Tools of the trade
Once lumened instruments arrive in sterile processing, pre-cleaning
continues.
• Enzymatic pre-soak. The first step is usually a 5- to 10-minute
soak in an enzymatic detergent.
• Brushing. Brushing is usually next. If your instrument manufacturer
has proprietary cleaning products, use those. In any case, use the right
brush for the job — with the right diameter, the right length, the right
bristle type, and so on. One manufacturer claims its microfiber brush
tested more effective than others in a head-to-head matchup, but it does-
n't say whether the brush it compared itself against was the one the
instrument manufacturer recommended, so there's no way of knowing
for sure.
• Automatic flushing devices. To further dislodge stubborn soil, you
can use an automatic flushing device that can fit into sinks and on
countertops to force pressurized water through channels. Different
systems can accommodate different specialties, including delicate
ophthalmology instruments. In addition to doing a better job than
manual flushing, flushing devices may also help eliminate the
ergonomic challenges associated with repeated manual use of
syringes.
• Sonic irrigation. As a final step, some manufacturers recommend
sonic irrigation, which combines ultrasonic technology and controlled
irrigation to deliver exceptionally high wash-fluid pressure. But not all
instruments are suitable for the sonic machines, so remember your
IFUs.
• Dual-chamber cleaning. A relatively new cleaning device on the
market uses a dual-chamber approach, which simultaneously pushes
and pulls water through endoscope channels. Though it sounds prom-
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