Cleaning Guide
30 Pages
Preview
Page 1
x
HANDS-ON MODULE 5 CLEANING FLOW-i V3.0
|1|
HANDS-ON MODULE 5 (continued)
Cleaning the FLOW-i
Before cleaning
1 BEFORE CLEANING – CLEANING PROCEDURES OVERVIEW
Cleaning procedure when a bacterial/viral filter IS used
Cleaning procedure when NO bacterial/viral filter is used
Dismantle
= D1 method
Dismantle
Wipe off/discard
= D2 method
Wipe off/discard
Assemble
= autoclave method
Rinse D1
System checkout
D2
Washer- or Disinfectant disinfector
Rinse
Dry
Steam autoclave
Dry
Assemble
System checkout
FLOW-i V3.0, HANDS-ON MODULE 5
3
| 1 ||
HANDS-ON MODULE 5 (continued)
Cleaning the FLOW-i
Before cleaning cont...
1.1 BEFORE CLEANING - GENERAL INFORMATION ABOUT HYGIENE Notes: If the CO2 absorber is bypassed then the absorbent’s cidal effect on microorganisms will not be activated MAQUET recommends that a bacterial/viral filter is always connected to the expiratory inlet of the patient cassette to minimize the risk of cross infection. The filter should always be replaced between patients. If a Servo duo guard (or performance equivalent) filter is connected, then it is usually unnecessary to disinfect or steam autoclave the patient cassette, volume reflector and associated parts. However, a complete cleaning procedure should still be performed at regular intervals according to hospital routines, or after treating a known carrier of pulmonary contagious agents. Water quality affects cleaning/disinfection. MAQUET recommends using deionized water for this purpose. The water quality must never be less than drinking water quality.
4
FLOW-i V3.0, HANDS-ON MODULE 5
|2|
HANDS-ON MODULE 5 (continued)
Cleaning the FLOW-i
Dismantling procedure
Note: Before dismantling, shut down the system and disconnect it from the power and gas supplies.
1.2 REMOVING EXTERNAL APPLIANCES 1.
Remove water trap (1) and gas sampling line (2).
2.
Remove and discard the filter from the expiratory connection (3).
Remove filter
3 2 Remove sampling line
Remove water trap
1
3.
Remove the suction bottle/single use bag and associated suction hose.
4.
Remove filter on the suction unit (4).
Note: After each patient the bacterial/viral filter on the suction unit should be checked for signs of moisture or fluid and replaced if necessary. Fluid in the filter will compromise the functionality of the filter and suction unit
Bacterial/viral filters Hazardous waste
4 Pull out and insert new (a “click” must be¨ heard)
FLOW-i V3.0, HANDS-ON MODULE 5
5
| 2 ||
HANDS-ON MODULE 5 (continued)
Cleaning the FLOW-i
Dismantling procedure cont...
5.
Remove patient tubing (5).
6.
Remove Y-piece (6).
7.
Remove manual breathing bag including tubing (7).
Patient tubing
5
Y-piece Manual breathing bag
6
7
8.
Release the CO2 absorber using the locking switch (8) and remove it (9).
Remove absorber
9
8
”Locked” to ”Unlocked”
6
FLOW-i V3.0, HANDS-ON MODULE 5
|2|
HANDS-ON MODULE 5 (continued)
Cleaning the FLOW-i
Dismantling procedure cont...
1.3 REMOVING AND DISASSEMBLING PATIENT CASSETTE: Remove the patient cassette from the FLOW-i as follows: 1.
Release the locking device (1).
Release locking switch
1
2.
Open the cover by: pressing the lid downwards (2)
Press lid downwards
2
pressing the button on the right (3) pulling out the release catch (4)
Press button
3
4 Pull out the release catch
FLOW-i V3.0, HANDS-ON MODULE 5
7
| 2 ||
HANDS-ON MODULE 5 (continued)
Cleaning the FLOW-i
Dismantling procedure cont...
3.
Remove patient cassette by lifting the cassette upwards and out using the grip located between inspiratory and expiratory connections (5).
5
REMOVING CAPS AND VALVE CAGES FROM PATIENT CASSETTE 1.
Remove caps (1) and valve cages (2) from inspiratory and expiratory valves.
1 2
2.
Remove caps (turn counterclockwise) Remove valve cages (turn counter-clockwise)
Reattach the caps (3).
Re-attach caps (turn clockwise)
3
8
FLOW-i V3.0, HANDS-ON MODULE 5
|2|
HANDS-ON MODULE 5 (continued)
Cleaning the FLOW-i
Dismantling procedure cont...
REMOVING ABSORBER VALVES FROM PATIENT CASSETTE 1.
Turn patient cassette upside down.
2.
Remove the 2 absorber valves - first 1 and then 2 (1) by turning them counter-clockwise, and attach them to a metal framework (2).
1 2 1 2 Metal framework
3.
