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Infacol and endoscopy

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  • #73523
    Jennifer McCarthy
    Participant

    Author:
    Jennifer McCarthy

    Position:
    Infection Control Coordinator

    Organisation:
    Maryvale Private Hospital

    State:

    Dear members
    At the recent ACIPC conference in Melbourne there was some discussion
    about using “infacol” during endoscopy and the risk of developing
    biofilm in the channels.
    Does anyone have any literature regarding this so I can show one of my
    general surgeons – who doesn’t seem to think this is an issue!
    Thanks
    Jenny

    Kind regards,
    Jenny McCarthy
    Operating Room Manger/Infection Prevention and Control Coordinator
    Maryvale Private Hospital
    PO Box 348, Morwell, 3840
    286 Maryvale Rd. Morwell, 3840
    T +61 3 5132 1283 | F +61 3 5132 1281
    E jenny@maryvaleph.com.au
    Maryvale Private Hospital Confidentiality and Privacy Notice

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    P Please consider the environment before printing this email

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    #73524
    Joanna Harris
    Participant

    Author:
    Joanna Harris

    Position:

    Organisation:

    State:

    As I was unfortunately unable to be at the conference I’d be interested to know what the issue with this is, and whether infection prevention and control concerns have been identified as theoretical or real issues.

    Just this afternoon I have been asked to advise about the use of infacol by endoscopists. Apparently the intention is to reduce the development of mucus ‘bubbles’ that could obscure the field of vision.
    Our endoscopy unit staff are concerned about a build-up of residue and possible biofilm in the CO2/water channels and on the tubing leading from the CO2 bottles to the ‘scope. They are also finding that insufflation seems to have been affected recently and think it might be due to a greasy coating affecting valves and seals etc.

    Although there are clearly a few non-IPC issues here, I am hoping to be able to answer infection control-related concerns.

    Has anybody had any experience of the use of infacol in CO2 and/or water channels confirmed as leading to the transmission of pathogens, or ineffective reprocessing?
    Thanks in anticipation 🙂

    Jo Harris

    Nurse Manager, Illawarra Shoalhaven Local Health District Infection Management and Control Service (IMACS)

    Telephone – mobile 0475 943494 / Wollongong office 02 4222 5898 / Warrawong office 02 4221 6820
    Joanna.Harris@health.nsw.gov.au
    http://www.health.nsw.gov.au

    [http://www.health.nsw.gov.au/images/communications/e-signatures/images/NSW-Health-Master.jpg]

    Dear members
    At the recent ACIPC conference in Melbourne there was some discussion about using “infacol” during endoscopy and the risk of developing biofilm in the channels.

    Does anyone have any literature regarding this so I can show one of my general surgeons – who doesn’t seem to think this is an issue!

    Thanks
    Jenny

    Kind regards,
    Jenny McCarthy
    Operating Room Manger/Infection Prevention and Control Coordinator
    Maryvale Private Hospital
    PO Box 348, Morwell, 3840
    286 Maryvale Rd. Morwell, 3840
    T +61 3 5132 1283 | F +61 3 5132 1281
    E jenny@maryvaleph.com.au

    Maryvale Private Hospital Confidentiality and Privacy Notice

    NOTICE – This e-mail is only intended to be read by the named recipient. It may contain information which is confidential or proprietary. If you are not the intended recipient please notify the sender immediately and delete this e-mail. If you are not the intended recipient you should not copy this e-mail or use the information contained in it for any purpose nor disclose its contents to any other person. Maryvale Private Hospital Pty Ltd accepts no responsibility for electronic viruses or damage caused as a result of this email or for changes made to this email or to any attachments after transmission from Maryvale Private Hospital. You should not distribute or publish the contents of this email or any attachment without the prior consent of Maryvale Private Hospital.
    * Please consider the environment before printing this email
    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

    The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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    Views expressed in this message are those of the individual sender, and are not necessarily the views of NSW Health or any of its entities.

    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

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    #73525
    Anonymous
    Inactive

    Author:
    Anonymous

    Position:

    Organisation:

    State:

    Hi Jo,

    The simethicone issue was raised due to an article published in AJIC –
    Ofstead et al. (2016) “Simethicone residue remains inside gastrointestinal
    endoscopes despite reprocessing.” AJIC (44) 1237-40.

    http://www.ajicjournal.org/article/S0196-6553(16)30581-8/pdf

    So I purchased the paper by Ofstead and in it she indicated that the
    endoscope manufacturers advise against the use routinely and usage be
    restricted to circumstances “when clinically indicated”. Also – during my
    own audits I have become aware that many endoscopy centres are now ROUTINELY
    adding it to the air / water or the auxiliary water bottles and not just
    using it when a bowel is found to be “bubbly”. The endoscopists want to use
    it because they believe they have a clearer view and are less likely to miss
    lesions.

    So I did a little digging around and found that Olympus raised this issue
    back in 2009

    https://medical.olympusamerica.com/sites/default/files/pdf/SimethiconeCustom
    erLetter.pdf

    And Pentax have a warning in their reprocessing instructions

    FYI – Below are two slides from the paper I presented at the Australasian
    College for Infection Prevention and Control Conference in Melbourne.

