FLEXIBLE ENDOSCOPES

For the cleaning of flexible endoscopes – consult manufacturer’s instructions, AS/NZ 4187 and GENCA Guidelines. The is also a Queensland Health web site on Endoscopic Reprocessing which is interactive.

Endoscopes should be cleaned as soon as possible so that secretions do not dry and harden which makes cleaning much harder.

Manufacturer’s instructions should always be followed as well and AS/NZ 4187.

Staff should be familiar with the structure of the endoscope and be trained in cleaning techniques and practices.

FLEXIBLE URETEROSCOPE – (Urology)

Flexible Ureteroscope

Always protect flexible scope. Staff are to wear PPE. Use appropriate Leak Tester (usually supplied from company) to perform leak test.

Ensure all valves, luer lock taps etc. are opened or removed prior to leak testing. Attach leak tester to fitting.

Pump leak tester up to anywhere in the blue shaded area, and observe for 30sec. The needle in the gauge should not fall if there is no leak. Manipulate distal end of scope whilst leak testing. If a leak is identified follow manufacturer’s instructions for return of scope for repair. Deflate and remove test from scope. Follow manufacturer’s instruction as to whether a dry or dry & wet leak test is to be performed.

In a clean soak dish mix enzymatic cleaning solution with water – dilute as per manufacturer’s instructions. Immerse scope into cleaning solution.

Leak tester

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Flush channels with cleaning solution using a syringe. Using a lint free cloth and keeping the scope immersed clean the entire scope starting from the eyepiece. The eyepiece can also be cleaned with a cotton bud.

Clean down the insertion tube to the distal end. A bristle brush can be used to clean any grooves and crevices.

Brush both instrument and irrigation channels with appropriate brush supplied from company.

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Using the long channel brush, insert it through the instrument channel port and with short strokes feed it through past the distal end. Clean the brush head off before pulling the brush back through the channel. Repeat this step until the brush appears clean and no debris are observed coming from the scope.

Remove valves and brush the valve housing. Accessory items can be cleaned in the ultrasonic cleaner and thoroughly rinsed.

Use sterile water to rinse and flush.

The flexible scope and all accessory items should be meticulously rinsed in a clean soak tray with sterile water.

Brush

Brush

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With a clean lint free cloth wipe over the scope with sterile water to remove any residue of cleaning solution.

Use sterile water from another bowl to flush lumens & channels.

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Flush both channels with sterile water. Remove scope from rinse container and flush channel with a syringe filled with air the remove any water.

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Wipe and dry the scope with a lint free cloth. Be gentle with wiping the flexible insertion tube.

Sterilise flexible scopes as per manufacturer’s instructions.

Dry all accessory items in dryer if applicable.

Re-check the leak test.

To aid in the drying the channels use medical grade compressed air.

Connect Oxygen tubing to one channel port and close off the other. Dry channels for approx 10-20min at 3L/min or as recommended by the manufacturer.

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