Be careful not to damage the expiratory outlet one way valve that is located at the back of the patient cassette (3). Do not remove this valve.
3 4.
5.
Place the 2 dismantled valve cages and the 2 absorber valves inside a fine mesh box (4). The absorber valves are first placed onto a metal framework (5).
Valve cages with ceramic discs
Absorber valves
4
Rinse the ceramic discs as well.
5 Note: The box holds the parts when they are submerged into disinfectant or are placed in the washer-disinfector.
FLOW-i V3.0, HANDS-ON MODULE 5
9
| 2 ||
HANDS-ON MODULE 5 (continued)
Cleaning the FLOW-i
Dismantling procedure cont...
PATIENT CASSETTE´S FILTERS 6.
Newer systems are not equipped with the gas sampling filters array. Do not remove the protective covers replacing the array.
1.4 REMOVING VOLUME REFLECTOR 1.
Remove volume reflector adapter (1).
2.
Optional: remove safety valve (2) using Allen key and place on a stand (or something similar) (3) together with adapter
Volume reflector adapter
Safety valve (option)
1
2
Note: Cleaning the safety valve is usually not necessary unless special conditions apply; the patient is a carrier of pulmonary contagious agents etc.
Metal stand (or something similar)
10
3
FLOW-i V3.0, HANDS-ON MODULE 5
|2|
HANDS-ON MODULE 5 (continued)
Cleaning the FLOW-i
Dismantling procedure cont...
3.
Pull out the volume reflector.
FLOW-i V3.0, HANDS-ON MODULE 5
11
| 3 ||
HANDS-ON MODULE 5 (continued)
Cleaning the FLOW-i
Wiping off and discarding procedure
1.5 WIPING OFF 1.
Use a soft lint-free cloth (1) moistened in soap (pH <10) and water or a mild detergent-based disinfectant (2) to wipe off: Exterior surfaces
1 2
Patient cassette compartment Volume reflector compartment All removable parts 2.
Wipe any remaining soap and disinfectant away with a lint-free cloth moistened only in water.
3.
Check the fan filter (3) and rinse under water if necessary. Shake out all excess water from the filter.
Open the fan filter compartment
3
12
Checking the filter
FLOW-i V3.0, HANDS-ON MODULE 5
|4|
HANDS-ON MODULE 5 (continued)
Cleaning the FLOW-i
Rinsing before disinfection procedure
1.6 RINSING PATIENT CASSETTE 1.
Connect cleaning adapter to back of patient cassette (1).
Cleaning adapter
1
2.
Connect patient cassette to a source of running water using connective tubing (2).
3.
Allow water to flow through the cassette for at least one minute (flow >10l/min.)
4.
Connective tubing
2
Turn patient cassette upside down (3) and let water flow through it for at least one minute.
3
Patient cassette turned upside down (still attached to the tubing and adapter)
FLOW-i V3.0, HANDS-ON MODULE 5
13
| 4 ||
HANDS-ON MODULE 5 (continued)
Cleaning the FLOW-i
Rinsing before disinfection procedure cont...
5.
Attach connective tubing to the expiratory connection (4) and let the water flow through the cassette for at least one minute.
6.
Repeat procedure for inspiratory connection.
7.
Remove tubing and cleaning adapter.
8.
Carefully shake and tilt the cassette.
9.
Turn upside down and repeat.
4 Expiratory connection
1.7 RINSING VOLUME REFLECTOR 1.
Stand the volume reflector on its long side and attach connective tubing to one inlet (1), allowing water to flow through for at least one minute.
1
Note: Make sure no air pockets remain in the internal compartment. 2.
14
Rinse the volume reflector adaptor and safety valve (if removed) under running water for at least one minute.
FLOW-i V3.0, HANDS-ON MODULE 5
|5|
HANDS-ON MODULE 5 (continued)
Cleaning the FLOW-i
Disinfection with washer-disinfector procedure (D1)
1.8 DISINFECTION WITH WASHER-DISINFECTOR (D1) Notes: There are two disinfection procedures for the patient cassette, volume reflector and associated parts (known as D1 and D2). In D1 (recommended procedure), a washer-disinfector is used, (with A0 value 600), o o o o typically at a maximum temperature ranging from 90 C to 95 C (194 F to 203 F), a water pressure of <1,5 bar and a water flow of >10l/min. If detergents are used with the washer-disinfector, MAQUET recommends detergents with a pH <10: neodisher MediClean forte has been validated: In procedure D2 only a disinfectant is used. 1.
Connect special cleaning adapters to the patient cassette (1 and 2).
1
2 patient cassette (upside down)
FLOW-i V3.0, HANDS-ON MODULE 5
15
| 5 ||
HANDS-ON MODULE 5 (continued)
Cleaning the FLOW-i
Disinfection with washer-disinfector procedure (D1)
3.
Connect a washer-disinfector water outlet to the patient end of the volume reflector (upper inlet).