    So long story short – awareness has been raised. Questions are being asked.
    However whether the findings of Ofstead are able to be linked to a real and
    not theoretical risk of transmission remains to be seen.

    As for a ‘where to from here’ I imagine the quickest way to find out if the
    problem affecting your endoscopes is simethicone related is to purchase a
    borescope and have a look in your endoscope channels for whitish fluid
    residues.

    Hope this helps.

    Kind Regards

    Terry McAuley

    Sterilisation & Infection Prevention and Control Consultant

    STEAM Consulting Pty Ltd ACN 604 439 698

    E: terry@steamconsulting.com.au

    W: http://www.steamconsulting.com.au

    A: PO BOX 779

    Endeavour Hills

    VIC Australia 3802

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    Of Joanna Harris

    As I was unfortunately unable to be at the conference I’d be interested to
    know what the issue with this is, and whether infection prevention and
    control concerns have been identified as theoretical or real issues.

    Just this afternoon I have been asked to advise about the use of infacol by
    endoscopists. Apparently the intention is to reduce the development of mucus
    ‘bubbles’ that could obscure the field of vision.

    Our endoscopy unit staff are concerned about a build-up of residue and
    possible biofilm in the CO2/water channels and on the tubing leading from
    the CO2 bottles to the ‘scope. They are also finding that insufflation seems
    to have been affected recently and think it might be due to a greasy coating
    affecting valves and seals etc.

    Although there are clearly a few non-IPC issues here, I am hoping to be able
    to answer infection control-related concerns.

    Has anybody had any experience of the use of infacol in CO2 and/or water
    channels confirmed as leading to the transmission of pathogens, or
    ineffective reprocessing?

    Thanks in anticipation 🙂

    Jo Harris

    Nurse Manager, Illawarra Shoalhaven Local Health District Infection
    Management and Control Service (IMACS)

    Telephone – mobile 0475 943494 / Wollongong office 02 4222 5898 /
    Warrawong office 02 4221 6820

    Joanna.Harris@health.nsw.gov.au

    http://www.health.nsw.gov.au

    mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Jenny McCarthy

    Dear members
    At the recent ACIPC conference in Melbourne there was some discussion about
    using “infacol” during endoscopy and the risk of developing biofilm in the
    channels.

    Does anyone have any literature regarding this so I can show one of my
    general surgeons – who doesn’t seem to think this is an issue!

    Thanks
    Jenny

    Kind regards,
    Jenny McCarthy
    Operating Room Manger/Infection Prevention and Control Coordinator
    Maryvale Private Hospital
    PO Box 348, Morwell, 3840
    286 Maryvale Rd. Morwell, 3840
    T +61 3 5132 1283 | F +61 3 5132 1281
    E jenny@maryvaleph.com.au

    Maryvale Private Hospital Confidentiality and Privacy Notice

    NOTICE – This e-mail is only intended to be read by the named recipient. It
    may contain information which is confidential or proprietary. If you are not
    the intended recipient please notify the sender immediately and delete this
    e-mail. If you are not the intended recipient you should not copy this
    e-mail or use the information contained in it for any purpose nor disclose
    its contents to any other person. Maryvale Private Hospital Pty Ltd accepts
    no responsibility for electronic viruses or damage caused as a result of
    this email or for changes made to this email or to any attachments after
    transmission from Maryvale Private Hospital. You should not distribute or
    publish the contents of this email or any attachment without the prior
    consent of Maryvale Private Hospital.
    * Please consider the environment before printing this email

    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO
    NOT REPRESENT THE OPINION OF ACIPC.

    The use of trade/product/commercial brand names through the list is
    discouraged by ACIPC. If you wish to discuss specific reference to products
    or services by brand or commercial names, please do this outside the list.

    Archive of all messages are available at http://aicalist.org.au/archives
    registration and login required.

    Replies to this message will be directed back to the list. To create a new
    message send an email to aicalist@aicalist.org.au

    To send a message to the list administrator send an email to
    aicalist-request@aicalist.org.au .

    You can unsubscribe from this list be sending ‘signoff aicalist’ (without
    the quotes) to listserv@aicalist.org.au

    This message is intended for the addressee named and may contain
    confidential information. If you are not the intended recipient, please
    delete it and notify the sender.

    Views expressed in this message are those of the individual sender, and are
    not necessarily the views of NSW Health or any of its entities.

    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO
    NOT REPRESENT THE OPINION OF ACIPC.

    The use of trade/product/commercial brand names through the list is
    discouraged by ACIPC. If you wish to discuss specific reference to products
    or services by brand or commercial names, please do this outside the list.

    Archive of all messages are available at http://aicalist.org.au/archives
    registration and login required.

    Replies to this message will be directed back to the list. To create a new
    message send an email to aicalist@aicalist.org.au

    To send a message to the list administrator send an email to
    aicalist-request@aicalist.org.au .

    You can unsubscribe from this list be sending ‘signoff aicalist’ (without
    the quotes) to listserv@aicalist.org.au

    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

    The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

    Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

    Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au

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