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Good afternoon Pam,
The reference to endotoxins is within ISO 15883-4, please see below.
“4.5.3 Depending upon the intended site of use of the endoscope (e.g. sterile body site) the level of
bacterial endotoxins in the final rinse water shall be controlled and monitored within the limits specified
in national regulations, using the method described in ISO 15883-1:2006+Amd 1:2014, 6.4.2.3.NOTE It is the dose of endotoxin that ultimately impacts on the patient and this includes the exposure
surface area of an endoscope as well as the endotoxin concentration in the final rinse water.”The advice would be to risk assess the patients these scopes will be use for. It is for the hospital to determine the potential risk to patients. I would avoid using the scopes for sterile cavities and immunocompromised patients.
My understanding with Endotoxins is, when they are introduced to the body, your body does not know they are dead bacteria and this triggers an immune response. These symptoms are usually mild in healthy patients but can be worse for patients with underlying health conditions.
In the long term, you need to determine where the endotoxins are coming from and what is killing the bacteria/biofilm. At some stage there is live bacteria that is being killed. Are the Soluscope machines colonised? Are the endotoxins high in your incoming water? What water sampling procedure are you following? If the machines self-disinfect cycle is being used directly before taking the samples, is that impacting the endotoxin levels?
Until you can ascertain the route cause, it is very difficult to find a long term solution.
Kind regards,
Stephen Adnams
T 1300 680 898
F +61 (0)3 9533 6193
M +61 (0)403 129 444[cid:image001.jpg@01D72BBE.CCC5E1A0]
[cid:image002.jpg@01D72BBE.CCC5E1A0]
Tristel Pty Ltd.
40/328 Reserve Road | Cheltenham | VIC | Australia | 3192If you have received this message in error, please notify us and remove it from your email system.
Save a tree. Don’t print this email unless it’s really necessary.Good morning brains trust,
I would really appreciate some advice:
Through routine water testing in CSD our soluscope water returned Bacterial endotoxins were above the Reference range 30 EU/mL
I have reviewed GESA guidelines but cannot determine what we should be doing with the potentially contaminated scopes;
* can we continue to use them with no further action
* should we microtest each and quarantine pending appropriate results
* should we quarantine all scopes until water line issue is fixed through engineering – we have no other means of cleaning the scopesKind regards,
PamPamela Boon | Clinical Nurse Manager
Infection Prevention and Management Unit
Royal Darwin Palmerston Hospitals | Top End Health ServiceNorthern Territory Government
2nd Floor, Royal Darwin Hospital, Rocklands Drive, Tiwi
GPO Box 41326, Casuarina, NT 0811p …08 892 28045
f … 08 892 28889
e … Pamela.Boon@nt.gov.au
w… http://www.nt.gov.au/healthOur Vision: Building Better Care | Better Health | Better Communities Together
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Good morning Fiona,
The pump you have been recommended is a macerator pump. See below link. This is for a toilet system but the principle is the same.
https://www.bunnings.com.au/saniflo-sanitop-domestic-macerator-pump_p4817625
Your sink outlet empties directly in to the unit. Internally there will be a float indicating when the unit is full. When the unit is full, the float will turn on the pump and the unit will empty itself automatically.
From leaving your sink to entering your waste supply, the system is completely enclosed.
The plumbers will know this, but they need non-return valves to stop the waste water flowing back in to the unit, without non-return valves, as soon as the pump switches off, the water in the pipe will run back in to the unit. Personally I would ask for 2 non-return valves. One at the outlet from the unit and one where it connects to the existing water line. That way you will have protection from the waster water you have just pumped out and will also have protection from any waste within the existing waste line. If you don’t have a non-return valve at the point you connect to the existing waste line and there is a blockage on this line, you could be in a position where that waste is flowing in to your pump line.
The only other point to be aware of is the pumping capacity of the pump. Your plumber should work this out, but the pump will have a limit to how far it can pump water. The pump on the link can pump 50 meters across a horizontal pipe or can pump 5 meters vertically. Your plumber will need to work out the vertical distance as well as horizontal distance from your macerator pump to the waste line they are connecting to. This is to make sure you have a pump with a big enough capacity to pump the water the required distance.
Hopefully that all makes sense. If you have any questions, please feel free to contact me.
Kind regards,
Stephen Adnams
T 1300 680 898
F +61 (0)3 9533 6193
M +61 (0)403 129 444[cid:image001.jpg@01D69BC5.6A2FFA00]
[cid:image002.jpg@01D69BC5.6A2FFA00]
Tristel Pty Ltd.
40/328 Reserve Road | Cheltenham | VIC | Australia | 3192If you have received this message in error, please notify us and remove it from your email system.
Save a tree. Don’t print this email unless it’s really necessary.Hi Brains Trust,
I have recently had a ‘waste water pump’ recommended as a solution for a waste water issue. I am unfamiliar with these devices but I believe these pumps are being suggested to pump waste water from clinical hand wash basins up and over a wall into a ceiling and then connect to an existing waste stream elsewhere in the building.
Is anyone familiar with these pumps or has anyone assessed their infection control risk previously, if so can you please provide feedback on them.
Kind regards,
Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
Launceston General Hospital, Level 2, Launceston TAS 7250
phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email: fiona.de.sousa@ths.tas.gov.au |
intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_controlIPCU – ‘By working together we promote a culture of safety to reduce preventable infections and transmission of multi-resistant organisms’
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