Contact times for cleaning fluids depends on the types of agent against which protection is required:
10 min contact for bacteriocidal and fungicidal protection.
10 min contact for virucidal protection.
30 min contact for tuberculoicidal protection.
30 min contact for sporocidal protection.
30 min contact for protection of immunocompromized patient.
Always check manufacturer's recommendation for cleaning instructions.
Test kit to ensure cleaning fluids will be efficacious.
Step 1 - Prepare cleaning solutions
Prepare proteolytic cleaning solution to manufacturer's recommendations. Test efficacy with test kit if available.
Disassemble endoscope from light source and suction.
Fit watertight caps as directed for your endoscope and immerse in cleaning fluid.
For non-immersible scope do not disconnect light source and suction and immerse tip only in fluid. Do not immerse endoscope unless manufacturer expressly recommends.
Rinse thoroughly with water and drain.
Step 2 - Check for damage
Attach a leak detector and immerse the scope in water. If bubbles are seen coming from the body of the scope do not continue with the cleaning process.
Step 1 - Disinfect endoscope
Prepare 1 l of disinfectant solution at appropriate concentration.
Add to large plastic bowl.
Place the tip of the endoscope in the bowl below the level of the disinfectant.
Suck disinfectant into the scope by using the suction channel.
If immersible scope immerse in disinfectant solution for required time.
Step 2 - Clean biopsy channel
Remove biopsy valves and clean and disinfect as required, rinse and dry.
Pass the cleaning brush through the biopsy channel at least three times.
Aspirate disinfectant and then clean water to rinse.
Step 3 -
Block the water inlet valve with a finger and depress the air/water button to blow the water out of the channel.
Wipe insertion tube with a 4x4 gauze soaked in disinfectant solution.
Rinse in clean water. Never immerse the endoscope (unless specifically recommended by manufacturer).
Dry endoscope channels with a pressurized air-line if available.
Step 4 - Clean outside of endoscope
Wash outside of endoscope with 4x4 gauze soaked in disinfectant.
Brush tip with soft toothbrush.
Clean lens with a cotton bud dipped in 70% alcohol.
Step 1 - Drain
Dry outside with clean 4x4 gauze if reusing immediately.
Hang endoscope on a hook with distal tip downwards to allow any residual fluid to drain out. Do not autoclave or dry in hot oven.
Step 2 - Storage
Once dry store endoscopes hanging vertically in safe area - ideally padded storage cabinet.
They should not be stored coiled in carrying case for prolonged periods.
If putting scope into carrying case place a clean plastic sleeve over insertion tube to prevent contamination of the clean scope. Take care not to crush or bend scope at an acute angle as this may break optical fibers inside.
Reasons for treatment failure
Damage to the fiberoptics (caused by excessive bending) results in a blind spot in the visual field.
Clogging of the biopsy channel prevents further biopsy.