1、預(yù)處理

1. Preprocessing

內(nèi)鏡從患者體內(nèi)取出后，在與光源和視頻處理器拆離之前，應(yīng)立即用含有清洗液的濕紗布擦去外表污物，擦拭用品應(yīng)一次性使用。將內(nèi)鏡的前端置入裝有清洗液的容器中，啟動(dòng)吸引功能，抽吸清洗液直至其流入吸引管，反復(fù)送氣與送水至少十秒；內(nèi)鏡與光源和視頻處理器拆離，蓋好內(nèi)鏡防水蓋，放入密閉運(yùn)送容器，送至清洗消毒室。

After the endoscope is removed from the patient's body and before being detached from the light source and video processor, the external dirt should be immediately wiped off with a damp gauze containing cleaning solution. The wiping products should be used once. Place the front end of the endoscope into a container containing cleaning solution, activate the suction function, and pump the cleaning solution until it flows into the suction tube. Repeat air and water supply for at least ten seconds; Detach the endoscope from the light source and video processor, cover the waterproof cover of the endoscope, place it in a sealed shipping container, and send it to the cleaning and disinfection room.

2、重視測(cè)漏

2. Pay attention to leak detection

a:在內(nèi)鏡進(jìn)行清洗、消毒前，需要進(jìn)行常規(guī)測(cè)漏檢測(cè)。測(cè)漏是早期發(fā)現(xiàn)內(nèi)鏡問(wèn)題的辦法，測(cè)漏不一定100％可以查出問(wèn)題，但不做無(wú)法預(yù)防小問(wèn)題衍生為大麻煩而送修，甚至報(bào)廢。

a: Before cleaning and disinfecting the endoscope, routine leak testing is required. Leakage testing is a method for early detection of endoscopic problems. Leakage testing may not be 100% effective in detecting problems, but not doing so cannot prevent small problems from turning into major problems and causing them to be repaired or even scrapped.

b:測(cè)漏方法：取下各類按鈕和閥門，連接好測(cè)漏裝置，并注入壓力；將內(nèi)鏡全部浸沒于水中，使用注射器向各個(gè)管道注水以排出管道內(nèi)氣體；觀察鏡體各部位有無(wú)氣泡冒出，再觀察插入部、操作部、連接部等部分，如發(fā)現(xiàn)滲漏，應(yīng)及時(shí)保修送檢。

b: Leak detection method: Remove various buttons and valves, connect the leak detection device, and inject pressure; Immerse the endoscope completely in water and use a syringe to inject water into each pipeline to expel gas from the pipeline; Observe whether there are bubbles emerging from various parts of the mirror body, and then observe the insertion part, operation part, connection part, and other parts. If any leakage is found, it should be promptly repaired and sent for inspection.

3、不管是手工清洗還是機(jī)械清洗都要經(jīng)過(guò)沖洗—洗滌—漂洗—終末漂洗—消毒—干燥的過(guò)程。我們對(duì)用過(guò)的軟鏡進(jìn)行表面大的污漬、蛋白進(jìn)行低纖維絮布擦拭或流動(dòng)水沖洗。

3. Whether it is manual cleaning or mechanical cleaning, it must go through the process of rinsing, washing, rinsing, final rinsing, disinfection, and drying. We clean the surface of the used soft mirror with large stains and protein using low fiber wadding cloth or rinse it with flowing water.

4、洗滌用清洗液濃度一定要達(dá)標(biāo)，應(yīng)根據(jù)產(chǎn)品說(shuō)明書正確配置，需現(xiàn)配現(xiàn)用，活性酶在水溫40℃左右活性高，一般4小時(shí)就失效。刷洗軟式內(nèi)鏡的所有管道，刷洗時(shí)應(yīng)兩頭見刷頭，并洗凈刷頭上的污物，反復(fù)刷洗至沒有可見污染物。

4. The concentration of cleaning solution used for washing must meet the standard, and it should be correctly configured according to the product manual. It needs to be prepared and used immediately. The active enzyme has high activity at a water temperature of around 40 ℃, and generally fails within 4 hours. Brush all the pipes of the soft endoscope, and when brushing, the brush head should be visible at both ends. Clean the dirt on the brush head and repeatedly brush until there are no visible pollutants.

