When should channel and lumen inspection be performed?
The AORN & SGNA both state that visual inspection is a separate step prior to high level disinfection or sterilization for endoscopes. The waterproof INSPEKTOR® CT is a perfect tool to use right at the sink. It can help speed up the process. If debris is found in the channel, it can be removed right at the sink.
Why is the INSPEKTOR® a necessary tool for every department responsible for cleaning endoscopes and surgical instruments?
Multiple clinicals have documented that dirty channels and lumens can infect patients.
You cannot clean what you cannot see. You can guess that it is clean, but you will not know until it is inspected. The INSPEKTOR® technology allows the technician to visually confirm the inside of the instrument or endoscope is as clean as the outside.
If I see debris/foreign matter in a lumen, how will I know what I am looking at?
A simple test to ask yourself is: if you saw the same debris on the outside of the instrument or endoscope, would you send it back to decontamination? To be sterile or high level disinfected, the inside of the instrument needs to be as clean as the outside.
What is being found in instrument lumens when inspected with the INSPEKTOR®?
• Bone Cement
• Human Hair
• Brush bristles
• Unidentifiable debris
Do you need a computer to be able to use the INSPEKTOR®?
No computer is required. The INSPEKTOR® is plug and play. If you choose to record images or video – software is supplied and the INSPEKTOR® may be connected to a computer to store images/video.
Can you get the INSPEKTOR® wet?
Yes, all INSPEKTOR® scopes are waterproof.
If you slide the INSPEKTOR® through a dirty lumen, how do you clean it?
The INSPEKTOR® is waterproof and can be cleaned with a hospital approved disinfectant wipe – followed by wiping with a water moistened fiber-free wipe.
Are there any guidelines as to how to clean instruments if debris is found inside?
Once debris is observed it is common sense to reclean the instrument.
The FDA commissioned the University of Michigan to analyze the cleanliness of lumens. They took 350 suction tubes and used an endoscope to inspect the cleanliness of the instruments. They found 95% had foreign matter in the lumens. Initially they soaked the instruments in enzymatic solution for 20 minutes and found only 25% of the instruments passed. They were able to get 80% of the instruments clean by soaking them for 40 minutes, re-brushing and putting them through the ultrasonic cleaner. The 20% that were not cleaned were soaked overnight in enzymatic solution and still did not pass inspection.
Are hospitals using the INSPEKTOR® to inspect all lumen instruments and endoscopes?
There are hospitals that have purchased INSPEKTOR® systems for each work-station and strive to have all lumen instruments inspected.
In an ideal world, the answer is yes. 2017 ANSI/AMMI ST79 18.104.22.168, 2015 ANSI/AMMI ST91 and all other national organization advocate visual inspection. Most discuss the use of a borescope to confirm the inside is as clean as the outside.
What arthroscopic shaver handpiece IFUs state to use an endoscope in to inspect lumens?
At the time of this writing, Stryker and Arthrex both state an indication for use of a borescope to inspect the handpiece lumens and confirm they are clean. ST79 7.2.2 states “The written IFU should always be followed.” The INSPEKTOR® is a perfect tool for this inspection.
Is there clinical documentation that dirty lumens can cause surgical site infections?
The oldest clinical we have found documenting that dirty channels infected patients dates back to 1994.
The December 2011 clinical in Infection Control and Hospital Epidemiology documenting that arthroscopic shaver handpieces were found to infect multiple patients (http://www.jstor.org/stable/10.1086/662712). Many of the U.S. media reported this to the public (CBS, NBC, FOX + more) and the FDA recently (October 6, 2014) issued a safety bulletin on the necessity to inspect. Here is a hand full of clinicals you may review that discusses dirty channels and lumens cause infections.
Correlation between outbreaks of multidrug-resistant Pseudomonas aeruginosa infection and use of bronchoscopes suggested by epidemiological analysis. – Biol Pharm Bull. 2014;37(1):26-30.
Acute glutaraldehyde mucosal injury of the upper aerodigestive tract due to damage to the working channel of an endoscope – Ann Otol Rhinol Laryngol. 2010 Mar;119(3):150-4.
Outbreak of Pseudomonas aeruginosa surgical site infections after arthroscopic procedures: Texas, 2009 Infect Control Hosp Epidemiol. 2011 Dec;32(12):1179-86. doi: 10.1086/662712. Epub 2011 Oct 17.
An outbreak of bronchoscopy-related Mycobacterium tuberculosis infections due to lack of bronchoscope leak testing. Chest. 2002 Mar;121(3):976-81.
Transmission of a highly drug-resistant strain (strain W1) of Mycobacterium tuberculosis. Community outbreak and nosocomial transmission via a contaminated bronchoscope. JAMA. 1997 Oct 1;278(13):1073-7.
Pseudo-outbreak of pseudomonas aeruginosa in HIV-infected patients undergoing fiberoptic bronchoscopy. Scand J Infect Dis. 1994;26(6):653-7.
More recently at the 2013 annual conference for the Assn. for Professionals in Infection Control and Epidemiology, in Fort Lauderdale, FL, it was reported that rates for bio dirt were as high as 30% for reusable endoscopes used for upper gastrointestinal exams.
How durable is the INSPEKTOR® Flexible Scope?
The INSPEKTOR® fiberscopes have been lab tested over 40,000 times passing through a 90 curved lumen and has been used in the field by individual hospitals over 70,000 times.
The INSPEKTOR® CT Scope has been bench tested through a 90∞ (degree) curved Frazier suction tube 100,000+ times and the sheathing and optics were excellent. We have hospital accounts that have used a single INSPEKTOR® CT borescope in over 80,000 individual inspections and still functioning.
All INSPEKTOR® Borescopes detach from the CT Monitor. If a CT Borescope breaks, it can be replaced without having to purchase a complete system.