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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.

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