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
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toothbrush before it is withdrawn.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