Rigid endo final-aorn-2010
Transcript of Rigid endo final-aorn-2010
Rigid Endoscopes:
The Care and Handling
7/20/2010
1Copyright 2010, AORN Inc.1
Rigid Endoscopes:Rigid Endoscopes:
The Care and HandlingThe Care and Handling
Rigid Endoscopes:Rigid Endoscopes:
The Care and HandlingThe Care and HandlingKay Ball, PhD, RN, CNOR, FAANKay Ball, PhD, RN, CNOR, FAAN
[email protected]@aol.com7/20/20107/20/2010
Disclosure InformationDisclosure Information
AORN’s policy is that the subject matter experts for this product must disclose any financial AORN’s policy is that the subject matter experts for this product must disclose any financial
relationship in a company providing grant funds and/or a company whose product(s) may be relationship in a company providing grant funds and/or a company whose product(s) may be
discussed or used during the educational activity.discussed or used during the educational activity. Financial disclosure will include the name of the Financial disclosure will include the name of the
company and/or product and the type of financial relationship, and includes relationships that are in company and/or product and the type of financial relationship, and includes relationships that are in
place at the time of the activity or were in place in the 12 months preceding the place at the time of the activity or were in place in the 12 months preceding the
activity.activity. Disclosures for this activity are indicated according to the following numeric categories:Disclosures for this activity are indicated according to the following numeric categories:
1. Consultant/Speaker’s Bureau 1. Consultant/Speaker’s Bureau 2. Employee 2. Employee
3. Stockholder 3. Stockholder 4. Product Designer 4. Product Designer
5. Grant/Research Support 5. Grant/Research Support 6. Other relationship (specify) 6. Other relationship (specify)
7. Has no financial interest7. Has no financial interest
Speaker: Kay Ball, PhD, RN, CNOR, FAAN
1. Consultant/Speaker’s Bureau 1. Consultant/Speaker’s Bureau
Planning Committee:
Susan Bakewell, MD, RN-BC
2. AORN Employee2. AORN Employee
Accreditation
AORN is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on
Accreditation.
AORN is provider-approved by the California Board of Registered Nursing, Provider Number CEP 13019.
AORN IS PLEASED TO PROVIDE THIS WEBINAR ON THIS IMPORTANT TOPIC. HOWEVER, THE VIEWS EXPRESSED IN THIS WEBINAR ARE THOSE OF THE
PRESENTERS AND DO NOT NECESSARILY REPRESENT THE VIEWS OF, AND SHOULD NOT BE ATTRIBUTED TO AORN.
ObjectivesObjectivesObjectivesObjectives
1. Discuss the evolution of rigid 1. Discuss the evolution of rigid
endoscopy, including the history and endoscopy, including the history and
components of rigid endoscopes.components of rigid endoscopes.
2. Describe reprocessing, storage, and 2. Describe reprocessing, storage, and
handling concerns associated with handling concerns associated with
rigid endoscopes.rigid endoscopes.
