Apparatus for automatic disinfection, cleaning, neutralisation and drying of medical equipment

1.

Technical Field: <b>scope of application</b>

The fully automated processing method for cleaning, disinfecting, Neutralization and drying of medical laundry, has the task by a selectable standardized flow in the closed system of Treating chambers to ensure proper hygienic disinfection.

The scope of the invention is particularly the use of the range of Medical thermolabile material, ie; Temperature range in the cleaning, disinfection and neutralization to a maximum of 60 ° C. This temperature range is called themolabil because plastic material and adhesive joints come in the flow region. These Application takes place in instruments, tubes and devices, as well as for Combination instruments made of metal and plastic as well as for other surgical and Klinikwaschgut.

As a case study for the description of the invention is the application, the hygienic vollautomastische preparation processes Application flexible endoscopes represented. The flexible endoscope in the design, as an operational research tool for upper or lower digestive tract, on the function and the type of construction, and on the type of image transfer of the flexible endoscope over fiber or by video chip is disregarded below.

Applicable the inventors use is both in human medicine, veterinary medicine and for industrial applications. The following naming Aufarbeitungsgut does not claim to Completeness of uses but only opens a view, on the possible applications.

When processing material is referred to below;

Gastroscopes, Duodenoscopes, colonoscopy, sigmoidoscopes, Choledochoskope, Bronchoscopes, Nasopharingoskope, Hysteroscopes, Laparoscopes and Atros-nephroscopes. Other probes of all types for insertion into body orifices, natural or surgical. As Transesophogeal Ultrasonic instruments and Introduction probes with image recognition during transmission ultrasound or ultrasonography. Furthermore, surgical instruments, for diagnosis and therapy, MIS instruments, foreign body forceps, biopsy forceps, irrigation catheter, Cytology, Coagulation forceps - and electrodes, hot biopsy forceps, diathermy snares, Papillotomes and other instruments more. The other large group of applications relates to the ventilator and Nakoseschläuche, and tubing for pharmaceuticals, blood, and infusions Dialysis.

In addition to the range of use for thermolabile processing material, is the invention, by a double shell construction with insulation as an option for the chemotermischem fully automated processing of up to 100 ° C maximum usable. The same inventor modern construction is consequently suitable for higher Temparaturbereiche, this is a temperature control required.

The fully automatic processing methods differ in the Temparaturbereichen -C 60 °. Here, a reuse of the Disinfectant. When chemotermischen Hot Disinfection is in the automatic cleaning and disinfection process in each batch, the used Reinungs disinfectant after the programmed execution the waste water supplied. There is no re-use.

1:11 <u>General Technical status</u>

The currently available on the market automatic, chemical and chemo thermally working fully automatic cleaning and disinfecting machine are indeed distinguished by a standardized procedure, small Personnel and time required from, but have a high energy, Disinfectant and water consumption.

Further improvement, however, the hygienic quality of the cleaned and disinfected ware.

The cause of these deficiencies is the spültechnisch unfavorable, horizontal, slightly downward guided circular position of the laundry on the holders of to display baskets. At all points of support of the laundry, Endoscope dirt particles constitute through the nozzles washes. The Pollution remains have by the inclusion of micro-organisms and by rapid encrustation and encapsulation in the core area fours, which can survive the disinfection process without killing. Upon removal the instruments, it comes through Bedienungshändling to the Kontamienierung Outer surfaces of the instruments.

As causation zone is the circular, partially superimposed Positioning and supporting the flexible endoscopes to see. In the Kreis location incurred in the thin-walled plastic rubber material kinks and folding pockets on both the outer side, as in the narrow thin-walled inner channels in the flexible parts of a mehrlagien Material are made. This folding bags a faster Flüssigkeisablauf is prevented. By kinks leads to areas missed, this lead to a poor quality of the cleaning and disinfection of instruments.

