EFHSS Questions and Answers - Question Q00189

Dear Sir

I am Mohan Warrier from India once again posing silly questions. Can you help me with the details of, preferably economical, but effective Endoscopic Cleaners available and used there? During our visits, we find that the endoscopes are exposed to Acrylic chambers filled with Formaldehyde and believed that they are sterile. Most of them do not even have an ultrasonic cleaner here.

Regards
Mohan Warrier

Dear,

Hereby the procedure for the cleaning of endoscopes as it is proposed by the committees of hospital hygiene in our province - West Vlaanderen, Belgium, www.azbrugge.be/ziekenhuishygiene -.
I hope it can give you guidance.

"The newest generation of endoscopes is totally immersable and is preferred. If non immersable scopes are used (handpiece - connecting hose) special attention has to be given to these parts to prevent transmission of microorganisms.
Thorough mechanical cleaning of the endoscope (internally and externally) always takes place immediately after each examination. Hereafter always follows a disinfection or sterilization procedure.

Always use a fresh soft soap solution and lukewarm water for cleaning the outside of each endoscope, the internal channels, the not immersable handpiece and connection hose: scope - light source. (soap doesn't solve well in cold water). As cleansing agent an enzymatic solution is preferred e.g.: biotex, endozyme. Respect the contacttime (most of the time 1 to 2 minutes). Ask the manufacturer of the endoscope if the detergent is compatible. When you use a powder make sure it is solved completely. Not solved grains can block the internal channels. The same is true for not well mixed solutions of liquid soap. You can also use Savlon 1% (chlorhexidine-cetrimide) or liquid handsoap.
Use a brush to remove all foreign material from aspiration and biopsy channel (eventually water and air channel). The scope is dismantled as much as possible. The pieces are also immersed in the cleansing solution. The end of the scope is brushed carefully to remove all organic material from every exit. The cleaning must be followed by a abundant rinsing with tap water to remove all rests of soap. The rinsing water is removed as much as possible before the scope is placed in a disinfectant solution - to prevent dilution -. The cleansing brushes are disposable or have to be cleaned thoroughly. They are at least daily high level disinfected or sterilized."

More information on this topic you can find in the WIP guideline 21b: Cleaning and disinfection of endoscopes (see the EFHSS Education page) and on the website of our industrial partner Olympus, www.olympus.com.

Good luck,
Wim Renders