Rigid Endoscopes:
The Care and Handling
7/20/2010
2Copyright 2010, AORN Inc.1
ReferencesReferencesReferencesReferences
AORN RPs
Alexander’s Care
of the Patient in
Surgery
EndoscopyEndoscopyInspection of body organs or Inspection of body organs or
cavities by means of an cavities by means of an
endoscope, which is a device endoscope, which is a device
consisting of a tube and consisting of a tube and
optical systemoptical system
Evolution of EndoscopyEvolution of EndoscopyEvolution of EndoscopyEvolution of Endoscopy
Hippocrates II (460-375BC)-looked into rectum
Rigid Endoscopes:
The Care and Handling
7/20/2010
3Copyright 2010, AORN Inc.1
1012 AD Abulkasim-used
mirror to deflect light into
vagina
1585 Tulio Caesare Aranzi-
nasal cavity
1800’s1800’s1800’s1800’s
1805 Bozzani-large
tube, candles,
urethra (censored)
1826 Segalas-
obturator, mirrors
1835 Desmoreaux-
”Father of
endoscopy”
urethroscopy
1850’s1850’s1850’s1850’s
Louis Pasteur Louis Pasteur --
Infection ControlInfection Control
Rigid Endoscopes:
The Care and Handling
7/20/2010
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Late 1800’sLate 1800’sLate 1800’sLate 1800’s
1869 Cmdr Panteleoni-
birth of hysteroscopy
1877 Nitze-crude optical
system
1880 Edison-
incandescent light bulb
1887 Dittel-add light
bulb to endoscope
End of 1800’sEnd of 1800’sEnd of 1800’sEnd of 1800’s
Done in most med centrs:Done in most med centrs:
�� CystoscopyCystoscopy
�� ProctoscopyProctoscopy
�� LaryngoscopyLaryngoscopy
�� EsophagoscopyEsophagoscopy
1900’s1900’s1900’s1900’s
1901 Ott-Ventroscopy
1901 Kelling-
coleoscopy (dog)
1907 1st Gastroscope
1910 Jacobaues-
laparoscopy human
Rigid Endoscopes:
The Care and Handling
7/20/2010
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1900’s1900’s1900’s1900’s1912 Trendelenburg
1918 Arthroscopy
1924 CO2 insufflation
1929 Kalk-135° lens -
better visualization
1932 Semiflex
gastroscope
Mid 1900’sMid 1900’sMid 1900’sMid 1900’s1933 Lap (Dx to Rx)
1941 1st fulg of tubes
1952 Quartz rods
1967 Harold Hopkins
1968 Fiberoptics
1977 Insufflator (Semm)
Lap CholeLap Chole
Mid 1980’sMid 1980’s
Rigid Endoscopes:
The Care and Handling
7/20/2010
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Clinical Applications TodayClinical Applications Today
Rigid endoscopy moving into Endo Suite
Rigid scopesRigid scopes��ArthroscopesArthroscopes
��CystoscopesCystoscopes
��LaparoscopesLaparoscopes
��Sinus scopesSinus scopes
��Pediatric scopesPediatric scopes
��HysteroscopesHysteroscopes
Rigid Endoscopes:
The Care and Handling
7/20/2010
7Copyright 2010, AORN Inc.1
CystoscopyCystoscopy
HysteroscopyHysteroscopyHysteroscopyHysteroscopy
LaparoscopyLaparoscopy
Rigid Endoscopes:
The Care and Handling
7/20/2010
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ArthroscopyArthroscopy
New endoscopes
Semi-rigid endoscopes
Instrumentation AdvancementsInstrumentation Advancements
Components of Rigid Components of Rigid
EndoscopesEndoscopes
Components of Rigid Components of Rigid
EndoscopesEndoscopes
Rigid Endoscopes:
The Care and Handling
7/20/2010
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Rigid EndoscopeRigid Endoscope
�� Eye pieceEye piece
�� BodyBody
�� Light guide connectorLight guide connector
�� ShaftShaft
�� Distal endDistal end
Handling tipsHandling tips
Eye PieceEye Piece
Rigid Endoscopes:
The Care and Handling
7/20/2010
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Eye PieceEye Piece
Diopter GaugeDiopter Gauge
Rigid Endoscopes:
The Care and Handling
7/20/2010
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Oils from skinOils from skin
Cloudy ImageCloudy Image
Cloudy Clear
Decrease FoggingDecrease Fogging
�� Use antiUse anti--fogging solutionsfogging solutions
�� Heat scope to body tempHeat scope to body temp
�� Use endoscope warmer Use endoscope warmer
�� Warm irrigation solutionWarm irrigation solution
�� Warm Warm insufflationinsufflation gas gas
�� Replace faulty sealsReplace faulty seals
Rigid Endoscopes:
The Care and Handling
7/20/2010
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DeFogger
Scope Scope
WarmerWarmer
Warmer
Warmer
Video technology for
rigid endoscopy
