Cleaning And Maintenance Of Fiberoptic Bronchoscope
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Author : Cleaning Brush
Update time : 2022-11-04 15:58:41
1. Washing
After each application of the fiberoptic bronchoscope, immediately wipe off the dirt on the outer surface of the insertion tube with a damp gauze, then put the tip of the fiberoptic bronchoscope into the cleaning solution, suck it through the tube for 5-10 s, and suck the cleaning solution and air, in turn, several times to achieve better initial cleaning results. Remove the suction control valve and biopsy inlet valve, and use a medical cleaning brush to thoroughly clean the biopsy hole and suction pipe. When brushing, the brush heads must be seen at both ends, and the dirt on the brush heads must be cleaned. Make sure that the recessed parts are cleaned with the attached or similar cleaning brush. Then install the waterproof cover, rinse thoroughly under running water, and scrub the lens body with gauze repeatedly.
2. Disinfection
The disinfection methods of fiberoptic bronchoscope include manual disinfection and automatic washer-disinfector disinfection. Compared with manual disinfection, automatic cleaning and disinfection machine disinfection is more straightforward, more effective, and more standard, and the disinfection effect is not easily affected by human factors.
a. Sterilization of fiberoptic bronchoscope
The fiberoptic bronchoscope was manually cleaned and then placed in an automatic washer-disinfector for disinfection. Automatic cleaning and disinfection machines often use 2% alkaline glutaraldehyde or acidified water as a disinfectant. Combined with high-pressure flowing water rotary spray and disinfectant circulation spray and soaking, the outer wall and inner wall of the fiberoptic bronchoscope are automatically completed according to the process of washing-enzymatic washing-rinsing-drying-disinfection-rinsing-drying under the control of the microcomputer. duct to be disinfected. The disinfection time setting of the automatic washer-disinfector: usually the disinfection time is ≥ 20 minutes, and the soaking time of the bronchoscope for patients with special infections such as Mycobacterium tuberculosis and other mycobacteria is ≥ 45 minutes.
In particular, avoid sterilizing fiberoptic bronchoscopes with sharp-edged objects and accessories (biopsy forceps, syringes, aspiration needles, etc.) that can inadvertently damage the sheath of the insertion tube. Biopsy forceps are highly dangerous invasive medical devices that must be sterilized after use. Immediately after use, the biopsy forceps should be cleaned with a medical cleaning brushunder running water for blood and dirt on the forceps valve, and then sterilized. In the sterilization method of biopsy forceps, the pressure steam sterilization method of independent packaging is preferred. For biopsy forceps that are not resistant to high temperatures, the argon peroxide low-temperature plasma sterilization method can be used, or 2% alkaline glutaraldehyde can be immersed for 10 h for sterilization.
b. Self-cleaning problems of automatic cleaning and disinfection machines
In order to prevent the washer-disinfector from being re-contaminated after disinfection of the fiberoptic bronchoscope due to the contamination of the internal lumen, the cleaning and disinfection of the washer-disinfector should be carried out regularly (the fiberoptic bronchoscope is not placed in the washer-disinfector, and the standardized disinfection process is carried out). In order to strengthen the self-disinfection of the washer-disinfector.
3. Quality monitoring of venom
The concentration of 2% alkaline glutaraldehyde in the disinfection machine must be tested every day (use a qualified glutaraldehyde chemical indicator card to monitor whether the effective concentration of the disinfectant in use meets the requirements). The bacterial culture of the fiberoptic bronchoscope body, curved part, apex, and various accessories is carried out once a month. After disinfection of the fiberoptic bronchoscope, the total number of bacteria is less than 20 CFU/piece, pathogenic bacteria cannot be detected, and the biopsy forceps cannot be detected after sterilization—any microorganism.
4. Storage and storage of bronchoscope
The storage of fiberoptic bronchoscopes should be in a ventilated and dry place with suitable indoor temperature and humidity and avoid excessive cold, heat, moisture, and direct sunlight. The best solution is to store the fiberoptic bronchoscope in a storage cabinet. When hanging it in the storage cabinet, a sponge should be attached to the wall to prevent the tip of the fiberoptic bronchoscope from swinging freely. In the suspended state, the moisture in the fiberoptic bronchoscope can drip out by gravity, thus keeping it dry. If you need to take the fiberoptic bronchoscope out, you should put it in a special case. In particular, do not store fiberoptic bronchoscopes and accessories in a suitcase for long periods of time, as a dark, humid and unventilated environment will allow bacteria to multiply and increase the risk of cross-contamination.
In short, in the application of fiberoptic bronchoscopy, correct maintenance methods and strict disinfection measures are of great significance to reduce the failure rate of fiberoptic bronchoscopy and prevent nosocomial infections.
