ety of devices. While a syringe may be sufficient, I recommend finding
a mechanical option since it's usually more effective.
New independent devices can flush lumens with high-pressure water
and/or detergent with the added convenience of being hands-free.
These devices feature a variety of connector attachments that allow a
tech to attach the lumen to the device that pushes high-pressured fluid
through it for a set amount of time to ensure it's clean. Another afford-
able option is water pistols, which work well for small facilities. These
require a more hands-on approach from the tech since they need to
depress the trigger to flush the lumen, but deliver a similar outcome.
For even more thorough cleaning, instruments can be placed into an
ultrasonic washer following manual cleaning. While expensive, ultra-
sonic washers are able to remove fine debris that might be difficult to
remove during manual cleaning. New ultrasonic cleaners feature
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Sometimes, lumened instruments are just too difficult to clean, even if you follow the
correct process. For example, AORN recommends the use of disposable ophthalmic
instruments with cannulas when possible since the tiny lumens can be a risk. While I
advocate minimizing waste, consider disposables for items like tiny plastic tubing
that are too hard for busy techs to properly reprocess.
Another common problem I see is facilities that reprocess first-generation laparo-
scopic instruments, which don't come apart and are difficult to clean. I often see
these instruments sent out for repair that, when taken apart, are caked with debris
that's been missed for weeks or even months. If your docs are using these first-gener-
ation instruments, I strongly suggest considering new models that are designed to
come apart for easy cleaning.
— Donna Swenson BS, CRCST, CHL, ACE
WHEN CLEANING ISN'T ENOUGH
When to Consider Other Options