Video technology for
rigid endoscopy
Rigid Endoscopes:
The Care and Handling
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White BalancingWhite Balancing
�� Method for the camera to reference Method for the camera to reference
white so it can properly identify all white so it can properly identify all
primary colorsprimary colors
Rigid Endoscopes:
The Care and Handling
7/20/2010
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VideoconferencingVideoconferencing
Continuing EducationContinuing EducationContinuing EducationContinuing Education
BodyBody
Rigid Endoscopes:
The Care and Handling
7/20/2010
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ConnectorsConnectors
Light Guide ConnectorLight Guide Connector
Rigid Endoscopes:
The Care and Handling
7/20/2010
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IlluminationIlluminationIlluminationIllumination
Light Cable Connection
Glass Fibers
Rigid Endoscopes:
The Care and Handling
7/20/2010
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Decreased light outputDecreased light output
�� Damaged light cableDamaged light cable
�� Debris on ends of light cableDebris on ends of light cable
�� Mixed brands of adapters Mixed brands of adapters
�� Wrong adapterWrong adapter
�� Old or dirty light bulbOld or dirty light bulb
�� Wrong light bulbWrong light bulb
Rigid Endoscopes:
The Care and Handling
7/20/2010
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Replace when
>33% broken fibers
Rigid Endoscopes:
The Care and Handling
7/20/2010
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Rigid Endoscopes:
The Care and Handling
7/20/2010
20Copyright 2010, AORN Inc.1
ECRIECRIECRIECRILabel all fiberoptic light sources with:Label all fiberoptic light sources with:
“Warning: High“Warning: High--intensity fiberoptic light intensity fiberoptic light
sources and cables can ignite drapes and sources and cables can ignite drapes and
other materials. Complete all fiberoptic other materials. Complete all fiberoptic
cable connections before activating the cable connections before activating the
light source.”light source.”
Light SourcesLight Sources
�� Xenon Xenon (higher cost, focus down to small (higher cost, focus down to small
area, preferred for video)area, preferred for video)
�� Metal halide Metal halide (Less expensive, shorter (Less expensive, shorter
life, easy to handle)life, easy to handle)
�� Halogen Halogen (popular in Dr offices, low light, (popular in Dr offices, low light,
not for video)not for video)
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The Care and Handling
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Xenon LampsXenon LampsXenon LampsXenon Lamps
Metal Halide LampsMetal Halide LampsMetal Halide LampsMetal Halide Lamps
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The Care and Handling
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Light Source BrightnessLight Source BrightnessLight Source BrightnessLight Source Brightness
�� ManualManual
�� Automatic (adjusts Automatic (adjusts
according to video image)according to video image)
ShaftShaft
Rigid Endoscopes:
The Care and Handling
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Internal Shaft LumensInternal Shaft LumensInternal Shaft LumensInternal Shaft Lumens
Rigid Endoscopes:
The Care and Handling
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Rigid Endoscopes:
The Care and Handling
7/20/2010
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Distal EndDistal End
Rigid Endoscopes:
The Care and Handling
7/20/2010
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Rigid Scope
Prism LensNegative
Lens
30 degree
objective lensRod
Lens
Lens SystemLens System�� 00--degree angle: straight forwarddegree angle: straight forward
�� 3030--degree angle: forward obliquedegree angle: forward oblique
�� 7070--degree angle: lateraldegree angle: lateral
�� 9090--degree angle: lateraldegree angle: lateral
�� 120120--degree angle: retrospectivedegree angle: retrospective
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The Care and Handling
