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Reprocessing of Flexidock Camera Probes - Disinfection policy guide
Grampians Region Infection Control Group
December 2008
Issues:
The devices have the potential to be used as both non critical and semi critical devices.
The level of disinfection required will differ depending on how the probe is used.
The manufacturer’s instructions recommend:
The manufacturer’s guidelines recommend procedures for processing semi critical items that are
not consistent with either the AS/NZS 4187- 2003 Cleaning, disinfection and sterilising reusable
medical and surgical instruments and equipment, and maintenance of associated environments
in health care facilities Section 10.2.2 (1) or the CDNA Infection Control Guidelines 2004 Section
17.4. (2). The manufacturer recommends the use of alcohol, aldehydes or QUATS (quaternary
ammonium compounds) – of this list only aldehydes are considered adequate for high level
disinfection.
The manufacturer’s guidelines also recommend the use of sheaths to 'protect the hygiene of the
patient" - this is contrary to AS/NZS: 4187, section 12.5 which states, “Sheathes/sleeves for
instruments and equipment shall not be used as a substitute for cleaning, disinfection or
sterilization procedures”. Section 17.2.2 of the CDNA Infection control guidelines 2004 also
comment on the use of sheathes/sleeves.
Infection control guidelines1,2 recommend that devices in contact with intact nonsterile mucosa
or non intact skin (semi critical items) be reprocessed using a high-level instrument grade
disinfectant. For a chemical to be used as a high-level disinfectant or a sterilant it must be
registered as such with the Therapeutics Goods Association (TGA).
Recommendations:
1. The intended use of each probe/attachment must be documented and a risk assessment
completed to identify if the attachment will be categorised as non critical and semi
critical.
2. Smaller agencies that do not have access to high level disinfection must limit the use of
these devices to non critical sites/procedures only.
3. All probes deemed to be in contact with intact skin only (non critical) can be processed
using detergent and water then wiped over with alcohol.
4. All probes, where there is risk of contact with intact nonsterile mucous membrane or non
intact skin, must be processed using high level disinfection.
The high level disinfection method confirmed by the manufacturer as compatible with
probes is:
Ortho-Phthalaldehyde (OPA)
(The devices have not been tested for compatibility with Steris or Sterrad and
cannot be placed into a steam steriliser.)
The removable light diffusing tip on the dermatology probe cannot tolerate heat
so cannot be processed in a thermal disinfector, but will tolerate soaking in OPA.
5. Unless high level disinfection can be achieved the devices must not be used on semi
critical sites.
6. Where probes are classified as non critical, contingencies must be in place to ensure high
level disinfection is achieved in the event that one of the probes is accidentally used on
non intact skin or mucous membrane – probe could be sent off-site to be processed
appropriately.
7. Sheaths MUST NOT be used as an alternative to thorough cleaning and appropriate level
of disinfection.
Australian Government Department of Health and Aging [DoHA: 2004]: Communicable Diseases Network Australia
[DoHA: 2004] Infection Control Guidelines for the prevention of transmission of infectious diseases in the health care
setting (also available at www.icg.health.gov.au).
1
AS/NZS 4187:2003 “Cleaning, disinfecting and sterilizating of reusable medical and surgical equipment, and the
maintenance of associated environments in health care facilities”.
2
CLEANING AND DISINFECTION GUIDELINES:
Camera control unit and docking station:
After every use, wipe over exterior surfaces with a damp cloth moistened with detergent and
water, clean thoroughly. Dry surface then disinfect using alcohol impregnated wipes.
Hand piece:
After every use, wipe over handpiece and hose with detergent and water, cleaning thoroughly.
Dry surface then disinfect using alcohol impregnated wipes.
Camera probes:
Camera probes – NON CRITICAL SITES only (not used on non intact skin or mucous
membrane):
After every use, disassemble probe and clean thoroughly using detergent and water. Dry and
then disinfect all surfaces using alcohol impregnated wipes.
Specific information for sites using probes for non critical sites only –
Dermatology probe: - must only be used for surface magnification where probe comes into
contact with intact skin only, not to be used for non intact skin, open lesions, deep cavities or
wounds.
Mouth/face probe: - for external use only or very superficial viewing of mouth and nose. Not
to be used where there is a risk of contact with the mucous membrane of mouth and nose.
Otoscope probe: - disposable, single use speculae must be used for every patient. After
removal of disposable speculae, the probe must be washed and disinfected using alcohol wipes.
Ophthalmoscope probe: - must not touch surface of eye, must be washed and disinfected
after every use.
Camera probes – SEMI CRITICAL SITES (used on non intact skin or mucous
membrane) must be disinfected using a high level disinfectant:
(THOSE AGENCIES THAT HAVE THE ABILITY TO PROCESS PROBES USING HIGH LEVEL
DISINFECTION AND WHO CHOOSE TO APPLY THE PROBES FOR MORE COMPLEX, INVASIVE
DIAGNOSIS) e.g. non intact skin/lesions, deep wounds, cleft palates, tonsils and intra oral
lesions etc.
After every use, disassemble probe and clean thoroughly using detergent and water. Soak probe
in high level disinfectant (OPA) for required time then dry and store.
Note: The removable light diffusing tip on the dermatology probe cannot tolerate heat so
cannot be processed in a thermal disinfector; it will tolerate soaking in OPA as above.