ENDOSCOPY
l Advanced bronchoscopy (i.e guided bronchoscopy and endosonography) still needs to be performed with resuable bronchoscopes.
In conclusion, he stated that single-use bronchoscopes are very useful, but the pandemic has boosted their use beyond what their use would have been; quality improvements are needed (and are fortunately ongoing); and they will only become integrated once advanced bronchoscopes become available – in particular, EBUS scopes and thin and ultra-thin scopes with large enough operative channels.
Patient safety and hygiene Paul J Caesar, EMEA reprocessing and infection control leader at Pentax Medical further expanded on the important factors in infection prevention in endoscopy, citing the principle that guides the delivery of all healthcare – the hippocratic oath of “First do no harm”.
He highlighted a declaration by the Dutch Steering Group for Flexible Endoscope Cleaning and Disinfection (SFERD, 2017), which states: When it comes to endoscopy, all must avoid the occurrence of any exogenous contamination by micro- organisms during diagnosis or treatment using a flexible endoscope.
“When we talk about endoscope-related infections, we differentiate endogenous infections, caused by the patient’s own microbial flora, and exogenous infections, caused by inadequately reprocessed equipment – including the endoscope, the endoscope components and/or reusable endoscopic accessories,” Caesar explained. He pointed out that most cases of nosocomial infection have been linked to failures to follow national or international guidelines (as discussed in an ESGENA position statement, in 2018). He added that the figures for such cases are likely to be “just the tip of the iceberg”, as there is
a lack of surveillance for endoscopy-related infections.
“Endoscopes reprocessed appropriately, in accordance with reprocessing and infection control guidelines, pose virtually no risk of transmission of patient-borne or environmental microorganisms, but ‘appropriately’ is the magic word. I have seen many procedures in hospitals and many audits, and ‘appropriately’, in some cases, was just ‘one quick flush and a brush’ because of the high volume and high turnover of endoscopes,” he commented. Successful reprocessing, on the other hand, is dependent on many interrelated processes.
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