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Rigid Video EndoscopeRigid Video EndoscopeRigid Video EndoscopeRigid Video Endoscope
Rigid Video EndoscopeRigid Video EndoscopeRigid Video EndoscopeRigid Video Endoscope
�� 5 mm5 mm
�� Image and brightness of Image and brightness of
a 10 mm scopea 10 mm scope
�� OneOne--Piece Piece VideoScopeVideoScope
TechnologyTechnology
�� No ScopeNo Scope
�� No CameraNo Camera
�� No CouplerNo Coupler
�� No Light CableNo Light Cable
Rigid Endoscopes:
The Care and Handling
7/20/2010
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Rigid Endoscope with Rigid Endoscope with
Flexible TipFlexible Tip
Rigid Endoscope with Rigid Endoscope with
Flexible TipFlexible Tip
ReprocessingReprocessing
Trends Guiding ReprocessingTrends Guiding ReprocessingTrends Guiding ReprocessingTrends Guiding Reprocessing
�� Technology advancementsTechnology advancements
�� Complexity of devicesComplexity of devices
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The Care and Handling
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Trends Guiding ReprocessingTrends Guiding ReprocessingTrends Guiding ReprocessingTrends Guiding Reprocessing
�� Instrument technology Instrument technology --
FDA requirementsFDA requirements
Reusables must have Reusables must have reprocessing reprocessing instructionsinstructions
Decontamination during the procedureDecontamination during the procedure
During TransportationDuring Transportation
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The Care and Handling
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DecontaminationDecontamination
NO SalineNO Saline
AttireAttireAttireAttire
Rigid Endoscopes:
The Care and Handling
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DisassemblyDisassembly
Rigid Endoscopes:
The Care and Handling
7/20/2010
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Solutions & ToolsSolutions & Tools
Chemical SolutionsChemical Solutions
�� Protease will break apart proteinProtease will break apart protein
�� Lipase will break apart fatsLipase will break apart fats
�� Amylase will break apart starchesAmylase will break apart starches
�� CarbohydraseCarbohydrase will break apart will break apart
carbohydratescarbohydrates
Proper Cleaning SuppliesProper Cleaning Supplies
Rigid Endoscopes:
The Care and Handling
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Brushes and DevicesBrushes and DevicesBrushes and DevicesBrushes and Devices
Various Sizes of CleanersVarious Sizes of CleanersVarious Sizes of CleanersVarious Sizes of Cleaners
Ultrasonic CleaningUltrasonic CleaningUltrasonic CleaningUltrasonic Cleaning
Rigid Endoscopes:
The Care and Handling
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CleaningCleaningCleaningCleaning
No ultrasonic cleaners No ultrasonic cleaners --
damage tiny glass fibersdamage tiny glass fibers
RinsingRinsingRinsingRinsing
Manual vs. AutomatedManual vs. Automated
Rigid Endoscopes:
The Care and Handling
7/20/2010
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Automated CleaningAutomated CleaningAutomated CleaningAutomated Cleaning
Drying EndoscopeDrying EndoscopeDrying EndoscopeDrying Endoscope
Impact of Sterile DirtImpact of Sterile DirtImpact of Sterile DirtImpact of Sterile Dirt
��Increases adhesion formationIncreases adhesion formation
��Increases immune responseIncreases immune response
��Delays healingDelays healing
Rigid Endoscopes:
The Care and Handling
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Checking Integrity & FunctionalityChecking Integrity & Functionality
Checking Integrity & FunctionalityChecking Integrity & Functionality
Disinfection vs. Sterilization
Rigid Endoscopes:
The Care and Handling
7/20/2010
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Spaulding’s ClassificationsSpaulding’s Classifications
�� Critical (Sterilize) Critical (Sterilize)
�� SemiSemi--critical (Disinfect)critical (Disinfect)
�� NonNon--critical (Clean)critical (Clean)
Glutaraldehyde DisinfectionGlutaraldehyde Disinfection
GLUT
Broad spectrum antimicrobial “cold” disinfectantBroad spectrum antimicrobial “cold” disinfectant
Thorough cleaning first!!Thorough cleaning first!!
