corrosion, pitting and breakage. You may find that depending on the type
of soil, a detergent that is a little more or less acid or alkaline may be more
appropriate. The ideal cleaning agent is nonabrasive, low-foaming and free-
rinsing. Using a small clean hand-held brush, remove soil from all surfaces
of the instrument while fully immersed in the solution. During manual
cleaning, never use steel wool, wire brushes, scalpel blades or highly
abrasive detergent or cleansers to remove soil from surgical instruments.
These will damage the instruments' protective surface and lead to corrosion.
Use a clean soft bristled brush to clean instruments with an accessible
channel. Remove the soil from the ratchets, jaws, tips, box locks, and/or
hinge mechanism. The box lock and hinge portion of an instrument must
be thoroughly cleaned after each use. A build-up of soil, debris, lubricants,
etc. in these areas, will make it difficult to use the instrument and eventually
irreparably damage it. Vigorously flush channels with the cleaning solution.
Deionized water is recommended and preferred because it is free of the
many compounds which exist in ordinary tap water. These substances
alone, cause stains and when tap water is combined with some detergents
it will form insoluble deposits on the instruments. Manual cleaning should
remove all visible residue. It is essential to keep the box locks and hinges
open during any manual or automated cleaning process.
Step 5. Rinse: Thoroughly rinse instruments by immersing in tap water and
wiping with a clean, soft cloth. Flush lumens until water runs clear.
Step 6. Ultrasonic Cleaning and Rinsing: Follow the recommendations
of the ultrasonic manufacturer regarding cycle times, detergents, proper
placement of the instrument tray, and conditioning ("degassing") of the
cleaning solution, etc. Use an ultrasonic cleaner to remove soil from hard
to reach surfaces such as grooves, crevices, lumens, instruments with
moving parts, etc., after gross soil has been removed. Open or disassemble
instruments as appropriate. Place instruments in a mesh bottom stainless
steel instrument tray. Place the tray into the ultrasonic cleaner. Flush air
out of lumens and fill them with the ultrasonic cleaning solution (under the
solution level in the chamber) for effective removal of soil from that inner
surface by the ultrasonic activity.
Step 7. Final Rinse: should be with "treated water". Softened or deionized
water should be used for the final rinse to better remove the detergents etc.
Softening water removed calcium and magnesium ions that cause water
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