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turer instructions. You must flush lumens with solution, ensuring
there are no air bubbles. Use a timer to ensure that the soak time
adheres to the time listed on the HLD label. Timing begins once the
last item is placed in solution. If you place additional items in the
solution after you've set the timer, reset the timer to the required
soak time. Nothing can float in the HLD; all items must be complete-
ly submerged. Don't process floating items such as syringes in this
manner, as they'll not be high-level disinfected if floating. Triple-
rinse scopes to ensure you've removed all the HLD. Some automatic
endoscope reprocessors (AER) do this automatically.
Automate the process
AERs essentially automate a good portion of the scope-cleaning
process, but it's important to look at exactly what the AER does so
that the technician performs the steps that aren't covered. In general,
he'll still need to manually perform immediate flushing, soaking in an
enzymatic product and thorough brushing.
It's critical that you properly connect the endoscope to the AER.
This connection varies by type of scope and type of AER. Incorrectly
connecting the scope can lead to inadequate disinfection, putting sub-
sequent patients at risk for infection. Some AER manufacturers pro-
vide a quick-check guide attached to the machine to assist in proper
connection. Absent this, the connections should be posted near the
AER for worker reference. When possible, post the cleaning proce-
dure in the area used for scope processing.
AERs can heat the HLD solution to the HLD manufacturer's required
temperature and allow for the shortest possible soak time. Basins of
HLD usually can't be safely heated, meaning a longer soak time.
Different HLD products have different soak times. Always read the
label and follow the directions. Make sure that purchasing doesn't
E N D O S C O P Y
