Cidex

Can anyone tell me what you are using to soak your cystoscope. We are using cidex opa, but we got notice that it can't be used with pts that have a hx of bladder cancer. Checked out cidex plus, but was told by our scope manufacturer that it leaves a conductive residue on the scope and the lens that could cause damage to the scope and or pt if a bugee or laser was used. At a loss on what to use.

Man, I have not seen Cidex used in YEARS! Don't you have a Steris?

stevierae, unfortunately we still use Cidex where I work. We don't have anywhere to put a Steris and my director isn't really interested in buying one. We have been using it for years to soak mostly our scopes and some laryngoscope blades. We have been replacing our scopes with autoclavable ones but still have a few that need to be soaked. I am hoping one of these days the hospital will be forced into buying a Steris unit by some outside agency. We have a company that deals with biohazard materials to dispose of the used Cidex. Complicated but necessary for now. Mike

stevierae, unfortunately we still use Cidex where I work. We don't have anywhere to put a Steris and my director isn't really interested in buying one. We have been using it for years to soak mostly our scopes and some laryngoscope blades. We have been replacing our scopes with autoclavable ones but still have a few that need to be soaked. I am hoping one of these days the hospital will be forced into buying a Steris unit by some outside agency. We have a company that deals with biohazard materials to dispose of the used Cidex. Complicated but necessary for now. Mike

Yeah, you really get spoiled once you go to a place that has a Steris and/or those cool washing/disinfecting/sanitizing machines that you coil up your flexible endoscopes (gastroscopes, colonoscopes, etc.) in, push a button or two, and voila! Ready for the next use in half an hour or so.

I worked (travel assignment) at a little rural 4 room OR that did their endo procedures IN the OR (not an endoscopy ab) and they had one of those cool endoscope washers. They had some of the best equipment I have ever seen to date, come to think of it.

We use Cidex for our cystoscopes/GU scopes. We put them in for a 20 min cycle and rinse with sterile water for about 10 min before use. I don't know what kind of different Steris machines there are out there, but the only one we have has one cycle which takes 30 min to complete. We use the Steris to turn over our laparascopes. Can someone tell me why Steris is a big no-no? Even if JCHAO came by and recommended we get rid of our Cidex, I can so imagine my boss making every excuse as to why we can't make the change...

I posted to this thread, then I think I hit the wrong button, so sorry if there ends up being two replies here. Sometimes I'm more computer savy than others. :chuckle

ANYWAY........

Cidex probably has it's place, otherwise they would have gone out of business, I guess. But I'm with Shodobe and Stevie, CIDEX?????YIKES!!

Steris is the way to go. We quit using Cidex years and years ago, and got our Steris.

There is a couple of things about the Steris. Not EVERYTHING goes in it.

The solution must come in contact with all parts of the instrument. Frankly Steris over and over is tough on rubber gaskets like in a lens or camera.

Once in a while is fine, but over and over, we found that they start breaking down and leak.

We use a Sterad (sp?) for our laparoscope stuff, cameras and lens, etc. We got rid of our old ETO gasser a few years ago, I think. ETO is extremely nasty stuff, and they're being phase out I believe.

Frankly we don't use our Steris as much as we did. We have enough duplication and back up, and the Sterad is fast enough. We still use the Steris for cystoscopes, cameras, different lens and flex. scopes of all types.

Another tip, check with the instrument company or Steris to see if what you want to stick in there is ok. Steris tests everything, and then puts out a paper instructing you how to do it properly.

Trying to get the "bean counters" to buy a Steris. Good luck, but remember, compairing Steris/Sterad to Cidex/Eto, the former is much safer for the staff and pt's, it's easier to use than Cidex, I'm willing to bet more effective too.

In this day and age....easier on the hospital's lawyers too!? :chuckle

Mike

p.s. Shodobe....I've got a new puppy, his pix in in the gallery. mike

The only things we use Cidex for is our cystoscopes. We do very little urology anymore so the equipment gets soaked probably once every few months, not alot to get worried about. All of our cameras are autoclavable and only one scope is not. So we just either Sterad everything and flash when needed. Mike

Sterrad for regular processing, Steris for flashing.

I must confess I am not familiar with a Sterad. Is it a washer sanitizer, with racks, like a dishwasher? Is it something that would normally be kept in Central Sterile Processing (that is, the part of CSR where they wash, decontaminate and sterilize instruments?) Is it for sterilization of items that we used to gas sterilize with ETO? Or is it a unit that is kept in the OR, as a Steris is?

I googled it and couldn't find a picture. All I saw was that the items need to be bone dry before processing. That's what I was taught about Cidex, too, (lest you dilute the Cidex, and cut down on the efficiency of the disinfecting power) but so many people used to just wash their scopes, rince them, and throw them in without drying them it was like I was the only one who had been taught that way, so I was beginning to wonder if I had been taught wrong.

Makes sense, though, that dilution would certainly decrease the disinfectant properties, so I continued to dry anything I immersed in Cidex, regardless of what everyone else did. I am glad it's slowly falling out fo favor. Cidex spills are nasty, and hazardous to one's health.

The question that we asked management about Cidex was how can we justify using a sterile scope on the first patient of the day and only a clean one on all of the others. I think that the crowning blow to cidex was when we had 3 bronch cultures come back with the same unusual bacteria. (To our good luck, it was a non pathogen). The scope had been soaked in cidex between patients according to protocols.

Every patient deserves sterile (or terminally sterilized) instrumentation.

I must confess I am not familiar with a Sterad. Is it a washer sanitizer, with racks, like a dishwasher? Is it something that would normally be kept in Central Sterile Processing (that is, the part of CSR where they wash, decontaminate and sterilize instruments?) Is it for sterilization of items that we used to gas sterilize with ETO? Or is it a unit that is kept in the OR, as a Steris is?

Stevie: Right, a Sterrad (still not sure of spelling) in our hospital replaced our Eto gas sterilizer. It's MUCH safer, and faster than the Eto. No more airing instruments out after gassing, staff does not need to leave when you open the door, etc. The Sterrad is in sterile processing just like the other units. Everything is washed, decontam., etc the wrapped and run. You are right however, that the stuff needs to be bone dry before going in. As I said in our hospital we have enough duplication in most things that we are ok. We will do a laparoscopy, while doing #2, the #1 scope is going thru the Sterrad, and by the time we are ready for pt #3, scope #1 is done and ready to go. The run time is about an hour. Our Steris is in our center hall, and treated more like a flash-er. Run time around 30 min plus or minus.

Lindaloo.....Exactly the argument we used with our administration. How can you use a sterile scope on the first pt, and a clean one on the rest. Try offering your CEO a scope "on the house"......oh by the way.....you're the last case of the day.

I was just reading where a hospital, I think, in Pittsburgh was testing dozens of pts for HIV due to improper scope processing.

With the smaller, more flexible scopes we are using now-a-days, we can't be too careful!!!!!

Mike

A link for Sterrad:

http://www.sterrad.com/products_&_services/sterrad/index.asp

There's 3 links at the bottom of that page that has descriptions for different machines.