The endoscopic camera system is under good cold light source illumination, through the laparoscopic body connected to the abdominal cavity, the organs in the abdominal cavity are photographed on the monitor screen, and the surgeon monitors and guides the abdominal cavity under the high-tech display screen. Operate surgical instruments outside to perform operations such as exploration, electrocoagulation, hemostasis, tissue separation and incision, and suturing of diseased tissues. So after the operation, how should it be removed and cleaned? This article shares the removal and cleaning of laparoscopic instruments.
First of all preparations:
1. Nurse preparation: clean and wash hands, dress code 2. Environment preparation: bright, clean and spacious
3. Preparation of materials: No. 3, No. 4, No. 6 lumen cleaning brush, soft brush, toothbrush, electric knife cleaning sheet, small gauze, generous yarn, measuring cup, special multi-enzyme solution, lubricating oil, cleaning basket, Cleaning tank, high-pressure water gun, high-pressure air gun, special dryer.
4. Place the cleaning instruments in place.
Implementation steps:
(1) Inventory and inspection: Inventory the types and quantities of the equipment according to the recovery form, and check whether the function is intact (check that the equipment components are complete and not damaged, the structure is complete, the front end of the joint is well closed; whether the inner core is bent; the sleeve and the sealing ring are complete No deformation).
(2) Disassembly: Disassemble the detachable instrument to the smallest part, put it into the instrument tray with a hole, and soak in water.
(3) Cleaning: The whole process of removing dirt on medical equipment, appliances and articles, the process includes washing, washing, rinsing and final rinsing.
Rinse: After disassembly, the instruments are rinsed or brushed with running water to remove visible dirt, and the complete sets of instruments are kept in the same instrument box during the cleaning process.
Washing: A. Manual: Brushing, scrubbing, and high-pressure water gun flushing of instruments and accessories in enzyme solution, focusing on cleaning the inner wall of the lumen, gaps, joints, and alveolar. B. Ultrasound: The instruments and accessories are cleaned by ultrasound + enzyme for 5-8 minutes, and those that cannot be cleaned by ultrasound are manually brushed.
Rinse: The process of rinsing the equipment, utensils and articles left after washing with running water.
Final rinsing: Use purified water to perform the final treatment process on the equipment, utensils and articles after rinsing.
Maintenance of laparoscopic instruments
1. Laparoscopic instruments are precise and fine. Place them separately during cleaning. After scrubbing with a soft brush, blow them dry with a hair dryer. The shaft sections of the instruments are immersed in lubricant, arranged neatly and placed in a box. The lumen instruments were blow-dried with an air gun and then oiled. The tip of the thin instrument is protected by a silicone tube, which is tight enough. Rusty instruments are treated with a special rust remover, then routinely cleaned, and then boiled, lubricated, and dried. This plays a role in maintaining the equipment and prolonging its service life.
2. Endoscopic instruments must be stored at designated locations. Endoscope instruments are relatively delicate and cannot be placed at the same time as ordinary instruments. Special storage cabinets are required. Endoscopes must be placed in the original box. Insufflation needles and some detachable parts must be placed in a small box to avoid breaking and Lost; the wire should not be discounted to prevent damage when stored after cleaning.
3. Unified management With the continuous expansion of the application scope of laparoscopy, in order to improve the efficiency of laparoscopy clinical application, personnel with strong sense of responsibility, good professional ethics, and knowledge of disinfection and hospital infections should be arranged for unified management, and records of the abdominal cavity should be established. Special register for the use of laparoscopic equipment to ensure the safe use of laparoscopy.
4. Strengthen the detection of disinfection effect It is very important to monitor the disinfection effect of sterilized instruments. Due to the long and narrow tube diameter of laparoscopic instruments and the tightness of the joints, there will be incomplete liquid penetration in individual areas during immersion and disinfection. The hospital infection department should regularly check the disinfection effect of laparoscopic instruments, and deal with any problems in time. To ensure effective disinfection and sterilization of laparoscopic instruments.
Precautions
1. The equipment should be disassembled to the smallest unit. Keep the disassembled parts carefully to prevent loss.
2. For objects that cannot be disassembled, the cleaning of pipes, gaps, joints and tooth patterns must be strengthened.
3. Protect the functional end during cleaning.
4. Scrubbing instruments must be scrubbed under the surface of flowing water.
5. When the lumen instruments are immersed in the multi-enzyme cleaning solution, the lumen must be filled with the cleaning solution.
6. Do not use steel wire balls to clean equipment and articles.