FUJINON FUJIFILM ical Hygiene Reprocessing of flexible endoscopes and endoscopic accessories.For perfect hygiene in endoscopy. |As one ofthe leading manufactuore of foxlblearcoscopes, | are very conacieus of ow responsibilty owatls you and your patints, For this reson we woul ko to support you ial the Important agpacts regarding the perfect reprocessing of endo: soopes and endoscope accessories Hygiene i tha number one postyin hospitals ane doctors’ proc: tice. provides protection against tho transmission ofgenms and prevent infections in pationts, doctors and nursing sa Wt his ‘ochuro, Fylnon provides you wih a usetut guide tothe simile ‘ane lable cleaning ard disinfecting of your endoscope, king ‘your everyday working fe easier “The hygiono brochure ded chronologically takes you step bby etop tough tho indicus procedures: om proerinary clsan- Ing trough to fal insing. Each ndvual action is thereto 57 to understand, using phatographs for Bustration In akon the brochure provides you wih important product summaries and ipl practical ps. I.goes without saying that fl the procodures described here com- Py wih the guiatines ofthe Robert Koch Insttute FHC) entitled "Hygjone requraments inthe reprocessing oe endoscopes and adional endoscopic equipment. Together with the hi ‘vat products tom Funon, you can thus ensure the optimum condtons for rele dagnoses and treatments. Marui! epeocess 8 Machine roprocess: 910 Roprocecs and slerlization ofthe accessories 11 Curent cleaning brushes and adaptors 1243 General information fer reprocess 14 (Cleaning and disinfecting agents 18Manual reprocess Ei] Step! Pretminary cleaning 4 14, The preliminary cleaning is camied out inmecttely follow * Activate the aldwater valve and pay attention to the Ing the examination escaoing jot of watar and bubbles, {12 Wipe the outer surface of the endoscope with a cisposabie loth or damp compress (cleaning solutor), 418 Hold the distal end of the endoscope in @ container with leaning solution 414 Thoroughly nce the channel: * Activate the suotion valve Unt the souton fe cleat * Alternate drawing In clearing solution and ai A. withthe duodenoscope and utrasound endoscope with ‘Albarran lever the lever must be moved seversl times during proiminary cleanin. 1.5 Toke tho distal ond out of tho clearing solution and thor- ‘ughty suction tho channais, 1 Suction the out channel wih ar Unt emt. * Separate the wator tank torn the endoscope. 1 Plage a finger on the water tank attachment ancl activalo ‘ho sifwoter valve unt the flor of water stops. * Disconnect the device from the processodight source witha cloth1.6 Attach the protective cep for slectonic plugs with Video 17. Place the endoscope ina closed transporting how endoscopes. 4\ Take care that the effect of heat from the optical light- ‘uide connector will not damage the endoscope! VE Sate £00 ay oa ve sas c0 ester a 24 Garry out a task test under water in accordance with the manufacturer's inst 22 Always pump up the endoscope to 150 mmHg belere ve See 60D ay ag placing inthe solution, A\ Never connect and disconnect the leak tester in the2.3 Ramow all ves (alwater and suction voles, a weil as tho stl cap and jat channet closing cap) and place in tho solution. The dlsposable biopsy vale must be propery i disposed of ater each ws. 24 Place the endoscope ina basin withthe cleaning solution, 25 Activato tho bending whools and pay attention to arose that leak (sing Bubbles. In adcstion, examine the ma: Rome for any cto in pressure. A\ itis clear there is perforation, do not proceed further with reprocessing the endoscope. 