ENDOSCOPES HANDLING GUIDELINES

Flexible endoscope should be inspected often for

any irregularities including, before use and after
reprocessing.

 When inspecting the endoscope, you may find that

the adhesive is missing from the distal objective lens
or light guide cover glass
 A part of the lens may be scratched, cracked,
chipped or broken.

 Improper or careless handling can cause scratches,

cuts or pinholes to form on the distal bending
section rubber sheath.
 which may result in a leak and subsequent fluid
invasion creating extensive and costly damage

 An air and water nozzle becomes deformed from

impact.
 the water supply may be impaired preventing the
distal objective lens from being cleaned effectively.
 If tampered with such as by using the needle to
unclog a nozzle, the nozzle can develop sharp edges
and potentially cause patient trauma or injury

 You may also see signs of damage at the vase of the

rubber cone next to the operating section, which is a
sign of strain relief which may indicate that the
flexible portion was excessively bent.
 IMPROPER HANDLING OF THE SCOPE

 The scope distal end is subjected to impact ,

such as when it hits a metal sink while
preparing to clean the scope
 Similar damage may also occur during
transportation if the Scopes distal end makes
impact against a hard object such as a cart floor
or wall as it is being carried
 PROPER HANDLING OF THE SCOPE

 To protect the tip, hold the distal insertion

portion with one hand while grasping the
operating portion with the other and carry the
scope with extreme care
 When placing the scope in the sink for cleaning,
be careful no to hit the distal end or stack
portions of the scope on top of each other.
 If using a transporting and storage tray it is
recommended that the scope be placed gently
in the tray and that during transportation take
careful steps to ensure the scope does not
move within the tray. Movement of the scope
in the storage tray can result in damage to the
lenses or to the flexible portion of the scope
 Reason for Cleaning and Disinfection of Endoscopes is to
prevent the transmission of disease, this is achieved by observing
standard precautions such as:
1. Hand-washing.
2. Wear of personal protective clothing or equipment.
3. Utilizing the appropriate method of reprocessing for flexible
endoscopes and the use of an appropriate enzymatic or biofilm
remover

 Equipment Required
1. Personal Protective Equipment
  Fluid repellent gowns that provide full skin protection for
arms and body, safety goggles/spectacles or face shields
should be used when reprocessing endoscopes and when
handling hazardous substances specially where splashing
of the concentrated solution may occur, gloves used
when reprocessing endoscopes must be impervious to
the cleaning agents and biocides being used, disposable
gloves can be used if contact with this chemical is for only
short periods and contact with the skin is preventable

2. Accessories

 Cleaning adaptors and syringes

 Octopus or flushing systems relevant to the endoscope
brand and model

 Short stubby brush

 Brush for each channel selected for correct size

3. Chemicals

 Enzymatic solutions or biofilm remover

CLEANING PROCESS
A. Do NOT reprocess the endoscope together with any sharp-edged objects including forceps, needles,
etc.

B. Prepare fresh enzymatic detergent solution as per detergent manufacturer’s recommendations

C. Immerse entire endoscope and all scope components in fresh detergent solution; keep scope fully
submerged during subsequent steps; clean all exterior surfaces of the scope using a lint-free cloth,
sponge and/or brush

D. Avoid tight coiling of the flexible portions - insertion tube and umbilical cable; larger coiling of the
scope will allow easier channel brushing (less frictional resistance) compared to tighter coiling of the
tubes

E. Using OEM-provided cleaning brushes intended for specific channel sizes mechanically clean
accessible channels, ports, valves, scope tip, around nozzles, elevator mechanism, etc.; typically, non-
OEM brushes have not been validated by the scope OEM as being effective. Check with the brush
supplier to confirm their effectiveness for cleaning device-specific endoscope channels.

F. Brush the suction tube within the LG/umbilical cable – insert brush from the suction cylinder through
the LG cable until the brush exits the suction connector; wipe debris off bristles before withdrawing
brush back into channels

G. Brush the suction/instrument channel(s) within the insertion tube starting from suction valve cylinder
down to scope distal end – also pass brush from forceps inlet (biopsy port) to scope distal tip and from
the suction cylinder to the forceps inlet; again, wipe debris off bristles before withdrawing or re-
introducing brush into channels

H. Brush instrument channel inlet ports, valve cylinders, recessed areas, etc. until all surfaces are visibly
clean

I. Brush all other accessible channels or lumens (in applicable scopes)