Endoscopy is classified as an Aerosol Generating Procedure (AGP). It is very important to maintain high standards of decontamination and disinfection in the procedure room to infection transmission risk to the Endoscopist, Staff and Patients.
Procedure Room
The Endoscopy procedure room is like a miniature OT requiring adequate and designated space for all necessary equipment, supplies and services.
A few examples –
Trolley for Endoscopes, image processors and endoscopy ancillaries,
Image recording / printing devices,
Patient bed,
Patient monitoring systems,
Oxygen cylinders / supply pipeline,
Specialised storage closets for endoscopes,
Anaesthesia equipment,
Resuscitation equipment,
Storage containers for biological samples,
Medicines,
All personal protection gear like, PPE Kits, Masks, Gloves etc should be stored outside the procedure to avoid contamination of fresh unused gear. Used items can be thrown in a dedicated hamper inside the procedure room after a procedure is completed.
The endoscopy procedure room should be clutter free and facilitate easy movement of the Endoscopist and nursing staff so that procedures can be carried out smoothly.
Reprocessing Room
The endoscope reprocessing area should ideally be just outside the procedure room with enough area for the Endoscope Reprocessors, sink and space for initial rinsing of the soiled equipment. After a procedure, the endoscope should be transported to the reprocessing room packed in a special airtight container. Always wear a fresh face-mask and full face shield while transporting and reprocessing the endoscope.
Adequate levels of disinfectant, detergent and alcohol solutions should be maintained in the reprocessor.
Maintain a ‘dirty-to-clean’ flow of endoscopes and equipment in the reprocessing and equipment areas to avoid cross-contamination between soiled and newly cleaned instruments. Adequate counter space on both sides of cleaning areas must be available to accommodate one or more instruments. Counter space with compressed air for drying should be available nearby.
Reprocessing the Endoscope
Reprocessing staff should wear full body Personal Protective Equipment (PPE) gear.
Pre-cleaning of used endoscope should start in the procedure room and be done by the staff already in the room.
Place endoscope in a fully enclosed and labelled container for transportation to the decontamination room.
Reprocessing of Endoscopes should be done by experienced staff only.
Proper documentation of the reprocessing process should be maintained.
All endoscopes should be undergo full reprocessing process after every procedure.
Ensure that Endoscope should be fully dry internally & externally after reprocessing & before use.
Transport dry endoscopes to storage or drying cabinet wearing clean gloves.
Post reprocessing, Endoscopes must be stored in a closet where they can be hung freely without coiling. The closet should be moisture and dust free and away from direct sunlight.
Procedure Room cleaning
Procedure Room should be cleaned meticulously cleaned after each procedure.
All medical waste and linen should be removed from the room.
Staff involved in the cleaning of endoscopy rooms should wear full body PPE suits.
Manual Endoscope reprocessing has always been a tough & challenging job for endoscopists & technicians. The Covid-19 pandemic has made it even more challenging.
After a endoscopy, the procedure room, endoscope and its accessories require careful and proper disinfection. Missing out even a single step may lead to high risk of cross-contamination to the Doctor, Patients and the healthcare staff. In this pandemic proper reprocessing of endoscopes & related accessories is extremely crucial to maintain the safety of the Doctor, Patients and the healthcare staff.
The best solution to ensure proper cleaning and disinfection of the endoscope is to use an endoscope reprocessing machine like Ottomed EndoWasher, a fully automatic twin endoscope reprocessing machine for washing, disinfecting & drying endoscopes with standardised processes. This greatly reduces the risk of cross contamination between Doctors, Patients and the Healthcare staff and makes Endoscopy safer for everyone involved.