Prevalence of Visible and Occult Blood on the Surfaces of Fiberoptic Bronchoscopes

摘要

Previous studies have demonstrated visible and/or occult blood on operating room equipment such as laryngoscope blades, blood pressure cuffs, anesthesia control knobs and pulse oximetry probes identified as ready for use. Anesthesia providers are in close contact with many or all of the equipment noted and have a responsibility to ensure proper cleaning is occurring to prevent transmission of blood-borne pathogens. This study was conducted to determine if current cleaning, disinfection and sterilization procedures used at one medical center was adequate to remove visible and occult blood from fiberoptic bronchoscopes. Data were collected on 27 bronchoscopes from a major medical center and each flexible shaft, distal tip and biopsy channel was tested. These samples were subjected to a visible inspection and a modified Phenolphthalein DISCHAP(Trademark) test to determine the presence or absence of occult blood. This test detects the presence of blood via an oxidation-reduction reaction. If hemoglobin is present, the hydrogen peroxide releases an oxygen to phenolphthalein resulting in a color change (bright pink). None of the fiberoptic bronchoscopes used for this study tested positive for visible or occult blood. Fiberoptic bronchoscopes must undergo high-level disinfection. This includes removing all organic debris before exposing the bronchoscope to chemical agents followed by either manual (gastroenterology clinic) or mechanical (operating room) disinfection with appropriate agents. It appears that these guidelines are adequate for removing blood from fiberoptic bronchoscopes and the medical center chosen adheres to these guidelines.