ed had a wire loop at the distal end that was very close in size to the
diameter of the elevator channel on our pediatric duodenoscope, and
we were concerned about causing damage by trying to force the
brush into the channel.
We were forced to choose between the manufacturer-recommended
brush or continuing to use cytology brushes because they come ster-
ile and are smaller in diameter. We chose the latter. It was the best
option we had.
While deciding between the brush options, we made another discov-
ery. A new proceduralist wanted to use endoscopic ultrasound
scopes, but the elevator mechanism in some models was similarly
designed to that in our duodenoscopes, making them more challeng-
ing to clean. We therefore applied our duodenoscope culturing
process to the endoscopic ultrasound scope. That was a proactive
step on our part.
We've never had any trouble with infections from duodenoscopes —
most likely because we're constantly refining our cleaning processes
based on the latest data and guidelines, as well as our own experi-
ences.
OSM
Ms. Underberg (karin.underberg@childrenscolorado.org) was clinical educa-
tor for the ORs at Children's Hospital Colorado in Aurora, Colo., during imple-
mentation of its scope cleaning protocols.
J U L Y 2 0 2 0 • O U T P A T I E N T S U R G E R Y . N E T • 2 5
