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
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