The additional risk of transmission of hazardous germs consists in the respect that in the buckling and folding bags residues the cleaning and disinfecting agents collect the following through the Neutralization are not flushed out enough and then by the Drying powder. By often porous, rougher material properties the kinks, the powdered residue beds in the Plastic tubing and a. The flexible endoscopes is the Outer sheath, introducing additionally with a protective glossy layer provided, through the use of instruments leads to small cracks in the frequently claimed bending points of the surface layer to accumulations of possible critical bacteria. have become known deaths in the daily press, through the use of ventilation tubes for Kids Anestesie at the MHH Hanover 1995th Residual water nests in the bending area of ​​the breathing tubes in the tube interior by the type of construction of the incorporated support spiral are dried and pulverized and then passed into the lungs.

1:12 <u>State of the art</u>

The current technical state of Technick in Full Auto-Semi-automatic and manual Aufbreitungsverfahren for cleaning, Disinfection and neutralization to apply for medical laundry. is used in the following description of the various systems an example of the cleaning of flexible endoscopes (thermolabile material) described. The same applies for application in accordance with another wash - be disinfected and Instruments.

1:13 Fully automatic processing methods

With fully automatic preparation cleaning and disinfection is carried out endoscopic instruments and the rinsing and drying in a purpose designed machine. are used as chemical chemo thermally effective disinfectant. The design is in the broadest comparable to household dishwashers. Drying takes place over heating coils underneath the basket systems and by fans. In the wash chamber, extract Basket Cart arranged, these have storage receptacles for endoscopes with type horizontal recording, where the dishes are slightly is inclined downwards. It carried out one or more liquids and compressed air-Verbindungsanschlüße to flush the inner channels, and for a leak test for the endoscope.

Up to three flexible endoscopes superimposed in basket system circular be connected fluidly and automatically be prepared. In the wash chamber are top and bottom nozzles arranged. In some embodiments, these are by hydropower Rotating spray arms with jet nozzle assembly above or below the laundry arranged. The washing chamber is closed by a front operation hinged door Hinge assembly is level. About this flap shutter door are the Laundry basket receiving carriages challenges to better feed and pushed. By pushing and load-through variants, bring a job separation in Reine- Unreinezone and a separation of the treatment rooms.

1:14

Fully automatic processing methods with pressure chamber

The procedure differs from the above, in the Form, which comes just a thermochemical disinfection for use. The disinfection process is fully automatic. The difference is in Material and receiving carriage for flexible endoscopes. This is equipped with pressure chambers. The operation part finds inclusion in the Pressure chamber, the flexible insertion tube of waterproof endoscope is inserted into a downward helically run plastic pipe. Pressure chamber and FLEXIBLE plastic pipe accept the recording of Endoscope. The fully automatic cleaning and disinfection processes running via the pressure chamber, in which the cleaning disinfectant and Rinsing solutions are designed without transmission links to the endoscope. Additional wash arms spray the supply hoses and the accessories of Endoscopes.

1:15

Fully automatic disinfection

For large hospitals and central sterilization throughput conveyor systems used with a thermochemical disinfection. The Transport baskets are loaded with the laundry and an automatic Cleaning sequence for a production line - cleaned a continuous process, disinfected and dried.

Statement:

disinfection

In chemical disinfection microorganisms are not all killed. A distinction is high-level, intermediatelevel and low-level disinfection:

In the high and intermediate-level disinfection; werdem vegetive bacteria including tuberculosis Myobaterium killed, but not bacterial spores.

Low-level disinfection kills all viable microorganisms, but not mycobacteria and spores.

Non-critical surfaces of the instruments that touch intact skin, but do not penetrate, can with intermediate-level or low-level Disinfection, disinfected.

The ideal disinfectant does not yet exist. Choosing presents therefore a compromise of toxicity, health side effects, Width of antimikobiellen effectiveness, duration of required Exposure and material-saving effects on coatings, Plastic, rubber, lenses and metals represent.

1:16 Semiautomatic treatment

In the semi-automatic processing endoscopes in tubs are, in usually completely immersed in plastic, so that all components are liquid default covered with disinfection- Neutralisationssmittel. For more economical use of disinfectants are the well increases -and- depressions have formed according to the contours of the endoscopes and a Fall towards the drain. The filling can be done either from the top, as equally by shut-off devices, which formed as a barrier or valves are controlled and filled from below. The pumps are located under the pan body. The device channels are connected to circulators and flushed over an adjustable period of time with the media.