Device PreparationDevice Preparation
Rigid Endoscopes:
The Care and Handling
7/20/2010
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Glut Test StripsGlut Test StripsGlut Test StripsGlut Test Strips
Glut ActionGlut ActionGlut ActionGlut Action
Bonds ProteinBonds Protein
Rigid Endoscopes:
The Care and Handling
7/20/2010
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Exposure LevelsExposure LevelsExposure LevelsExposure Levels
�� 0.04 0.04 ppmppm Detect odorDetect odor
�� 0.2 0.2 ppmppm Exposure levelExposure level
�� 0.3 0.3 ppmppm IrritantIrritant
�� 0.4 0.4 ppmppm PouringPouring
Rigid Endoscopes:
The Care and Handling
7/20/2010
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VentilationVentilation
Glut
Vent
Processing Area
Glut Ventilation SystemGlut Ventilation SystemGlut Ventilation SystemGlut Ventilation System
Rigid Endoscopes:
The Care and Handling
7/20/2010
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Soak Time ControversySoak Time Controversy
ControversyControversy
FDAFDA
45 min soak45 min soak
25 degrees C.25 degrees C.
Prof. OrgProf. Org
20 min soak20 min soak
Room temp.Room temp.
Glove RecommendationsGlove RecommendationsGlove RecommendationsGlove Recommendations
??
Rigid Endoscopes:
The Care and Handling
7/20/2010
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Spill ProcedureSpill Procedure
AmmoniaAmmonia
Other “cold soak” solutionsOther “cold soak” solutionsOther “cold soak” solutionsOther “cold soak” solutions
Hydrogen peroxide?
Phosphoric acid?Phosphoric acid?
8 min. soak for HLD?
25 min. soak for HLD?
Automatic ProcessorAutomatic ProcessorAutomatic ProcessorAutomatic Processor
Rigid Endoscopes:
The Care and Handling
7/20/2010
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Sterilization OptionsSterilization Options
�� SteamSteam
�� Ethylene OxideEthylene Oxide
�� PeraceticPeracetic AcidAcid
�� Hydrogen Hydrogen
Peroxide Peroxide (Plasma (Plasma
or vapor)or vapor)
�� OzoneOzone
Sterilize
Steam SterilizationSteam SterilizationSteam SterilizationSteam Sterilization
Autoclavable ScopesAutoclavable Scopes
Number of
sterilizations?
Best sterilization
method?
Rigid Endoscopes:
The Care and Handling
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Action of Steam SterilizationAction of Steam SterilizationAction of Steam SterilizationAction of Steam Sterilization
Types of Steam SterilizationTypes of Steam SterilizationTypes of Steam SterilizationTypes of Steam Sterilization
�� Gravity Gravity
displacementdisplacement
�� PrevacuumPrevacuum
Monitoring
Bacillus Bacillus StearothermophilusStearothermophilus
Rigid Endoscopes:
The Care and Handling
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Flash SterilizationFlash SterilizationFlash SterilizationFlash Sterilization
Autoclavable ScopesAutoclavable Scopes
How are they marked if steam sterilizable?
