i. a printout of cycle parameters which can be retained for quality assurance
It is essential to confirm that a machine is compatible with the disinfectant to be
used. The disinfectant will remain in contact with the machine for much longer
periods than with the endoscope. Advice on compatibility should be sought from
the disinfectant and machine manufacturers. Users are advised to review
independent test reports before purchasing automated processing equipment.
Cleaning and disinfection - practical recommendations
The cleaning and disinfection of endoscopy equipment is a specialised procedure
and should only be carried out by personnel who have been trained for the
purpose and who have an understanding of the principles involved. If an
emergency endoscopic procedure is done out of hours, someone with this
knowledge should be available and be responsible for the cleaning and
disinfection of the equipment.
The most important aspect of the process is the manual cleaning of instruments
with detergent. The aim is to remove all blood, secretions and other organic
material prior to the surfaces coming into contact with the disinfectant If this
process is not performed thoroughly, organic material may become fixed and
organisms not accessed by the disinfectant. The utmost care must be taken at
this stage of the cleaning process. All modern endoscopes are fully immersible
but caps must be fitted when required (eg with video endoscopes).
Manufacturers' instructions must be assiduously followed.
The following recommendations are made for cleaning and disinfection of
endoscopes for which an automated system is preferred: at the start of the day.
1. Instruments to be used during the list should be checked for faults.
2. If instruments have been thoroughly cleaned and disinfected at the end of
the previous day, they should be put through an automated cleaning and
disinfection process (or subjected to a manual disinfection procedure)
with, in the case of glutaraldehyde, a 10 minute exposure at the start of
the next day. There is no necessity to clean the endoscope channels
providing this was done at the end of the previous day.
3. All channels should be flushed with the disinfectant either independently
or by using an all-channel irrigator. Care should be taken to ensure
disinfectant emerges from all ports on the light guide connector and distal
end of the instrument. Appropriate personal protection must be worn by
staff before immersing equipment in disinfectants.
4. The instrument should be fully immersed in disinfectant for the correct
contact time; a timer should be used to indicate when the correct time is
attained. A variant of this might be to include the endoscope in the selfdisinfection
cycle of the automated washer/disinfector machine at the start
of a day or session, provided an endoscope- compatible disinfectant is
5. The raiser bridge or auxiliary channel in some endoscopes requires
flushing manually using a 2 ml syringe and a channel adapter. A new
syringe should be used for each endoscope.