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. 2020 May;21(5):416-422.
doi: 10.1631/jzus.B2000109. Epub 2020 May 9.

Analysis of an Improved Workflow of Endoscope Reprocessing for Bedside Endoscopic Diagnosis and Treatment on COVID-19 Patients

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Free PMC article

Analysis of an Improved Workflow of Endoscope Reprocessing for Bedside Endoscopic Diagnosis and Treatment on COVID-19 Patients

Qing Gu et al. J Zhejiang Univ Sci B. .
Free PMC article

Abstract

Severe cases infected with the coronavirus disease 2019 (COVID-19), named by the World Health Organization (WHO) on Feb. 11, 2020, tend to present a hypercatabolic state because of severe systemic consumption, and are susceptible to stress ulcers and even life-threatening gastrointestinal bleeding. Endoscopic diagnosis and treatment constitute an irreplaceable part in the handling of severe COVID-19 cases. Endoscopes, as reusable precision instruments with complicated structures, require more techniques than other medical devices in cleaning, disinfection, sterilization, and other reprocessing procedures. From 2016 to 2019, health care-acquired infection caused by improper endoscope reprocessing has always been among the top 5 on the list of top 10 health technology hazards issued by the Emergency Care Research Institute. Considering the highly infective nature of COVID-19 and the potential aerosol contamination therefrom, it is of pivotal significance to ensure that endoscopes are strictly reprocessed between uses. In accordance with the national standard "Regulation for Cleaning and Disinfection Technique of Flexible Endoscope (WS507-2016)," we improved the workflow of endoscope reprocessing including the selection of chemicals in an effort to ensure quality control throughout the clinical management towards COVID-19 patients. Based on the experience we attained from the 12 severe COVID-19 cases in our hospital who underwent endoscopy 23 times in total, the article provides an improved version of endoscopic reprocessing guidelines for bedside endoscopic diagnosis and treatment on COVID-19 patients for reference.

目的: 在疫情期间, 需要通过保证内镜处理质量, 避免 过程环节操作中的接触污染, 防止气溶胶的散 发, 从而保护从业人员, 杜绝院内感染。

创新点: 内镜诊疗对改善重症患者预后及降低患者死亡率 有重要作用。该研究依据实际临床工作特质, 对 内镜再处理过程中的部分方法及化学清洗消毒 剂的选择进行了改良与替换。

方法: 从12 例重症患者行23 次内镜诊治后的内镜处理 操作中提取经验, 结合相关指南规范, 提出了新 型冠状病毒肺炎患者床边内镜诊疗后内镜再处 理改良流程。

结论: 内镜诊疗在重症及危重症患者治疗中不可或缺。 临床工作中床旁预处理操作及专线转运流程对 于预防院内感染具有重要意义。替换后的化学清 洗消毒剂(0.23%过氧乙酸)对新冠病毒可达到 高水平消毒。改良后的床边内镜诊疗后内镜再处 理操作流程顺畅, 感染控制严谨, 值得临床进一步推广。

Keywords: Novel coronavirus; Coronavirus disease 2019 (COVID-19); 2019 novel coronavirus (2019-nCoV); Disinfection; Gastrointestinal endoscopy; Infection prevention and control.

Conflict of interest statement

Qing GU, Hua-fen WANG, Ying FANG, Ye LU, Zhe SHEN, Yan WANG, Xin WU, Li CEN, and Yi-shu CHEN declare that they have no conflict of interest.

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