1:17

Semiautomatic treatment

As described above, there is another embodiment of wells is to insert the flexible endoscopes, the flexible insertion tube inserted into an attached container or pickup tube device. The operation part and the supply tube of the endoscope are in When part.

1:18

Manual preparation process

Just for the record presented; the gewöhliche manual preparation. After thorough mechanical cleaning of the exterior parts and Brushing the channel of the endoscope systems, carried out a flushing of the channels Disinfection. At the sole washing in a disinfectant bath, are the channels by hand, syringe, pump, free of air purged. Disinfection and tap water or distilled water is used. There is no drying.

A disadvantage of manual preparation, the odors from the open trough shape and health side effects by infection allergies the skin and mucous membranes of the staff. Basically need protective gowns, worn gloves, mouth, nose and eye protection will.

Statement:

More Desinfektionsvarfanten

As <b>sterilization</b> physical or chemical methods are referred to any Microorganisms including spore kill. This can by irradiation in gamma or Plasmasterilisatoren by gas in the form of ethylene oxide and Formaldehyde happen. In the autoclave sterilization is carried out by Heat or steam.

<b>Chemical liquid cartridge systems</b> be in changeable When systems used for cleaning, disinfection and neutralization in the US. The procedure can be chosen as half full car Maisch. There trade is a one-way process, to each new batch is a new chemical cartridge necessary.

<b>alcohol</b> Although kills fours, but not vegetative organisms, Spores. The use of small amounts of alcohol in the Kanalsytem endoscopes is known. However, remaining small amounts are flammable and explosive. There are material incompatibilities through the partial dissolution splices.

<b>enzymes,</b> Special cleaner with organic cell structures are in Clinical testing and reach only a shortened cleaning. on the Use of a subsequent disinfection and neutralization can to current knowledge is not waived.

2.0

<b>Technical problem:</b>

The technical set object, a high hygienic, flawless verifiable quality in the automatic preparation process for the high sensitive application fields of Aufbreitungsgutes made the today Knowledge a new Innovative design and process flow necessary.

The main task of the device is to prevent the transmission of serious infections caused by microorganisms for subsequent Patient, physician and staff is only through a thorough standardized automatic preparation of the OP and Klinkinstumentarium possible. By microprocessor control with permanent function control, all driven inputs and outputs. Printing and error control, and Temperature and dosage control can be different programs, which are adapted to the Waschgutart, in the program memory available deposited.

Only through a thorough automatic additional nozzle-brush cleaning system it is possible to target Correct cleaning of the outer shell of the Patient insertion tube to ensure. The rapid coagulation proteins such as mucus, secretions, blood or stool require umspülendes Nozzle-brush system to aldehydes-alcohol induced solid impurity residues remove and crystalline deposits residue. So intensive cleaning processing of the outer shell is carried out in Area of ​​the instrument part which was inserted in the patient. The uncritical surface of the supply hose and the operating portion of the Endoscope undergo a cleaning and Düsenspülverfahren.

Anwenderart conditional, long flexible instruments in body orifices are inserted have different ion channels. Read case study endoscopes; is it mostly to round laundry, in the field of patient application.

The invention was based on the object to provide a device in of the disinfectant is reused. This means a Reduction of disinfectant consumption of cost and wastewater pollution. Environmentally friendly chemical disinfectant is quantitatively provided a machine dosage in the reservoir.

The disinfectant is separated per wash chamber through the circulation performed a reservoir, so that a separation of the wash chambers for the User requests can be flexibly adapted.

The chemical disinfectants have today a multi-use on the degree of contamination to. By inventor Proper application, the disinfectant solution is purified and mitschwimmende organic airborne particles are the disinfectant permanently withdrawn in the rinse cycle. Thus, a sanitizing solution changes, working day or possible to use times. Thus, the system is very economical and environmentally friendly.

