A few days ago, I posted an article on the disinfection and maintenance skills competition of endoscopy equipment in the disinfection supply center of a county-level hospital in the west on the promotion platform of the disinfection product supplier. It was formulated based on the "Guidelines for the Cleaning and Disinfection of Rigid Endoscopy Equipment" Propaganda articles for the two links of practical operation and knowledge Q&A.
It can be said that this kind of activity is very meaningful and has a positive effect on promoting the standardization of hard endoscope CDS in the grassroots disinfection supply center.
But there is a phenomenon: due to the limited fields involved at the grassroots level, there may still be some misunderstandings in some professional knowledge.
A soft endoscope leak detection problem
The flexible endoscope should be tested for leaks every time before cleaning, and should be tested once a day if conditions do not permit.
What is this condition?
Answer: According to the instructions and requirements of the endoscope manufacturer, every lens must be leak-tested before cleaning; because the 2016 version of the soft endoscope decontamination specification is a standard set for medical institutions in China, the hospital can follow the department staff , The number of mirrors, the number of patients... and so on.
If the previous patient was treated, especially the use of sharp or high-frequency electrocautery and other energy treatment work, it is recommended that leak detection be required before cleaning. In addition, you must check before using these cleaning brushes or treatment accessories every day.
1 The leak detector of the soft endoscope uses a manual type
Or is it automatic? Which way is better?
Answer: It is divided into manual type and automatic type. Manual type: continuous air pump leak detector-Olympus or watch pressure leak detector-Fuji, Pentax and most domestic endoscope manufacturers; automatic type: Aohua, domestic reprocessor equipment manufacturers.
It is recommended to select the leak detector and method according to the requirements of the endoscope manufacturer. Whether it is manual or automatic, it must be carried out according to the process and the endoscope is placed in the water to observe the location of the leak. If the bent rubber leaks, it must be wrapped with adhesive tape. Measurement. (Note: For smaller endoscopes such as fiberoptic bronchoscopes and choledochoscopes, observe more carefully)
How long does it take for a flexible endoscope to detect leaks?
Answer: According to the standard leak test process, it usually takes 3 to 5 minutes. One principle must be mastered: all pipes inside the endoscope must be exhausted, and each angle must be the largest (the angle is not enough, please adjust in time) and at least each angle Observe for more than 30 seconds.
Two soft endoscope disinfection (sterilization) problem
The soft endoscope is used as the choice of disinfectant. If some disinfectants (sterilization) are recommended in the 2016 version of the soft endoscope decontamination specification: OPA, GA, PAA, chlorine dioxide, AEOW, can any of them?
Answer: In theory, it is possible, but because the endoscope is under the manufacturer's warranty during the new product warranty period. For unnecessary trouble, please choose according to the requirements of the endoscope manufacturer's instructions; on the other hand, you can consider the principle of cost performance.
1 It can be sterilized for more than or equal to 10 minutes. Is this kind of disinfectant (sterilizer) the best choice?
Answer: No matter which disinfectant (sterilizer) is selected, the quality and drying of the endoscope are the key factors. If you choose PAA sterilization, how to prevent secondary pollution after sterilization should be considered?
The endoscope should not be immersed in any liquid for more than 2 hours, otherwise it will accelerate the aging of the mirror, right?
Answer: According to the manual of Olympus, the first soft brand, the electronic soft endoscope cannot exceed 60 minutes, the fiber soft endoscope cannot exceed 10 hours, and the wolf brand soft endoscope cannot exceed 2 hours. (The rigid endoscope is not specifically stated)
4 The sterilization method of the endoscope cannot be changed frequently, otherwise it will accelerate the aging of the mirror and damage the mirror sealing system, right?
Answer: Yes, because each sterilization method may damage the endoscope, but the degree is different. Repeated replacement will accelerate the aging of the mirror. Therefore, when using some high-dose sterilizers, special attention and careful selection are required.
Three decontamination water problems, can normal saline be used?
Answer: Surgical instruments or endoscopes cannot use saline, which will corrode the instruments or endoscopes. If you accidentally use it, you must wash it thoroughly before proceeding to the next step.
2 How to disinfect (sterilize) the water bottle?
Answer: Since the water injected into the patient's body is sterile in the 2016 version of the soft endoscope cleaning specification, it is recommended to wash the water bottle once a day.
Imported endoscope manufacturers can basically use high temperature and high pressure, and can also choose epoxy. Domestic products may not be capable of high temperature and high pressure, please consult the manufacturer for specific details.
Four storage problems of flexible endoscopes
When is the disinfection function of the soft endoscope storage cabinet used?
Answer: The disinfection function of the storage cabinet is only to disinfect the air in the storage cabinet space, so the endoscope cannot be used in the storage cabinet. Avoid damage to the endoscope.
2 Can the lens case provided by the soft endoscope manufacturer be stored?
Answer: The mirror box is only used for transportation from the manufacturer to the hospital or during normal maintenance, and cannot be used for other purposes.
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