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Proper
Care and Maintenance of Endoscopes and Endoscopic Instruments: These are general care and maintenance principles for all rigid endoscopes and endoscopic instruments. Proper care of endoscopes and endoscopic instruments may result in: w Increased life span of the endoscopes and instruments w Decreased repair and replacement costs w Reduced number of microorganisms, thus limiting the possibility of infection The personnel that will be handling the endoscopes and instruments should be wearing scrubs and rubber aprons to prevent soiling their street clothes. The area where instruments are opened should be a designated area that has BIOHAZARD waste containers. All boxes and their contents should be disposed of in these containers. Cleaning Disassembly and meticulous mechanical cleaning is essential to remove organic matter and residual debris. Proper contact of the sterilization or disinfection medium to the scopes and instruments will occur only if they are clean. Ethylene oxide gas and disinfection solutions will not efficiently penetrate residual organic matter. Removing residual debris requires complete disassembly of instruments as indicated by manufacturer's instruction manual, followed by thorough cleaning and rinsing. When cleaning, avoid using abrasive materials. Instead use soft cloths, cotton tip applicators, a soft tooth or scrub brush. This will protect the scope or instrument surface from scratches. Brushes of various lengths and diameters can aid in cleaning the lumen of sheaths, instrument channels and stopcocks. Residual moisture will promote corrosion, therefore thorough drying before reassemble, sterilization and storage is essential. Corrosion is a common cause of instrument malfunction. Although manufacturing defects are frequently blamed for corrosion, the belief that stainless steel instruments will not stain or corrode is a more prevalent cause. Contrary to this belief, stainless steel does spot and stain. When endoscopic instruments do spot or stain common causes are w Very acid or alkaline pH detergents w Improperly dissolved detergent leaving residual powder w High mineral content of the water used for cleaning, rinsing, or in the steam autoclave w Residual disinfection solution w Disinfection solutions with an acidic pH w Residual blood, organic matter, or irrigation solution (e.g. saline), especially if instruments are not completely disassembled or thoroughly cleaned w Chemical change resulting from prolonged exposure of dissimilar metals to electrolytic solutions (e.g. normal saline, disinfection solutions) w Scratches on instruments that allow corrosive agents to get below the passivation layer, a protective layer on the instrument surface All moving parts should be lubricated before reassemble to prevent "freezing" of stopcocks and forceps jaws. Check your instruction manual to determine which parts to lubricate. A water-based lubricant may be used when reassembling portions of instruments before sterilization/disinfection. Because sterilization/disinfection mediums may not penetrate tight-locking mechanisms, endoscopic instruments should not be reassembled before sterilization or disinfection. Instruments that are terminally disinfected at the end of the day should be rinsed with demineralized water, dried thoroughly, and stored in protective containers. These general principals will help you properly care and maintain your institution's endoscopes and endoscopic instruments. |
