Why should we use a plug for gas disinfection of endoscope?

After using the endoscope, immediately wipe off the dirt on the external surface with wet gauze, and repeatedly send air and water for at least 10 second. Take down the endoscope and install a waterproof cover, put it in a suitable container and send it to the cleaning and disinfection room. Cleaning steps, methods and key points include:

First, washing

(1) Put the endoscope into the cleaning tank:

1. Rinse thoroughly under running water, scrub the mirror repeatedly with gauze, and clean the operating department at the same time;

2. Remove the biopsy air inlet valve, aspirator button, air supply button and water supply button, and thoroughly brush the biopsy channel and aspirator pipeline of the catheter with a cleaning brush. When brushing your teeth, be sure to look at the brush heads at both ends and clean up the dirt on the brush heads;

3. Install the integral pipeline perfusion device, pipeline plug, waterproof cap and aspirator, and use the aspirator to repeatedly aspirate the biopsy channel;

4. The whole pipeline perfusion device is connected with a 50 ml syringe to suck clean water and inject it into the gas supply and water supply pipeline;

5. Absorb the moisture in the biopsy channel with an aspirator and dry the endoscope.

(2) Rinse the removed aspirator button, air supply button, water supply button and biopsy air inlet valve with clear water and dry them.

(3) Endoscopic accessories such as biopsy forceps, cell brush, incision knife, guide wire, lithotriptor, basket, contrast catheter, foreign body forceps, etc. First put it in clean water, then scrub the inner surface and seams of the forceps flap with a small brush, clean it and dry it.

(4) The cleaning gauze should be used once, and the cleaning brush should be disinfected once.

Second, enzyme washing

(1) The preparation and soaking time of multienzyme lotion shall conform to the product instructions.

(2) Put the dried endoscope into an enzyme washing tank, inject and suck out multi-enzyme lotion 100ml, flush the gas and water supply pipelines, suck the enzyme-containing lotion into the biopsy hole with an aspirator, and wipe it with multi-enzyme lotion in the operating department.

(3) Soak the dried fittings, various buttons and valves in multienzyme lotion, and clean the fittings with ultrasonic cleaner for 5- 10 minutes.

(4) Multi-enzyme lotion should be replaced after cleaning the endoscope.

Third, clean.

(1) For the endoscope soaked with multienzyme lotion, wash all the pipes thoroughly with a water gun or syringe to remove multienzyme lotion and loose dirt in the pipes, and wash the outer surface of the endoscope at the same time.

(2) Blow air into each pipeline with a 50 ml syringe to discharge the water in the pipeline, so as not to dilute the disinfectant.

Fourth, disinfection.

When soaking or disinfecting with 2% alkaline glutaraldehyde, the cleaned and dried endoscope should be placed in a disinfection tank, completely immersed in disinfectant, and each channel should be filled with disinfectant with a syringe. The operating part of the non-total immersion endoscope must be wiped with clean water, and then wiped with 75% ethanol for disinfection. When the endoscope to be disinfected is disinfected with 2% alkaline glutaraldehyde, the soaking time is:

The soaking time of gastroscope, enteroscope and duodenoscope shall not be less than 65438 00 minutes;

The immersion time of bronchoscope is not less than 20 minutes;

Patients with tuberculosis and other special infections should be soaked in the endoscope for not less than 45 minutes after use;

When the endoscope to be sterilized is sterilized with 2% alkaline glutaraldehyde, it must be soaked for 10 hour;

Endoscopes that need disinfection, such as gastroscope, enteroscope, duodenoscope and bronchoscope, which are no longer used that day, should be disinfected with 2% alkaline glutaraldehyde, and the disinfection time should be extended to 30 minutes;

When using automatic cleaning and disinfection equipment, the endoscope should be cleaned first, and then disinfected with the equipment.

Five, after disinfection, endoscope should be cleaned and dried according to the following methods and steps:

1. Before the endoscope is taken out of the disinfection tank, the cleaning and disinfection personnel should change gloves, inject air into each lumen from the syringe, and remove the disinfectant.

2. Put the endoscope into the cleaning tank, clean the outer surface of the endoscope with gauze under running water, and repeatedly suck clean water to clean all channels.

3. Clean the outer surface of the endoscope with gauze, suck out the water in each pore, remove all kinds of special pipes and buttons for cleaning, put on all kinds of accessories for diagnosis, and then give them to the next patient.

