Outpatient Surgery Magazine - Subscribers

Battle Post-op Pain Without Opioids - April 2016 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 93 of 122

routinely conducted. "There are circumstances where traditional clean- ing and high-level disinfection will still leave a microbial load," says Mr. Lavanchy. "If we can't get them 100% clean, maybe that's justification for hitting it with the strongest process, sterilization." At present, the most effective sterilization option that scopes can toler- ate is ethylene oxide (EtO) gas. However, a limited number of facilities have ready access to EtO treatment, given its toxicity risks and ventila- tion requirements, and the process takes 24 hours to complete. While liquid chemical sterilants are available, the research into their effective- ness is not as well established, says Mr. Lavanchy, and manufacturers have not yet developed a scope that can stand up to steam sterilization. Step 4: Storage When you're retrieving a scope for a case, you presume that it's free of microbes and safe to use on a patient. Hand on the same assurance when you're returning it to the storage cabinet. After either manual or mechanical high-level disinfection, while wearing freshly donned gloves and barrier protection, flush the scope's channels to make sure they're dry. First with compressed, filtered air to drive out moisture, then with alcohol to evaporate any that remains and to prevent micro- bial growth. At this point in the process, "colony counts may be low, but if scopes are stored moist, they may multiply," says Mr. Lavanchy. "Hanging a wet scope creates a hospitable environment for bacterial growth." Various tests are available for monitoring scope cleanliness through the detection of organic residue, an indirect marker of micro- bial presence. Since it takes time to conduct these tests, though, and may sideline your inventory, it's likely not practical to test every scope after every use for an up-to-the-minute status report. OSM 9 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A P R I L 2 0 1 6

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