ENDOSCOPY
Reducing risk of endoscope damage
The endoscopy units of both the King George’s Hospital and Queen Elizabeth Hospital in London have reduced scope repairs by over 50%, following the introduction of a new protection device.
According an article recently published in Gastroenterology and Endoscopy News,1 a broken endoscope is more than just an equipment failure. It can delay treatment for patients and create unhappy staff who lack appropriate tools and must work late, increasing overtime costs and decreasing revenue due to cancelled procedures. Scope defects and damage can also harbour debris which has been implicated in cross-contamination issues.2
In a recent webinar, two members of an Olympus service and repair team shared tips on preventing the most frequent and expensive types of endoscope damage and minimising the effects on facilities, staff and patients. “Roughly 85% of endoscope repairs are avoidable,” said Louis Mariani, an endoscope service expert at Olympus. “The distal end is the most fragile part of the endoscope, accounting for nearly 45% of all endoscope damage. The distal end houses
a protective cover, charge-coupled device, camera, light guide lenses, and nozzle for air and water.”
“Damage to any of these components can cause image issues, light issues, and even harbour patient debris,” Mr. Mariani continued. “A broken lens cover or nozzle entering a patient can be a very serious concern because patient debris can be lodged into a break or breach of material.” The main cause of damage to the distal end is impact, with the floor or peripheral equipment. “Impact can occur during transport, inspection or maintenance, and can have serious consequences,” said Eric Smith, an Olympus endoscope support specialist. The air/water nozzle has a small opening that flushes water and air over the objective lens, and this can be deformed or slightly serrated by impact.
Most endoscope damage is preventable and occurs during transport. The distal end should be isolated from anything that might damage it; the scope connector and control body can act as a battering ram. “The distal end is the first thing I pick up and protect whenever I handle a scope, and the last thing I set down in placing the scope in a sink or cabinet,” Mr. Smith commented. There is no doubt that protecting the tip of your endoscope can help maintain your scope and reduce damage over a prolonged period.³ In one study, facilities using a distal tip protector reported a 50% reduction in bending rubber section replacements.4 Spongy distal tip protectors or boot sponges have been commonly used to protect scopes from compression damage. However, caution should be exercised so that placement of these shields does not occlude the scopes’ distal tip’s openings.5 The Association for the Advancement of Medical Instrumentation (AAMI) Guidelines6 stated that such scope protectors may create an environment favourable for microbial growth if the endoscope is not dry and cannot hang straight.7,8
Often, clean NOVEMBER 2020
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