runs in your browser; nothing you enter is sent anywhere.