Extending the Life of the Endoscope: Cleaning and Reprocessing
Pre-cleaning - Device reprocessing starts at the bedside, immediately following the procedure. Flush the internal channels, and suction clear liquid or properly diluted enzymatic detergent cleaner. Some scopes may require additional valves or adapters provided by the device manufacturer in order to flush the air and water channel properly. Wipe the outside of the insertion tube with a moist soft cloth, and then completely contain the instrument for transport to the cleaning area. The containment should not over coil the flexible tubes or otherwise impact the scope, which could lead to damage.
Leak Testing - Leak testing each scope after every procedure and prior to fluid immersion is the single most effective process any facility has for preventing scope damages due to fluid invasion. Follow each manufacturer’s specific guidelines for leak testing; always remove detachable valves and install all fluid protective caps required prior to the test.
It is useful to augment the leak test process by massaging video switches during the pressure test, and if testing a duodenoscope, to activate the forceps raiser.
Manual Cleaning - In the cleaning area, the scope must be meticulously manually cleaned using enzymatic detergent designed for endoscope use. The detergent should be diluted according to label instructions in a sink or basin large enough to contain the scope without over-coiling. All detachable parts, removed for effective leak testing should remain off during the cleaning process.
Wipe all of the outside surfaces with a non-abrasive sponge, and use a brush to clean valve and port openings. With the scope immersed, brush the biopsy and suction channels until clear. Air and water channels cannot be brushed.
Flush detergent through all internal channels using the appropriate manufacturer supplied irrigation tubing. To clean scopes with elevator function, use an appropriate tubing connector to flush the elevator-cleaning channel. Rinse the scope thoroughly using the irrigation tubing to flush the internal channels with rinse water. Purge the channels with air, removing excess water from the scope.
Disinfection - Following manual cleaning, place the scope into disinfecting solution or automated reprocessor.
For an automated reprocessor, use all appropriate supplied tubing and follow device instructions. Ensure that the disinfectant chemical you use is compatible with the method of disinfection provided by the processor. Should there be limitations, additional manual rinsing may be needed to comply with the approved utilization of the chemical. The irrigation tubing should be used to rinse all internal channels.
After the cycle is complete, flush the internal channels with 70% alcohol
solution to promote drying, and then purge them with air. Depending on your
automated reprocessor’s capabilities, you may need to manually instill
the alcohol. Dry the exterior of the scope with a clean cloth and then place
into storage.
Thinking Cap
For manual soak use the irrigation tubing to flush disinfectant through all internal channels. The scope must be completely immersed in disinfectant solution for the entire recommended exposure time. Then remove the scope and rinse thoroughly. Flush with 70% alcohol and purge with air. Dry the exterior of the scope with a clean cloth and then place into storage.
The scope’s necessary chemical-exposure period may reduce as the temperature of the chemical disinfectant increases. Overexposure to excessive temperatures may cause premature aging of endoscopes.
Leak testing is the most effective process for preventing scope damage due to fluid invasion.