28 Wipe the outar surface with cinecting soluton, Wrap the enddosrope in a protoctve fol cover, pack inthe despatch ase, mark wth leaking, not disinfcted anda description of the felt and send tothe maintenance end repalr shop, 2,7 After repair, carry outa leak test and clean and csinfoct the endoscope, aa 32 33 34 For masons of persona safety, carry out all clearing proos- dures under te surfaco ofthe ni (Clean the surface ofthe endoscope with antes cloth Using the CA-S09A st, fil all channots with clsaning sok tion so that there ara no bubbles, (Cloan tho biopey channel, valve openings and valves with ‘double valve cleaning brush,8.5 In the case of duodenossopes, move the Albarn lever to the mice position and cloan from al sides witha suitable brush, ‘With the @8 series, the al/water channel con be cloaned separately with a brush, The WA-800 (guide for tho clcan- Ing brush) Is need fo this. 36 Clean allaccesste channel systems with a sultable endo- ‘scope brush unite brushes can be pushed through fre ct conteeinants. 87 ln the case of channel which arenct be cleaned with brush 109, 0g tho akatar channel, ot channels rinsa chan balloon a foad channel withthe double balloon endoscope (08) and boon weter feed channa wih the ultrasound cendescones (EG-530UR end £G-S80U7, connect to de- vico-spectic adapters anc rinse thoroughiy with solution. “The 4-500 i tha cleaning adapter for the et onan! wth ‘tho G5 endoscopes and the ballon nator feed chan with the ulasound endoscopes. The CA3GON and CA-5OON ‘ere cleaning adapters forthe akwater channel A. In case of the G8 duodenoscopes, the alrwater channel ‘can also be cleaned with a brush. With the EG-630UT. utrasaund endoscope, the balloon wator feed channel can also be cleaned witha brush, A\ steps 1 to 8 are identical with manual, semi-automatic: ‘machine and machine reprocess. [EiStop: intermediate rinsing ‘41. Placethe endoscope andvatvesina basin wih nicrobiolog ‘ally cloan inking water or ster warn order to remove residues of chemicals, blood, proteln and mexcation, 42 Using the CASOSA got or @ wator gun, thoroughly rinse all channolo and then romavo al rematring wate with a. Abwaye nse soparetely the jet chenne! and balloon alr feed ‘’channel and belloon water food channel and Tkawise ro- ‘meve raining water[Estee Disinfection > 5.1 Plaoe the cleaned endoscope and valves in the dsinfec tion solution. Connect the CA-503A set and il until there are no bubbles, 5.2 Connect the jst chan, one rinsing chan, and air andt water supply channels to dovioa specie adapters andor {with syringes, Use the CJ-500 clesning adapter for the Jel channol and the baleon water toed chanrl. In the caso ‘ofthe duodenoscope and uitasound endoscope move the Abarran lover to the middle positon. ‘Achat rl etl ee ote) 5. Ensure cones tration and residence time complies with tho manufacturer's instructions, 5.4 For reasons of personal eaety, close the bow tighty with the cover, 55 At the ond of the cisiniection time, il the channals vith air to remove the dlairfectat 5.6 Using new disposable gloves, remove the encescops fom the disbfectant solution 6.1 Plaos the endoscope and vahes ina disinfocted bow wit rmicrobiologicaly clesn crinking water or strle water. 4. Fresh water should be used for each deviee. 6.2 Rings cut the cuter endoscope aurtace and valves, 6.8 Thorcughly rinse all the channels with the CA-SOGA end vie spectc adaptors ora waler un with ster fer.‘Step: Drying and storage 71 Remove the endoscope and valves with cleinfocted hands oF wearing new disposable gloves 722. Wh alin-tes cot, remave any water remaining on endo scope surface, operating section and valves. 2% 73 Airthe electrical contacts and channels witha compressed fr gun ox using a connector eet, connect the endoscope to.8 compressor for approx. 20 minutes (maximurn prac: sure 07 bar) 4. Te owing important withthe couble lon endo- cope: the water in te balloon si feed chanel must | Be compat removed because his channel must be | compet ay. 774 Tha preferred mothod of storing the endoscope is hanging up In a spacial endoscope cabinat in a dry anvronment protected ram cust andl with sutable fasteners. 