Endoscopes, light sources and tweezers should be inspected before commencing the procedure in order to confirm their correct functioning or state of conservation.
The bronchoscope should receive high-level disinfection (HLD) prior to the first study of the day and immediately following each study.
All of the removable parts should be disassembled for mechanical cleaning. The inside and outside of the bronchoscope should be cleaned vigorously with enzymatic detergent.
The channels should be brushed. The parts that have been removed should be submerged in a neutral enzymatic detergent during a period of time that will depend on the detergent used. The head of the non-submersible bronchoscope should be cleaned with gauze soaked in detergent.
Disinfection should be carried out through the complete immersion of the device in a container with a 2% glutaraldehyde solution without surfactant (being particularly careful when filling the working channels) for 20 minutes.
In the case of non-submersible endoscopes, a rigid tube can be used, making it possible for the entire moveable part to be submerged. The device should be aspirated through the channel using a syringe while maintaining the syringe attached to the aspiration channel. This ensures that the channel it is in contact with the glutaraldehyde during the entire disinfection period.
The activity of the glutaraldehyde solution should be controlled and the containers should be adequately labeled in order to confirm the activation date. Rinsing should be carried out with abundant common water (or preferably distilled sterile water; a physiological solution should not be used) on the exterior cover and the working channels.
The final drying is carried out with oxygen or filtered compressed air. At the end of the day, the bronchoscope should be kept (preferably hung) in a dry, dust-free location.
Biopsy forceps or foreign-body forceps should be washed with enzymatic detergent and subsequently sterilized in an autoclave.
The brushes for cytological and bacteriological studies should be discarded. During the study, the light source should be covered with a disposable sheet of plastic in order to avoid contact with the biological materials. Afterward, it should be cleaned with a piece of gauze soaked in detergent.
Advice:
The immersion of the endoscope in glutaraldehyde for 60 minutes is advised when the study will be conducted in a patient with a compromised immune system.
Frequent monitoring of the pH of the glutaraldehyde is advised, given that the time needed for the activity is variable depending on the quantity of studies carried out. Its estimated duration time is 14 days.
Routine bacteriological control of the endoscope is not advisable, except in the case of a suspected cross-infection. In these cases, the best method of bacteriological isolation is the brushing of the channel.
In the case that persistent contamination of the endoscope channel is confirmed, it should be sterilized with ethylene oxide following exhaustive washing.
Thursday, May 2, 2024
Refrences
Sterilization manual for health centers
Please Check out file at the following link
High-level disinfection stages – Drying
High-level disinfection stages – Rinse of the disinfecting agent