4. After the above operation, the bronchoscope needs to be dried with 75% ethanol or clean compressed air.

Disinfection of endoscope accessories:

Endoscopic accessories: such as biopsy forceps, cell brush, incision knife, guide wire, lithotriptor, basket, contrast catheter, foreign body forceps, etc. It should be disinfected once and soaked in pressure steam or 2% glutaraldehyde for 10 hour.

Disinfection of other articles:

1. Mouth pads, curved plates and dressing tubes shall be disinfected by pressure steam.

2. Disinfection of injection bottles and connectors should be soaked in 500mg/L chlorine-containing disinfectant for 30 minutes, and residual disinfectant should be thoroughly rinsed with clean water and dried for later use. The water used in injection bottles should be sterilized water, which should be changed every day.

3. Disinfection of suction bottles and straws: After inspection, clean the suction bottles first, then soak them in 500mg/L chlorine-containing disinfectant for 30 minutes, scrub them and dry them for later use.

4. The cleaning tank, enzyme washing tank and flushing tank should be fully scrubbed and wiped with chlorine-containing disinfectant with available chlorine content of 500mg/L. When changing the disinfectant, the disinfection tank must be thoroughly scrubbed.

5. After fully scrubbing the organizer after daily use, wipe it with a chlorine-containing disinfectant with an effective chlorine content of 500 mg/L. Before the start of daily diagnosis and treatment, the disinfection endoscope to be used that day must be disinfected again. If soaked in 2% glutaraldehyde, the disinfection time is not less than 20 minutes, and it can be used for diagnosis and treatment of patients after washing and drying.

Other chemical disinfection methods include formaldehyde fumigation and ethylene oxide sterilization. Formaldehyde fumigation has the following disadvantages: ① White sticky substance produced after polycondensation will damage the equipment; ② Slow sterilization; ③ Strong pungent smell; (4) poor penetration. So most hospitals in China use glutaraldehyde fumigation instead of traditional formaldehyde fumigation. Traditional chemical methods will slowly corrode surgical instruments and pose a poisoning threat to operators, so they have been eliminated in major hospitals.

The physical disinfection method includes:

(1) ultraviolet disinfection: mainly used for disinfection of oral mirrors and endoscopic lockers. HEsAg can be inactivated after 5- 10 minutes of irradiation.

(2) Pressure steam sterilization is mainly used for various valves and biopsy forceps of hard endoscopes and fiber endoscopes.

(3) Low temperature plasma sterilization device is being accepted by many large hospitals in China. Imported brands are mainly American Johnson & Johnson's 100S model, and domestic excellent brands include Chengdu Laoken and Beijing Baixiang.

Disinfection mechanism of low-temperature plasma: There are many particles with high chemical activity such as electrons, ions, active groups and excited molecules in low-temperature plasma.

Many chemical reactions that require high activation energy can occur, and pollutants that are difficult to remove by conventional methods can be transformed or decomposed. Under the action of external electric field, a large number of high-energy electrons generated by dielectric discharge bombard pollutant molecules,

Energy is converted into the internal energy of ground-state molecules, and a series of processes such as excitation, ionization and dissociation occur, which makes the gas in an activated state. When the electron energy is low, active free radicals are produced.

Activated pollutant molecules are removed by plasma directional chain chemical reaction. When the average energy of electrons exceeds the chemical bonding energy of pollutants, molecular bonds break and pollutants decompose. In this process,

A series of complex physical and chemical reactions took place, which transformed complex macromolecular pollutants into simple small molecular safety substances.

Or make toxic and harmful substances into non-toxic and harmless or low-toxic and low-harmful substances. The occurrence of these reactions mainly depends on the average energy of electrons, electron density, gas temperature, molecular concentration of polluted gas and gas composition. Unique sterilization environment and mechanism of low temperature plasma disinfection technology

It is especially suitable for sterilization of heat-sensitive instruments, metal instruments, electronic probes and sensors that are not resistant to high temperature and high pressure.

No residual toxicity:

The final products of hydrogen peroxide plasma sterilization are water and oxygen, and there is no harmful substance residue at all, which is safe for medical workers and patients and will not cause environmental pollution.

The choice of disinfection methods should be considered from the hospital's operation volume and disinfection equipment.