討論區

請問資深的前輩學姊們,急需要正確的每季內視鏡(大腸鏡.胃鏡)完整採檢流程,最近被此問題搞的很煩惱`~拜託盡快回覆我此問題~~謝謝各位前輩學姊們!

目前流程:從CIDEX液體取出後使用2至3瓶蒸餾水1000c.c沖洗後使用10C.C生理食鹽水從內視鏡管壁流出後用無菌容器接.

http://www.health.qld.gov.au/EndoscopeReprocessing/module_6/6_4.asp

以上提供美國官方指引

MICROBIOLOGICAL TESTING PROTOCOLS

Instruments should be sampled after usual processing and following storage of at least 12 hours to allow detection of micro-organisms arising from a biofilm. Endoscopes that have undergone sterilisation and been stored in a wrapped state should be removed from the packaging and tested at the interval indicated above.

首先做採檢前,SCOPE要正常流程清洗完並放置平時放置的地方存放12小時以上才採檢

Method of Sampling - Endoscopes

1. 10 mL of sterile water or normal saline is withdrawn from a freshly opened container using a sterile cannula/needle and syringe and put into a sterile specimen container.

採檢的方式與您所述,無菌蒸餾水也可以.

INTERPRETATION OF CULTURES

Each endoscopy unit in conjunction with a Clinical Microbiologist must set its own threshold for the initiation of action if cultures are positive. The following flowcharts reprinted from the New Zealand Standard SNZ HB 8149:2001 will guide decision making.

根據the New Zealand Standard SNZ HB 8149:2001 指引,培養陽性時如何處理

1.Bronchscope

http://www.health.qld.gov.au/EndoscopeReprocessing/documents/pos_bronch_culture.pdf

2.duodenoscpe

http://www.health.qld.gov.au/EndoscopeReprocessing/documents/pos_duod_culture.pdf

3.gastrioscope and colon scope 

http://www.health.qld.gov.au/EndoscopeReprocessing/documents/pos_colon_culture.pdf

Endoscope Type Frequency
Bronchoscopes............. 4 weeks
Duodenoscopes.............. 4 weeks
Gastroscopes ................3 months
Colonoscopies ..................3 months
Other flexible gastrointestinal ................3 months