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6. The valves that will be used during the list, ideally one set per case,

should be disinfected in the same way.

7. After disinfection, endoscopes and valves should be rinsed in bacteria-free

water ensuring that all traces of disinfectant are removed from the

channels, control body and eyepiece. Rinse water should be changed

frequently to avoid the build-up of toxic disinfectant residues. The

endoscopes should be dried carefully and valves inserted.

8. The instrument should then be plugged into the light source and

connected to the suction pump. Air should be blown through all the

channels to expel excess fluid.

9. The instrument should then be ready for use.

When an automated washer/disinfector is used, steps 3 to 7 will be performed by

the machine.

Cleaning and Disinfection of endoscopes : between cases

1. Before the instrument is detached from the light source or video processor

the air/water channel should be flushed with water for at least 15 seconds

to ensure that blood, mucus and other debris are expelled. Some

manufacturers provide a special valve for this. The auxiliary washing pipe

should be connected to the biopsy port and the suction button depressed

for 15 seconds with the distal tip of the endoscope and the washing pipe in

clean water to remove gross debris from the suction and biopsy channels.

The outer surface of the insertion tube should be wiped to remove organic

material. The endoscope may then be disconnected.

2. The instrument should be leak-tested and checked for obvious faults or

damage before being immersed in a suitable neutral or enzymatic


3. The outer surface of the endoscope should be carefully cleaned,

particularly around the control section, the angulation controls, the distal

end (especially the air/water nozzle) and the bridge mechanism of

duodenoscopes, using a soft toothbrush.

4. All valves should be removed and cleaned individually with a cotton wool

bud or small brush.

5. The suction/biopsy channel must be cleaned with a flexible brush of the

correct size. This is repeated until the cleaning brush appears visually

clean at the distal end and light guide connector. The brush is passed

through the suction port in two directions, i.e. insertion tube and umbilicus.

When it appears at the distal end the brush is cleaned using a soft

toothbrush before it is withdrawn. This should be carried out preferably

under water to prevent the risk of splashing or aerosol production. Prior to

reinsertion the brush is again cleaned using the toothbrush.

6. When the channels have been cleaned the suction and air/water ports

must be cleaned with a cotton wool bud or small toothbrush.

7. All channels of the endoscope should be irrigated now with a neutral or

enzymatic detergent using an all channel irrigation device. Suction and air

insufflation should be used to remove fluid residues.

8. After manually filling any auxiliary or raiser channel with disinfectant, the

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