FACT SHEET CENTRE FOR HEALTHCARE RELATED INFECTION SURVEILLANCE & PREVENTION

CONTRIBUTING TO SAFER HEALTHCARE

All anaesthetic equipment that comes into contact with a patient’s body fluids (including saliva) is classified as ‘semi-critical’ and must be changed, cleaned and sterilized before use on another patient. If items cannot with-stand sterilization, they must be exposed to at least thermal disinfection. This includes equipment that has come into direct contact with the anaesthetist's hands, which may be contaminated with blood, saliva or other body fluid. Additionally, unused items introduced into the anaesthetic work-field should be regarded as dirty and re-processed.

Anaesthetic equipment: cleaning methods

Thorough cleaning of all instruments and equipment is an essential prerequisite in disinfection and sterilization processes:

• All equipment must be disassembled completely to allow unrestricted contact of all parts with the cleaning and disinfection process

• Pressure gauges and measuring instruments must be processed separately according to the recom-mendations of the manufacturer

• Lumens of non-disposable endotracheal tubes, airways, facemasks, laryngeal masks, anaesthetic breathing circuits and cobbs connectors are to be placed over the appropriate nozzle/water jet on the washer/disinfector to ensure proper cleaning and rinsing

• The manufacturer’s instructions for cleaning and reprocessing of anaesthetic equipment should be followed

• Mechanical washer/disinfectors must not be overloaded

• Utilise an anaesthetic cycle in mechanical/disinfectors to process anaesthetic equipment as the cy-cle will not dispense a chemical during the rinse phase.

• All medical devices in direct contact with the patient are to be changed after each case i.e. ETT and catheter mount

“Single Use Only” products are to be discarded and

Multi-use products are to be cleaned and thermally disinfected in an automated washer before reuse

• Microbiological filters at the machine should be changed weekly

• External surfaces of all equipment, including circuits MUST be wiped over with detergent and wa-ter between cases

Anaesthetic circuits

• Reusable and ‘single use’ anaesthetic circuits may be used for a complete operating session without being changed between patients

• A bacterial/viral filter MUST be positioned between the circuit and the catheter mount/airway de-vice (patient end of circuit)

• The bacterial/viral filter MUST be discarded after each case

The cleaning of external surfaces of anaesthetic machines and associated equipment should occur on a regular basis; the use of detergent and water is sufficient. The internal components do not require cleaning and disinfec-tion.

Feb

2009

Cleaning & Reprocessing of Anaesthetic Respiratory Equipment

FACT SHEET

CONTRIBUTING TO SAFER HEALTHCARE

Laryngoscopes

The blade should be separated from the handle and the blade cleaned in detergent and water, rinsed and either sterilized or thermally disinfected. The handle must be wiped with detergent and water between uses.

Thermal Disinfection

Automated washer-disinfectors are recommended for use in the thermal disinfection process. Some innovative automated washer-disinfectors that are now available in Australia include cleaning mechanisms in their cycles. Refer to the manufacturer’s technical manual for reprocessing directions specific to this type of equipment.

The thermal disinfection process uses hot water at a temperature of 75° degrees for a contact time of at least 30 minutes.

References

• Australian and New Zealand College of Anaesthetists. Policy on infection control in anaesthesia [Online]. 2005 [cited 2007 Mar]; Available from: URL: http://www.anzca.edu.au/resources/professional-documents/professional-standards/ps28.html

• Australian and New Zealand Standard ASNZS 4187:2003. Cleaning, disinfecting and sterilizing reusable medical and surgical instruments and equipment, and maintenance of associated environments in health care facilities.

• Communicable Diseases Network Australia. Infection control guidelines for the prevention of transmission of in-fectious diseases in the health care setting [Online]. [cited 2007]; Available from: URL: http://www.health.gov.au/internet/main/publishing.nsf/Content/icg-guidelines-index.htm

• Infection Control Expert Advisory Group. ICEG Minutes 270207 item 5.2

• Queensland Health. Infection control guidelines [Online]. 2001 [cited 2007]; Available from: URL: http://www.health.qld.gov.au/chrisp/ic_guidelines/contents.asp

• Western Australian Department of Health. Operation Circular OP 2046/06 Anaesthetic Equipment and Preven-t i o n o f C r o s s I n f e c t i o n [ O n l i n e ] . [ c i t e d 2 0 0 7 ] ; A v a i l a b l e f r o m : U R L : http://www.health.wa.gov.au/circulars/circular.cfm?Circ_ID=12048