The important of

Preparation in
Endoscopic Accessories
Speaker : Ms Norizaitolakmam
Endoscopy Nurse Manager
Gleneagles Kuala lumpur

The important of Preparation in Endoscopic

Accessories
Endoscopic accessories are tool for examiner to
use in diagnose and treatment of GI disease.

Practice standard base on Spaulding `s Classification

system
Classification
Critical Devices

Definition

Level of reprocessing

Devices that penetrate

tissues

Cleaning followed by sterilization

Semi-critical
devices

Devices that in contact with

mucosal membranes but do
not penetrate

Cleaning followed by HLD.

Sterilization preferred

Non-critical
devices

Devices that touches only

skin intact

Cleaning followed by Low Level

Disinfectant.

What is ERCP

Endoscopic Retrograde Cholangiopancreatography

Description
It is an endoscopic procedure for radiologic
visualization of the biliary and/or pancreatic duct.

ERCP is one of the most technically demanding

and high-risk procedures performed by
gastrointestinal endoscopist.
Indication:
Choledocholithiasis (gallstone in the common
bile duct)
Jaundice of undetermined etiology
Pancreatic duct obstruction.
Pancreatitis

Indication - Continued
Cholelithiasis
Cholangitis
Cholecystitis
Primary Sclerosing
Cholangitis (PSC)

Intraductal PapillaryMucinous Tumours

Cholangiocarcinoma
Extrahepatic Bile
Duct Cancer

Gallbladder Cancer
Ampullary Cancer
Pancreatic Cancer

Potential Complications
Some potential complications associated with:
Diagnostic ERCP may include:

Pancreatitis
Infection / Cholangitis
Hemorrhage
Perforation
Sepsis due to a a partial
obstruction to CBD

Stone retrieval may include:

Pancreatitis
Infection
Bleeding
Trauma to the biliary tract
or duodenum

Perforation of the
duodenum

Basket entrapment
Stone impaction

Equipment used:
e.g. Sphincterotomes, balloons
Guidewires, basket, stents and stent pusher
Other specific accessories per physician
preference.

A single use accessories are used to prevent risk

Usage of endoscopic accessories between a

single use accessories and reusable accessories
have their advantages and disadvantages.

Advantages

Disadvantages

Cross contamination

risk of cross contamination

HLD
Inadequate cleaning

expose to HLD
Inadequate cleaning

disinfectant & sterilization

risk of failure to follow

procedures
Staff safety

CONCLUSION
Reuse of devices may increase:

Risk of infection.
Performance of the device unaccepted.
Unable to identify maximum usage of device
Types of wear and cracking
Unable to identify patient of whom reusable medical device
used.

Need a proactive data collection related to reuse device to

identify risks and improve processes.

THANK

YOU