By Waschguttrennung a hygienic pre is possible in the the automatic execution through special nozzles and purification processes is enhanced and the removal of dried mucus simplify secretions, blood or stool and so better to a safe and Disinfection contribute. The improved quality of the obtained Cleaning results that are a processing material gentle process contributes a higher security to the risk of infection a is minimized or eliminated.

For each batch, fresh detergent and germ-free fresh water used to rule out a re-infection. Tap water is processed aseptically through a UV system and in the VorZwischen and used in the neutralization transition.

The laundry is kept just above or hung in devices. More Contact points as shelf supports do not exist. An overlap is avoided. A disadvantageous purification by rinsing blind spots is avoided. Users According depends the endoscope and the patient-introducing tube and the inner channel system vertically without kinks and bending wrinkles. This causes a very fast cleaning disinfection and Trocknungsszeit by a faster flow of incoming and applied liquids. By Using filtered compressed air and dry hot air is a very faster perpendicular Abtrocknungsprozess, by gravity, both inside and outside reaches of the laundry. This is a significant improvement, thereby contributing to prevention recontamination and the germination of microorganisms at.

The seals of the doors with sheathed Mangnetsystem are easy to clean and can be adjusted. A pre-coated canopy ensures for the residual moisture when opening the door not on the floor reach, thereby preventing contamination.

2.5

Disclosure of the invention and its advantages:

According to the present invention, the washing and disinfected, is cleaned vertically, the pick-up device consists of durchspühlbarem Stainless steel wire mesh. The invention by your design for elongated laundry hygiene claims, to be cleaned and the disinfect medical, technical equipment and instruments only by upper vertical brackets, hanging freely without any further requirements in the Washing chambers cleaned by a fully automatic processing methods, be desinifziert and neutralized. The inventor contemporary embodiment has the advantage that the often circular flexible material to be washed, (70 + 72) kinks hangs vertically freely and no wrinkles and pocket kinks on the outside occur. For the inner Supply lines for liquids and air in the instruments and Appliances and for tubing this application also has the same advantage of kinks improved cleaning and disinfection and the lower residual moisture.

An additional nozzle, brush cleaning system is the outer jacket the laundry, here the example flexible endoscope, patient-introducing tube completely umwaschen so ensures the residual impurities be removed without a trace in the folds areas of the outer jacket.

The method of application has the further advantages in the improved kink-free liquid drain both outside and inside, or in the Supply lines and a much faster drying. This causes very rapid re-availability of the treatment good. A Nucleation is filtered compressed air and dry hot air minimized.

The inventor Proper advantage is by separating the treatment chambers takes place. The free time and independently of the available treatment chambers ensure permanent operational ability with no waiting. This provides the user achieves a faster way of re-use the treatment good.

The invention is characterized by simple handling in the operation and feeding the washing chambers of the laundry. By washing chamber design and the assemblies instrument holder is a universal Instrument holder (60) and the detachable small parts container basket (62) to Low valves and accessories workplace justice arranged.

No matter what size the operating portions of the flexible endoscopes (70) who and in what form and Design type, as well as the position of the connection terminals the supply tube of the endoscope are present, existing instrument holder (60) with variable height adjustment (61) and take a universal support for the supply hose connector (75) all Bauausführungen on.

It is made for each processing chamber separate from the reuse chemical disinfectants by unpressurized reservoir in the arranged assembly area. The eco-friendly recycling allows this method, a high efficiency.

The chemical disinfectants have a multiple use in the same Processing material to. The period depends by contamination level and the time of use. At a lower capacity is according the disinfectant manufacturers a usability up to a week given. At high frequency should work every day, to be replaced.

Mitschwimmende organic particulates are a turbine type the disinfectant in rinse deprived permanet. Thus extended the operating time of the reusability of the disinfectant.

3.0 <u>Preferred embodiment of the invention</u>

Chamber cabinet design with one, two or more doors (53) and Basket extracts that are on and extendable through telescopes. For the preparation process after drawing, Figure 2, may also be below the be arranged processing chambers a closet for chemicals etc.. The Instrument holder is easy alternately for the respective laundry and interchangeable. Case study after drawing application for flexible endoscopes.

