ENDOSCOPIC ACCESSORY INSTRUMENTS (EAIs) are intricate medical
devices used to diagnose and treat disease. Most EAIs come into
direct contact with sterile areas of the body and care must be
taken to ensure that only patient-ready devices are used for each
examination. Coiled metal sheaths, pivoting joints, and internal
lumens of heat-stable EAIs make visual inspection for cleanliness
nearly impossible, and a heat-based process is necessary for sterilization.
Now available to direct the reprocessing of heat-stable EAIs,
Standard Practice F 1992 for Reprocessing of Reusable, Heat-Stable
Endoscopic Accessory Instruments (EAI) Used with Flexible Endoscopes
has been developed by medical specialists in the GI Endoscopes
Subcommittee in Committee F04 on Medical and Surgical Materials
Those who use the standard will have a concise reference that
outlines a step-by-step procedure for the appropriate reprocessing
of heat-stable EAIs, says subchair David Greenwald, M.D., assistant
professor of medicine, Gastroenterology Division, Albert Einstein
College of Medicine, Montefiore Medical Center, Bronx, N.Y.
The standard practice details procedures for cleaning, sterilization,
storage, and functionality testing of reusable heat-stable EAIs
designed to be inserted into flexible endoscopes.
Greenwald comments on several benefits to users of F 1992: While
in the past, manufacturers of EAIs have provided reprocessing
instructions for their devices and certain professional organizations
have produced guidelines that address EAI reprocessing, this document
represents a current standardization of the most important issues.
The subcommittee believes the presence of a standard will provide
significant clarification amongst users of the devices as to how
to properly care for such instrumentation. This standard clearly
will be important in promoting effective practices in the reprocessing
of endoscopic accessory instruments labeled for reuse.
As each brand, type, and model of heat-stable EAI has a unique
design and components, F 1992 is particularly helpful. It carefully
presents sections on terminology, reagents, procedure, and rationale,
although it is not intended to replace manufacturers instructions.
An appendix lists descriptions and types of 23 models of reusable,
heat-stable EAIs for use with flexible fiberoptic and video gastrointestinal
EAIs covered in F 1992 may or may not have lumens or loosely-joined
surfaces, may or may not have access ports for flushing, and may
or may not be capable of being completely disassembled prior to
reprocessing. The standard practice is not intended to be applied
to the reprocessing of single-use, disposable endoscopic accessory
devices specifically designed and labeled as such by their manufacturers,
notes Greenwald. It is also not intended to address the reprocessing
of heat-sensitive EAIs.
ASTM standards are available through Customer Service (610/832-9585), or through the Web site.
Questions or comments may be directed to David Greenwald, M.D., Gastroenterology Div., Albert Einstein College of Medicine,
Montefiore Medical Center, 111 E. 210 St., Bronx, NY 10467 (718/920-4846).
Committee F04 meets during ASTM Committee Week, May 24-26, Toronto,
Ontario, Canada. For meeting or membership information, contact
F04 Staff Manager Teresa Cendrowska, ASTM (610/832-9718). //