Ethylene Oxide SterilizationEthylene Oxide SterilizationEthylene Oxide SterilizationEthylene Oxide Sterilization
Rigid Endoscopes:
The Care and Handling
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Heat /Moisture Sensitive DevicesHeat /Moisture Sensitive Devices
Ethylene Oxide SterilizationEthylene Oxide SterilizationEthylene Oxide SterilizationEthylene Oxide Sterilization
�� Instrument preparationInstrument preparation
�� Wash, rinse, dryWash, rinse, dry
ETO + H2O = Ethylene GlycolETO + H2O = Ethylene Glycol
ETO + Saline = Ethylene ETO + Saline = Ethylene ChlorhydrineChlorhydrine
Ethylene Oxide SterilizationEthylene Oxide Sterilization
Sterilization ParametersSterilization Parameters
�� ConcentrationConcentration
�� HumidityHumidity
�� TemperatureTemperature
�� TimeTime
ConcernsConcerns
�� AerationAeration
Biological Monitoring�Bacillus Atropheus
(formerly Bacillus Subtilis)
Rigid Endoscopes:
The Care and Handling
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EO AdvantagesEO AdvantagesEO AdvantagesEO Advantages
�� Effective sterilizer for heat & Effective sterilizer for heat &
moisture sensitive devicesmoisture sensitive devices
�� EO readily diffuses at low tempsEO readily diffuses at low temps
�� No lumen restrictionsNo lumen restrictions
�� Compatible with materialsCompatible with materials
�� Low costLow cost
EO LimitationsEO LimitationsEO LimitationsEO Limitations
�� Long cycle length and aeration Long cycle length and aeration
�� Installation requirementsInstallation requirements
�� FlammabilityFlammability
�� ToxicityToxicity
�� Cost of ensuring safetyCost of ensuring safety
Peracetic Acid SterilizationPeracetic Acid Sterilization
STERIS System 1TM
to
STERIS System 1ETM
Rigid Endoscopes:
The Care and Handling
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Peracetic Acid SterilizationPeracetic Acid SterilizationPeracetic Acid SterilizationPeracetic Acid Sterilization
�� Low tempLow temp
�� ImmersibleImmersible devicesdevices
PA AdvantagesPA AdvantagesPA AdvantagesPA Advantages
�� Short cycle timeShort cycle time
�� JITJIT
�� Variety of trays and containersVariety of trays and containers
�� Quick connects for lumensQuick connects for lumens
�� Closed system, ventilation not Closed system, ventilation not
requiredrequired
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The Care and Handling
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VHP Vaporized Hydrogen Peroxide
VHP Vaporized Hydrogen Peroxide
�� Uses HUses H22OO22 vapor to destroy vapor to destroy
microbes without using plasmamicrobes without using plasma
�� Free radicals disrupt & destroy Free radicals disrupt & destroy
microbesmicrobes
�� NonNon--toxic byproducts (water toxic byproducts (water
vapor, Ovapor, O22))
�� Sterilization < 1 hourSterilization < 1 hour
O O
H
H
�� Series of pulses in processSeries of pulses in process
�� Evacuation phaseEvacuation phase
�� HH22OO22 injection phaseinjection phase
�� HH22OO22 hold phasehold phase
�� Transition phaseTransition phase
�� Phases repeat x 4Phases repeat x 4
VHP Vaporized Hydrogen Peroxide
VHP Vaporized Hydrogen Peroxide
VHP CyclesVHP CyclesV-PRO 1 Sterilization Cycle
0.100
1.000
10.000
100.000
1000.000
0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 54 56
Time (min)
Pre
ssu
re (
mm
Hg
)
Condition Sterilize Aerate
Pulse 4Pulse 3Pulse 2Pulse 1
Sterilization Cycle
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VHP Vaporized Hydrogen Peroxide
VHP Vaporized Hydrogen Peroxide
�� Chemical indicator and challenge packChemical indicator and challenge pack
�� GeobacillusGeobacillus stearothermophilusstearothermophilus –– most most
resistant to VHP processresistant to VHP process
�� Compatible with a variety of materials to Compatible with a variety of materials to
be sterilizedbe sterilized
Lumen restrictions:Lumen restrictions:
VHP Vaporized Hydrogen Peroxide
VHP Vaporized Hydrogen Peroxide
Inner Diameter Length
> 1mm (3Fr) < 125mm
> 2mm (6Fr) < 250mm
> 3mm (9Fr) < 400mm
•Lumen cycle = 55 min
•Nonlumen cycle = 28 min
What can NOT be processed in the VHP System?What can NOT be processed in the VHP System?