75 During storage ofthe endoscope, the valves and protective cap forthe electionic plug must be removed and stored separa, [Lilstop: Reprocessing of wor materats 181 The cate the dsnfectant soliton was praparod must be documented 182 Label on the bow: date, concentration, residence time, service lo of the dainfootant solution, 8.3 The disinfectant solution must be raplacad in accordance wan the manufactures Instructions, 184 Ensure concentration and residance time comply with the manufacturers instructions. {85 When raping the cleaning solution (manual lesning with fa bash) the bei must be thoroughly eeaned and asn- fected mectenicaly 8.6 Used bushes musi tbe cleanedin an utrasound bath, insed, disinfected, ral sed and died aftr each ue, 187 See page 11 tor reprocess of accossoros.Machine reprocess AS The following steps must also be carried out in advance fof machine reprocess in an AWD (Automatic Washer } Disinfector for endoscopest: ) sscremrees ———— EiSien: teak test [Eiisitep: Manual cleaning wihabush Stops 1 to 8 are Identical with manual reprocess. See pages 310 6 'Steps Intermediate rnsing/rineing of the cleaning solution 41. Pace the endoscope and valves in a basin with mieroblo- logiealy clean cinking water or stele water in order to remove reskives of chemicals, blood, protein and medica ton. 42 Ringe all channels using the CA-SO3A set or with a wator gun. 4, Prease note that In accordance with AWD manufacturer inatructions the intermediate rinsing can be replaced by ‘the machine pretiminary cleaning phaso, 4. Caution: insufclont intermediate rinsing can cause interac- tions when atthe sama time using eldehyde-fee chemicals In the pralimnary cleaning/manuai caning with & brush steps and chemicals containing aldehycs in the machine [Ellstep: Disinfection 1 et macro wi mesh maniote te Ws cence 52 Connect the appropriate connector set and leak tester. 53 Select tho appropriate programme, profrably tho stand: ard programme. 5.4 Start the programme, EEStep: Drying ond storae ‘81 Remove the endoscope and valves trom the AWD with sintected hands or wearing new disposable gloves. 6.2 With a intiree doth, remove any water remaining cn the cuter surface, actuator and valves, 6.3 Airthe eloctice! contacts and channels with e compressed air gun or, using @ connsctor eet, connect the endoscope 0.2 comproseor for apprex 20 minutes (maximum pres- eure 07 bay,6.4 The prefered method of storing the endoscope is hanging Up in @ special endoscope cabinet in a dry envionment protected from dust and with sutable fastener, 85 During storage ofthe endoscope, the valves and protective cap forthe electronic plug must be removed and stored ‘seperately 74 A sofslsnfectng cyca is recommended hetore using te AWD pach day. 72 The containers forthe caring and dlsinfcting agents ‘must be marked withthe date of opening. 73 place the water filers and ar ites in accordanco with ‘tha manufacturer’ instructions, 74 Garry out a dlsinfectng and decalticalion cyete for the AWD in accordance wit the manufacturer's instructions. 75 When replacing the cleaning soon (manual clearing with ‘a brush), tho bow! must be thoroughly cleaned and me: chanicaly dsitectes 76 Used brushes must be cloaned in an ultrasoune bath, Finsed, distfected, rinsed and cred eter each use 77 Onyy dleinfoct accassories (biopsy forceps, brushes otc) in the AWD in accordance with the manufacturer's instruc- tors.Reprocess of accessories Manual reprocessing steps for multi-use medical appli- ‘ances such as biopsy forceps, polypectomy slings, papil- lotome/ERCP catheters, foreign body alligator forceps, water tank ote. A Cleaning: * Ciean aocesseres wth sft elath/orush,dsassembie, and se & nor-foaring clearing soluton. Change the solution daly oF more frequently if visibly contarrinatod. Clean ell cavities and channels under wot ' Caring the wator tank withthe CA-OTT coaring adapter 2! Utrasound bath: * The ultrasound bath should be sufcenty large and dep { ensure complete immersion. Avold dead space and do not oveioad, 8 cleaning solution and a temperature of approx. 30°C should be usedin the utrasound bath osidence te: 5-10, minutes. At higher temperatures there is the isk of protoln ‘oagulatinforotein fing. Fixthe biopsy forcaps and polypectomy sings witha cp In accordance with the manufacturers instructions and ia addition hold open the branch of the biopsy frcops with another cli. When rolled up the insneents should not excaed a dlameter of approx. 