4.
Connect the special cleaning adapters to the washer-disinfector water outlet using connective tubings.
2.
Place the disassembled parts in the washer-disinfector as suggested in the illustration.
3.
To increase washing efficiency, plug remaining water inlets (3) to increase water flow through patient cassette and volume reflector.
metal stand (or similar) safety valve
volume reflector adapter mesh box
patient cassette adapters
3
plugs on remaining water inlets
volume reflector volume reflector adapter
Note: Be careful as any water remaining in the patient cassette and volume reflector after a completed washing program may be very hot.
16
FLOW-i V3.0, HANDS-ON MODULE 5
|6|
HANDS-ON MODULE 5 (continued)
Cleaning the FLOW-i
Disinfection with disinfectant procedure (D2)
1.9 DISINFECTION WITH DISINFECTANT (D2) 1.
Remove the inspiratory and expiratory valve lids and place them in a fine mesh box (1) together with the valve cages (2).
Valve cages with ceramic discs
Absorber valves
1 2
2.
Lower the parts into the disinfectant fluid and make sure they are completely submerged and no air pockets remain inside.
3.
Let the disinfectant act according to manufacturer’s instructions - Cidex OPA has been validated.
Rinsing after disinfection
1.10 RINSING AFTER DISINFECTION Notes: Ensure that the cleaning adapters used have been disinfected according to either the D1 or the D2 disinfection procedure. Use deionized water when rinsing after disinfection to avoid mineral scale build-up. Remove all traces of disinfectant by rinsing the parts thoroughly in water according to the instructions described under “Rinsing before disinfection procedure” Take care to rinse the inspiratory and expiratory valve screwthreads and lids thoroughly before attaching the lids back onto the patient cassette. Before proceeding to “Drying procedures” make sure as little water as possible remains in the patient cassette and volume reflector and also check for residuals on the equipment.
FLOW-i V3.0, HANDS-ON MODULE 5
17
| 7 ||
HANDS-ON MODULE 5 (continued)
Cleaning the FLOW-i
Steam autoclaving procedure
1.11 STEAM AUTOCLAVING PROCEDURE Notes: Before autoclaving the equipment must be rinsed and dried (see “Rinsing procedure” and “Drying procedure” for details). This is important as any water remaining in the patient cassette can prevent complete energy transfer from the hot steam which will result in an incomplete process. System parts should be autoclaved in a validated process. 1.
Position the parts inside the autoclaving unit as shown in the illustration. Mesh box Volume reflector Patient cassette adapter
Safety valve
Volume reflector
Notes: System parts are typically autoclaved at a temperature of 121°C (250°F) for 15 minutes or 134°C (275°F) for 4-7 minutes. The system parts can also be autoclaved at a temperature of 134°C (275°F) for 18 minutes, (i.e. using the Prion autoclave program) However, using this method will further reduce the lifetime of the parts. The manual breathing bag and suction bottles should be autoclaved according to the manufacturer's instructions. 18
FLOW-i V3.0, HANDS-ON MODULE 5
|8|
HANDS-ON MODULE 5 (continued)
Cleaning the FLOW-i
Drying procedures
1.12 DRYING PROCEDURES Note: The patient cassette, volume reflector and associated parts, must be dried before use. If the assembled system parts are not dry, the System checkout may fail. Drying may not be necessary, or the drying time may be reduced, if the washer-disinfector has a drying phase. Before employing the drying procedures described below, remove as much visible water as possible by shaking and tilting the parts. REMOVING WATER FROM THE VOLUME REFLECTOR 1.
Hold the volume reflector horizontally and tilt the device so that water flows from the two openings into the sink (1).
FLOW-i V3.0, HANDS-ON MODULE 5
1
19
| 8 ||
HANDS-ON MODULE 5 (continued)
Cleaning the FLOW-i
Drying procedures cont...
2.
Hold the volume reflector vertically, with the top (smooth) side facing you. Slowly rotate clockwise at least four times until the flow of water is minimal (2, 3 and 4).
2
Note: Take care as there may be residues of hot water in the volume reflector if the equipment has been cleaned using a washer-disinfector
3
4
3.
20
Visually check for residual water in the channels by holding the volume reflector in front of a light source.
FLOW-i V3.0, HANDS-ON MODULE 5
|8|
HANDS-ON MODULE 5 (continued)
Cleaning the FLOW-i
Drying procedures cont...
USING A DRYING CABINET 1.
Disconnect the cleaning adapters from the patient cassette (1 and 2).
2
1
patient cassette (upside down)
2.
Place the patient cassette, volume reflector and associated parts in a drying cabinet (see illustration).
3.
Connect a 22 mm air hose (1) to the expiratory outlet of the patient cassette (2) for extra drying capacity.
22 mm air hoses
1 2
FLOW-i V3.0, HANDS-ON MODULE 5
21