1. Make up enzymatic solution
Make up fresh enzymatic detergent solution to the manufacturer's instructions for reprocessing each endoscope. Fresh solution prevents cross contamination.
2. Immerse instrument
Completely immerse the endoscope.
Whenever practical, leave the endoscope immersed in the detergent solution when performing all subsequent cleaning steps to prevent the production of aerosols of contaminated fluid.
3. Disassemble removable parts and clean
The endoscope must be completely disassembled so that all surfaces may be reached for thorough cleaning.
4. Brush and wipe exterior
Use of non-abrasive and lint-free cleaning tools will prevent damage to the endoscope.
Soft toothbrushes are useful to clean grooved handles and to brush the distal tip.
Valve seats and biopsy ports should be brushed using brushes supplied by the manufacturer which are designed for this purpose.
Cotton buds may be used to clean the suction valve port but should not be used in the air/water port as threads can become caught and cause blocked channels.
Check that all visible debris has been removed.
Cleaning brushes for valve ports are available from manufacturer.
5. Brush all channels
Cleaning brushes for all brushable channels are supplied by the manufacturer.
Use a brush size compatible with each channel. Rinsing the brush tip maximises cleaning of the channels by ensuring that as much debris as possible is removed before retraction or reinsertion.
Cleaning and thermally disinfecting brushes reduces the risk of contamination of endoscopes by inadequately cleaned brushes.
Inspect reusable brushes between uses and replace when bristles are worn, frayed, bent, if the shaft is kinked or the brush is otherwise damaged.
Worn bristles are ineffective in cleaning and damaged brushes may damage endoscope channels.
6. Properties of effective cleaning brushes
Brushes should:
Bristles should be:
Shafts should not kink during use or cause channel damage
7. Attach cleaning adaptors if required
All endoscopes are supplied with appropriate cleaning adaptors. It is vital that persons cleaning endoscopes are conversant with these adaptors and use them correctly.
Substitute cleaning equipment should not be used unless approved by the supplier of the instrument, e.g. using a syringe to squirt fluid into a port which requires a screw thread adaptor is not safe practice.
Rubber "0" rings on the adaptors must be inspected regularly for defects or looseness and should be replaced as required.
In order to achieve adequate flow through all lumens, various adaptors or channel restrictors may be required.
Flushing all channels removes debris, expels bubbles and ensures that the detergent is in contact with all surfaces of the channels.
All channel entrances must be under the surface of the detergent to ensure that no air enters the channel when the endoscope is immersed.
Product specific contact time is required to allow enzymes to penetrate organic material.
If there is a delay prior to further processing due to emergency circumstances, the endoscope can be left soaking in a container of enzyme solution for a short period only.
1. Water rinse
Clean running water should be used to remove all traces of detergent prior to disinfection.
The use of clean water for each endoscope will limit the potential for cross infection.
The amount of water required to throughly rinse the endoscope after cleaning will vary according to the design and length of the instrument.
2. Dry external surfaces
3. Purge internal channels with air
Removing water from all channels and the exterior of the endoscope prevents dilution of the biocide used for disinfection.
This process can be completed using a syringe or compressed air. If using compressed air see the Final drying before reuse section for information about air pressure.
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