Endoscope Reprocessing

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• Module 1. Disease Transmission & Control
  • 1.1 Disease Transmission & Control
  • 1.2 Standard & Transmission-Based Precautions
  • 1.3a Microorganisms
  • 1.3b Normal Flora
  • 1.3c Infectious Agents
  • 1.3d Bacteria
  • 1.3e Viruses
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  • 1.4 Review
• Module 2. Cleaning Disinfection & Sterilisation
  • 2.1 Cleaning, Disinfection & Sterilisation
  • 2.2 Impacting on Sterilisation & Disinfection
  • 2.3 Cleaning
  • 2.4 High-level Disinfectants & Chemical Sterilants
  • 2.5 Review
• Module 3. Workplace Health & Safety
  • 3.1 Workplace Health & Safety
  • 3.2 Biological Hazards
  • 3.3 Hazardous Substances
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  • 3.5a Risk Assessment-Glutaraldehyde
  • 3.5b Risk Assessment-Peracetic Acid
  • 3.5c Risk Assessment-OPA
  • 3.6 Review
• Module 4. Endoscope Structure & Function
  • 4.1 Structure & Function
  • 4.2 External Components
  • 4.3 Internal Features
  • 4.4 Review
• Module 5. Reprocessing
  • 5.1 Reprocessing
  • 5.2 Pre-cleaning
  • 5.3 Leak Testing
  • 5.4 Manual Cleaning & Rinsing
  • 5.5 Manual High-level Disinfection
  • 5.6 Final Drying
  • 5.7 Reprocessing Accessories
  • 5.8 Automated Reprocessors
  • 5.9 Damaged Endoscopes
  • 5.10 Review
• Module 6. Quality Assurance
  • 6.1 Quality Assurance
  • 6.2 Proof of Process
  • 6.3 Templates
  • 6.4 Microbiological Testing
  • 6.5 Water Quality
  • 6.6 Recall & Tracking
  • 6.7 Review
• Final Review
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5.2 Pre-cleaning

In the examination room immediately after the procedure:

1. Wipe the insertion tube with a disposable cloth dampened in an enzymatic detergent solution.

• Wipe the endoscope still attached to the light source, grasp the control head and using a disposable cloth dampened in freshly prepared enzymatic detergent solution, wipe the insertion tube from the control head to the distal tip.
• Discard the cloth after use.

2. Aspirate enzymatic detergent solution through the suction/biopsy channels.

• Place the distal tip in the enzymatic detergent solution.
• Aspirate the enzymatic detergent through the entire suction/biopsy channel system until the expelled solution is visibly clean.
  -  Immediate flushing of the biopsy/suction and air/water channels prevents drying of organic and inorganic debris on lumen surfaces and assists in the removal of large numbers of microorganisms.
• Alternate the suctioning of enzymatic detergent solution and air several times - finish by suctioning air.
  -  Alternate suctioning of fluid and air creates agitation and is more effective than suctioning fluid alone in dislodging debris from internal lumens.

3. Purge air/water channels.

• Depress and release air/water button several times to flush water channel.
• Occlude air button to force air through air channel.

Further processing depends on the type of endoscope.
At this point either:

• Insert the special air/water channel feed button.
• Depress air/water feed button to flush with water then release for air flow to expel water.

or 

• Disconnect the water bottle connector from the endoscope taking care not to contaminate its end.
• Occlude water connector port on the light guide plug and depress water feed button until all water expelled.

or

• Move lever on water feed connector to close off the water supply.
• Depress water feed button till all water is expelled.

4. Detach removable components

• Remove the endoscope from the light source.
• Attach protective video cap (if using video endoscope)
• Transport to the cleaning area in a container that does not cause contamination of th environment
• Remove all valves/buttons/caps and soak in enzymatic detergent solution

It is preferable to have extra supplies of valves/buttons/caps to ensure that adequate cleaning is performed prior to disinfection/sterilisation. This allows processing of valves/buttons/caps to be completed at an alternate time.

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