� PAPER or CELLULOSE PRODUCTS
� Count Sheets
� Huck Towels
� Gauze
� LIQUIDS or POWDERS
� SINGLE USE or IMPLANTS
� COPPER or MATED NYLON
� ITEMS or MATERIALS that ABSORB LIQUID
� Foam, Sponges
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VHP Advantages
Press start
�Easy to use
VHP Advantages VHP Advantages
� Short cycle time compared to EO
� Simple installation
� Shelf-life with wrapped devices
� Non-toxic, environmentally friendly
(byproducts are water vapor and O2)
� Conditioning phase – minimizes aborts due to
moisture
� H2O2 cup sealed and vented – easy to insert,
automated
2. Injection system
punctures cartridge
3. One cycle’s
worth of
sterilant is
drawn into
a reservoir1. Close the cartridge
interface door
VHP Advantages
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The Care and Handling
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VHP LimitationsVHP Limitations
� Can’t process cellulose or paper (must
use nonwoven or polypropylene wraps)
� Must use containers and trays cleared for
this sterilizer
� Lumen restrictions – no flexible
endoscopes, no long narrow lumens
Gas Plasma SterilizationGas Plasma Sterilization
19931993
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The Care and Handling
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Gas Plasma ActionGas Plasma Action
Free radicals + collisional byproducts sterilize
PLASMAPLASMA
Gas Plasma SterilizationGas Plasma Sterilization
�� Low temp H2O2 in gas plasma to Low temp H2O2 in gas plasma to
inactivate microorganisms without inactivate microorganisms without
harmful residuesharmful residues
�� Heat and moisture sensitive devicesHeat and moisture sensitive devices
�� 45 45 --75 minute cycles, different with each 75 minute cycles, different with each
system modelsystem model
�� H2O2 cassette enclosedH2O2 cassette enclosed
�� Lumen restrictions depending on modelLumen restrictions depending on model
Ozone SterilizationOzone Sterilization
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Ozone SterilizationOzone Sterilization
�� Natural processNatural process
�� O2 exposed to intense electrical fieldO2 exposed to intense electrical field
�� Separates oxygen molecules into Separates oxygen molecules into atomic oxygen (O)atomic oxygen (O)
�� O combines with other oxygen O combines with other oxygen molecules (O2) to form molecules (O2) to form triatomictriatomicoxygen (O3) or Ozoneoxygen (O3) or Ozone
�� Sterilization in approximately 4 Sterilization in approximately 4 hourshours
�� No toxic residuals No toxic residuals –– O2 + water O2 + water vaporvapor
Ozone SterilizationOzone Sterilization
Ozone AdvantagesOzone Advantages
�� Easy to Use Easy to Use
�� Low TemperatureLow Temperature
�� Safe, No Toxic ResidualsSafe, No Toxic Residuals
�� Cost EffectiveCost Effective
�� Compatible with Anodized Compatible with Anodized
Aluminum ContainersAluminum Containers
�� Cleared for multiple channel flexible Cleared for multiple channel flexible
endoscopesendoscopes
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Ozone LimitationsOzone Limitations
�� Long cycle time (compared to H2O2)Long cycle time (compared to H2O2)
�� Need source of oxygen or O2 tanks to Need source of oxygen or O2 tanks to
supply systemsupply system
�� Not widely acceptedNot widely accepted
�� Material compatibility??Material compatibility??
StorageStorage
TransportingTransporting
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The Care and Handling
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Wet
Storage?
Wet
Storage?
Sheath ProtectorsSheath Protectors
COMMON CAUSES OF
ENDOSCOPE DAMAGE
COMMON CAUSES OF
ENDOSCOPE DAMAGE
95% of repairs are procedure related!
Rigid Endoscopes:
The Care and Handling
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Original
Manufacturer
vs. 3rd Party
Repairs
Original
Manufacturer
vs. 3rd Party
Repairs
Repairs
Mobile Repair ServicesMobile Repair ServicesMobile Repair ServicesMobile Repair Services
Mobile Repairs
SummarySummary
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The Care and Handling
7/20/2010
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Questions??Questions??Questions??Questions??
To receive 1 contact hour for this activity, To receive 1 contact hour for this activity,
return the evaluation and verification of return the evaluation and verification of
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If more than one person listened to this If more than one person listened to this
webinar at your site, copy the forms for each webinar at your site, copy the forms for each
person to complete individually.person to complete individually.
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