連接全管道灌流器，使用動(dòng)力泵向各管道內(nèi)灌注清洗液三分鐘，浸泡時(shí)應(yīng)遵循產(chǎn)品說(shuō)明書。每條內(nèi)鏡清洗時(shí)所沉淀不同的微生物細(xì)菌堆積在清洗槽內(nèi)，增加感染的機(jī)會(huì)，所以一條內(nèi)鏡清洗完后應(yīng)更換洗洗液。

Connect the entire pipeline perfusion device and use a power pump to inject cleaning solution into each pipeline for three minutes. Follow the product manual when soaking. During the cleaning of each endoscope, different microorganisms and bacteria accumulate in the cleaning tank, increasing the chance of infection. Therefore, after cleaning an endoscope, the cleaning solution should be replaced.

5、漂洗及終末漂洗應(yīng)使用純化水或滅菌水，使用電導(dǎo)儀進(jìn)行測(cè)試電導(dǎo)率應(yīng)為≤I5μs/cm（25℃）。

5. Rinsing and final rinsing should use purified or sterilized water, and the conductivity should be ≤ I5 when tested with a conductivity meter μ s/cm（25℃）。

6、消毒：軟式內(nèi)鏡消毒劑是否達(dá)標(biāo)與其消毒合格具有密切聯(lián)系，目前使用多的是濃度為2%的戊二醛浸泡20分鐘，其具有消毒效果良好、價(jià)格便宜、對(duì)內(nèi)鏡及其附件無(wú)損害等優(yōu)點(diǎn)。不同功能內(nèi)鏡清洗消毒應(yīng)分開進(jìn)行，其中手工清洗槽和清洗消毒設(shè)備應(yīng)分開設(shè)置及使用。消毒后的內(nèi)鏡應(yīng)采用純化水或無(wú)菌水進(jìn)行終末漂洗。

6. Disinfection: Whether the soft endoscope disinfectant meets the standard is closely related to its disinfection qualification. Currently, it is commonly used to soak in glutaraldehyde at a concentration of 2% for 20 minutes, which has the advantages of good disinfection effect, low price, and no damage to the endoscope and its accessories. The cleaning and disinfection of endoscopes with different functions should be carried out separately, with manual cleaning tanks and cleaning and disinfection equipment set up and used separately. The disinfected endoscope should be rinsed with purified or sterile water for final rinsing.

7、干燥：內(nèi)鏡管道干燥通常用75％至95％的乙醇或異丙醇注入管道進(jìn)行干燥。推薦使用酒精是因?yàn)樗梢詢艋⒋龠M(jìn)內(nèi)鏡通道內(nèi)殘留水分的蒸發(fā)，從而減少生物負(fù)荷積聚的機(jī)會(huì)。也可用可調(diào)壓力的過(guò)濾空氣來(lái)干燥內(nèi)鏡管道。外表面用清潔低纖維絮布進(jìn)行擦拭干燥，干燥時(shí)間充足，至少10分鐘。

7. Drying: Endoscopic tube drying is usually performed by injecting 75% to 95% ethanol or isopropanol into the tube for drying. The recommended use of alcohol is because it can purify and promote the evaporation of residual water in the endoscopic channel, thereby reducing the chances of biological burden accumulation. Adjustable pressure filtered air can also be used to dry the endoscopic tube. Wipe and dry the outer surface with a clean low fiber wadding cloth, with sufficient drying time of at least 10 minutes.

8、環(huán)境終末處理：應(yīng)保持通風(fēng)良好。環(huán)境應(yīng)采用機(jī)械通風(fēng)，宜采取"上送下排"方式，換氣次數(shù)宜10次/h，小新風(fēng)量宜達(dá)到2次/h。物表用500mg/L—1000mg/L的含氯消毒液進(jìn)行擦拭或噴灑消毒30分鐘后，應(yīng)及時(shí)用清水擦洗干凈，不耐腐蝕的物體表面用75%乙醇進(jìn)行擦拭消毒。

8. Environmental final treatment: Good ventilation should be maintained. The environment should adopt mechanical ventilation, preferably using the "up supply and down exhaust" method, with a ventilation rate of 10 times/h and a small fresh air volume of 2 times/h. After wiping or spraying with 500mg/L-1000mg/L chlorine containing disinfectant for disinfection of the surface for 30 minutes, it should be promptly wiped clean with clean water. Non corrosion-resistant surfaces should be wiped and disinfected with 75% ethanol.

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