30 om. Fil a the channels and cewtios with solution. * Cloan for 5-15 minutes at 40 KHe inthe ultrasound bath, As Comply with the manufacturer's instructions, 8) Rinsing: * Fnse al channels and cavides with water and biow though vith a compressod sir gun. Ai Disintection: "= Disinfection options tor ine accessories in accordance with FI quidaines: ~ cherally wth a vieldal product = thermo-chemicaly the AWD with a viniidal product at a temperature f 25°C - 59°0 thermaly in tho AWD (Automatic Washor Disinfoctox) with an AO valuo of $000, Lo, at BO*C and a residence ‘ime of § minutes, [Bf Neutralisation: * Neutaistionvcleer sing to ernovs residuss ofthe dsin= fecting agent eis 8: Drying 1 Oyo al chanel wth compressed a gna c= tera tet. [Ri Stertisation: * Steam storilsation * Stoilstion in stole goods packaging in a class B auto lave with fractionated pre-vacuum process. * Dwelltimefor the gente rogrammals 1Gmintesat 12m | and bar just for FTS accessories. * Dwell tne forthe universal programme is 5 mninutes at | Ll!) 194°0 and 2ber. * Dwell time forthe pron programe is 60 minutes at 104°C ‘and 2 bar. A\ Comply with the manufacturers instructions, Bj storage ' Store dey andin the dark 1 Function tect: 1 Tost the function agein before using witha patent.Cleaning brushes Cai oa scription Reusable brushes 1 [Fen s0200° Pato ceringtnan ier ‘Poconecone ————— team 2 |renerxosorae Goan ahr Clocssaes tom 28 men 3 | oriio6o16oF ie [Oontiecnring nor | onetcoopereuotancone crnnas tv camer ect 1 | eremxoieor Sie sor Cosioepettncineope iis cere tater fem 28mm 6 |renorkresoiaae ote cee torcar | Enos hin deter FseceK 000° : rel at aetr up 02.2 Fee isnaco0r fleet concnrzanon error outa caning rsh forcran- | Endoeecpes wt tin aretr Ferxncssaosece $$ cet etorcerup to 22min FerK Pres0290F Lena t2rte0230 on 7] remurae0160° ‘han bn Prt chrnsin ses G8 Feri occocr ete 100200 © | Fsvoexna;2007 i | Dovtio weve deaning brush | vv bush or suction and aiwatar em paisa apps | menace 3 |reveensaasor Jee bon Netra osaton an seesaputaan, svat a supp a srs ype 3 “of revere20018 Neots kena ope channel Oo---— net suppats nsaies ype Disposable brushes “if icte008 == Tennaet [Sheek wth danse 0 oo pio 22 en "|e 182s0 emma /4. [Dake chang tna heme witha dametor wpw26:r0 ‘af eno-ran00| hina bh hannah dame ceaensensroe wpnzemm vac: 7280 sezsssae [Doble doen bush Gernaiwiva soe upto22 om fo erry pve bash iendoecnnAdapters tem Numb Type a 6] cAsOA ws Channel clearing set | Manual reprocess: erent 16968, lense [imi ering st ant ress d se bercesonps = Ee-aroandeaszv0 \ [& nce area doar ot |Monaiezoone eae ahensee 0 Tolono Sn cig wt ‘alpen | rsnres asia extort erdosopas pla % omen am Seti 9 aan rt | nloxcon 5 Seeing er Sas GH tare a] |i or ering ra Sees GB aa canned wlovot ii ome ie ert a oveco arog war aie OE cree ad louinnet > | Aclapter with return valve Series G5/08 jot chernet, F500 {Jot channel ede ont Sens GA jl chalGeneral “The marke for tho teprocess oF endoscopes provides 2 num ber of semi-automatic mactine solflans in action to machine solutions. However, fo lst each indvidusl process at this point ‘would go boyond the scope ofthis brochure. Fujinon would be nappy to provide you with comerohenchve and incvldualy tai lores advice, Various products have proved thelr woh for cleaning and ds Infection, The table onthe right-hand side shows these incu ally, Please obtain from your chemicals manufacturer the cor- roeponding product liabity declaration, In general, products based on diferent activo ingredients are Not to be used in a reprocess cycle. Tis is because insuitciant Intermediate ising can esultin chemical reactions such .e- Colouration ofthe cuter surface orto closure of the endoscope ohana, Froquenty chang the active ingretent can also havea dead: ‘vantagecus offoct on material compat Inreased wear and tear ofthe materials woul be the resi When changing chemicals rom aldohyce to aldehyel-tre