Design for parallel through-loading feature, Pure - Impure page, Aggregate assembly, rear, side or in the middle.

The chemical disinfectant or thermochemical disinfection agents is quantified with an automatic dosage reservoir already provided a respective separation of application areas and in Rinse disinfectant recycled. It is carried out with the use of chemical disinfectants a Re-use, depending on frequency of use, or operating hours is an sustainable use depending on the make of the disinfectant to one week possible.

3.1 unit arrangement

Due to the different water supply quality in the hospitals, the Water supply and reclamation opportunities associated respectively be adjusted. A direct connection to the mains water supply is provided, the use of tested and approved check valves, pressure reducer, Descaler, Inonentauscher and ultraviolet light water disinfection ensures equal, disinfected water quality. The other modules metering, Disinfection reservoir, control valves, pumps and compressors Warm air blower, sewage connections and others with connections to the treating chambers installed on the rear side (52) of the machine.

Per treatment room controls each electrical programmable controller independently the individual treatment chambers (50 + 51)

The assemblies and sub-assemblies and the programmable machine controller are individually commercially purchased parts, as assembly or fully assembled used. The necessary authorization tests are carried out.

The electrical controls (55) of the individual washing chambers is effected by a is control panel which angeordenet front of the doors. The electrical Operation surface is obliquely designed to better function and to enable control for the user. Below the operation panel (56), a protocol printer provides fully automated Preparation method per Aufbereitungskam mer document, the Program run time and type, date, time, batch duration and arrangements Fault. For this is below the electrical operator console a Access door or a vertical closure plate arranged.

4.0 <u>Industrial Applicability:</u>

Administration can be in use in human medicine and in the Veterinary medicine. This may be; University clinics, hospitals, clinics, specialist centers, established internists and specialists. Likewise, the application for Industriewaschgut is possible.

4.5 <u>drawing explanation</u>

The inventor subject is the embodiment with a flexible Endoscope in drawing, figure (1) explains.

In the drawing, figure (2) is a Anwenderart for flexible endoscopes of types; Sigmoidoscopes, bronchoscopes, Choloedochoskope, Nasopharingoskope, Hysteroscopes shown etc.. These instruments have a short Patient introduction part to about 0.70 m without operating part.

Figure (3) shows the operation of the additional purification process for application to the patient insertion portion

List of reference numerals:

<dl tsize="3" compact="compact"><dt>50</dt><dd>Treatment chamber (1)</dd><dt>51</dt><dd>Preparation chamber (2)</dd><dt>52</dt><dd>Physical arrangement</dd><dt>53</dt><dd>door</dd><dt>54</dt><dd>door lock</dd><dt>55</dt><dd>Elect. service</dd><dt>56</dt><dd>E. Services, Printer</dd><dt>57</dt><dd>Basket reduction with instrument Cradle</dd><dt>58</dt><dd>telescopic shelves</dd><dt>59</dt><dd>Basket summary Handle</dd><dt>60</dt><dd>instrument recording</dd><dt>61</dt><dd>Variable height adjustment</dd><dt>62</dt><dd>Removable small parts containers</dd><dt>63</dt><dd>Pipe supply line</dd><dt>64</dt><dd>Up f. Supply hose</dd><dt>65</dt><dd>Drip drip plate</dd><dt>66</dt><dd>Drip pan / Notüberlaufw.</dd><dt>67</dt><dd>Drain with Wi-strainer</dd><dt>68</dt><dd>Couplings for. Endoscope </dd><dt>70</dt><dd>Flexible endoscope operating unit</dd><dt>71</dt><dd>Introducing part-patients</dd><dt>72</dt><dd>Endoscope supply hose</dd><dt>73</dt><dd>Supply terminals for internal channels u. Pressure Test</dd><dt>74</dt><dd>Supply terminals for internal channels</dd><dt>75</dt><dd>Supply hose connector</dd><dt>76</dt><dd>spray nozzles</dd><dt>77</dt><dd>Additional nozzle / cleaning system</dd></dl>