Â Endoscopes are intricate instruments that combine mechanical, illumination, optical and video elements…none of which react well to fluid. Because of these sensitive components, endoscope leak testing is a critical part of the proper scope cleaning and disinfection process, but often, it is done improperly or not at all.
FLUID DAMAGE is responsible for over half of total endoscope repair costs. Damage can result as soon as moisture invades the scope.Â The longer fluid remains undetected and unaddressed, the greater the damage to the instrument. When troubleshooting common flexible endoscope problems, fluid invasion requires immediate identification and repair by a trained technician.Signs of undetected fluid invasion include the following:Â
A common mistake is waiting until after disinfection or sterilization to perform leak testing. Leak testing out of step creates a much greater chance of fluid invasion during the disinfection process.
THE SGNA RECOMMENDS leak testing be done “before immersion of the scope in reprocessing solutions to minimize damage to parts of the endoscope not designed for fluid exposure.”Â The SGNA recommends, “Attach the leak tester and pressurize the scope before submerging it in water. Refer to specific manufacturer’s instructions to determine if it is necessary to remove detachable parts before leak testing. With the pressurized insertion tube completely submerged, flex the distal portion of the scope in all directions, observing for bubbles. Submerge the entire endoscope and observe the head of the scope, the insertion tube, distal bending section and the universal cord for bubbles coming from the interior of the scope.”Â If a leak is detected, remove the endoscope from the testing water to prevent further damage and remove from patient service until a qualified technician repairs it.
Proper leak testing is one of the most important reprocessing steps as there is risk for cross-infectionÂ if a leak is left unchecked.Â If a scope has a leak, fluid, biologic materials, and biofilm can collect in areas that cannot be adequately cleaned and disinfected, increasing the risk of having scopes that are colonized with bacteria and viruses used on the next patient.
Endoscopic technicians, endoscopy nurses, or staff in the facility’s central sterile or sterile reprocessing department all clean endoscopes. Each of these departments should have both the knowledge and equipment to LEAK TEST…LEAK TEST…LEAK TEST.