pro- ducts, or vice versa, ensure thore Is a eutclent clearing and rinsing phaso of 1-3 hours ‘Compatible procucts create optrnum corestons for manual and ‘machine reprocess. The ideal stualion wousd be that al ro- ducts come from one manufactures, Le. products or preiminary Cleaning inthe examination room, manual cleaning of brushes, ‘manual and machine dsifeation ofthe endoscopes and also in te ultrasound bath forthe accessories, Examples: * For manual preininary clesning/brush clearing, use an alde- hyde-sroe product, for example glucopratamine, For markil/ machine dsirfecton, use a product based on guteraldohytlo, Result: insutfiiont intermediate rinsing can load to chemical reactions, ‘In the uttasound beth, use an aldelycle-tae product to cee ‘and disinfect and in the AWD use glutaraldehyde, Ifthe iforort solutions enter the same escape tube at the same timo, this can lead to chemical reactions and to closure of this escape tube. formation regarding reprocess ‘11 the AWD operates with glitarsderyde, In the event cf the ‘machine malfunctioning fepat, maintenance) productbased “oniuteralishvds shouid also be used for shor-term csinfoo- tion, With manual disinfection with akishyde‘ree products, {emmtir problems could arse Useful tips For the protection of stat: ' Avoid rinks of infction! For thie reason, when carrying out ‘manual process always woar eyo protection, long tear proot loves (vny) anc a watexproot apron — possibly even a mask. eo: long-sieaved protactive gown ana tong gloves, * Always ensure the reprocess room has @ sufficient supply of froan al ‘= Pay attention to tho unclean and clean side. Caution: ik of contaminetiont For reprocess in general * Caretuly brush all channots. * Use cleaning acaptorssyringes for acstiona chan. "= Aways olsen, disinfect and dry tha jel channel, lens rinsing channel, al- and wate supply chan ' Floprocess endoscopes wich hav not been used for along ‘ime since frst used, Periods of timo ar tobe specie. '* Naver use an endoscope on a pelientstralght from ie case, ANreys teorovess thoroughly before using. "= Regulaty lsifect endoscope cabinets. Caution: csinfocton periods must be spectad! | | |List of cleaning and disinfection agents Manual and machine reprocess with aldehydic products: /Pre-cleaning/ Disinfection | Pre-cleaning/ | Cleaning isinfoction Jcloaning ‘manual cleaning oto [eodedaxtorte —|Kaveaecanra | Bodedoxtore | Kortlox Ende- Cleaner Kersolox Endo dost toncise loaner | teraehyto | tansdo ceanor —_[ootinationiorzyna/tonido | glutaraldehyde senttes |Goazyne loasocire [parse ‘tremose Thermasopt ED Mar Joreymactearer | aldohydo eye cleaner | combinatonfonya/tnside | tradahydo Feo [estuwmpicceer [SekucldKorw | Sokusopt anor [Olympus Caner ETD ‘Opus snot ETD, oneidecoarer —_jationydo tensio clanar | combinaionanayma/tonside | gieraléines Foote |setaseptteaner | sokucia tense cleaner [ade ba Es or Deppe |nsou zy wer Pe ns Ze Labomat | enderat Ps [ereyre cleaner | attstnd famaaton | enzyme cleaner | ereyme cesnee hots ordain ‘bc Welger | neosher medciean [neater Sept 2000 needeharmeciclean |reccster median frie | nodisher Sept DN fete, aatne, | gttcraldelyde |r, alana, [alana tance oetalning | ley formutaon tenside contains Manual and machine reprocess with products based on peracetic acid Company | Eo Pre-cleaning/ [Disinfection Cleaning Disinfection cleaning a Foot |sclamopt®aitiv | Sokusept okt | Solanoperaktw | Ofympun EndoDet Oympun Encode peracetic pexaceticacis | poracato nest | pacotioacid | ereeia cleaner ‘oyna Enos actor Footy |selazyme Sotucpi* Easy Jergwme cteaner | parecaicacid | - be Weert [— 7 ecdisher meaicean | ood modkan rte | naodisher Sapo PAO tots ataino, | sano, tonsdecortaing | practic act xsd containFUJINON FUJHFILM Reprocess of flexible endoscopes in practice Series G5/G8 channel diagram ‘Aiciwater channet Suction channel Biopsy channel hae ¥ Light source 4 Socios tate range tent umn (EUROPE) OMB, 8 SESTASE PYLE GEA TEL AD A240 FD HEISE. wma ment Conronaon Ua Ah CATOMA CT 34 TNR ATE SEER 8 HE) EET Af