Flexible bronchoscopy is a crucial function for any Intensive Care Unit. Key concerns include on-demand scope availability, ensuring sterility, and managing equipment and reprocessing. On top of that, flexible endoscopes were called out in a recent CDC Health Advisory for being difficult to clean.
Using a PrimeSightTM flexible bronchoscope from Cogentix Medical with the EndoSheath® protective barrier helps overcome those limitations, providing a cost-effective, time-saving alternative which allows ICU bronchoscopes to be available in less than 10 minutes.
The Matter of Safety
The FDA has undertaken an ongoing, comprehensive investigation into infections associated with reprocessed reusable medical devices. The September 17, 2015 Infections Associated with Reprocessed Flexible Bronchoscopes: FDA Safety Communication identified bronchoscopes as devices that pose a greater likelihood of microbial transmission. The FDA indicated that there are two recurrent themes contributing to persistent device contamination or device-associated infection:
- Failure to meticulously follow manufacturer’s instructions for reprocessing
- Continued use of devices despite integrity, maintenance and mechanical issues
The FDA outlines a list of best practice recommendations to minimize the occurrence of microbial transmission. Given the significance of this issue, this will undoubtedly continue to be an area of FDA scrutiny.
The Role of the EndoSheath Protective Barrier
The EndoSheath protective barrier is designed to isolate the scope from contact with the patient and is a proven effective barrier to micro-organisms as small as 27 nanometers in diameter. Additionally, the PrimeSight bronchoscopes do not have a working channel. Instead, the working channel is incorporated into the EndoSheath protective barrier. As a result, there is no need to use high-level disinfectant on a PrimeSight scope between procedures. And, we all know that less exposure to caustic chemicals mean greater bronchoscope longevity.
Shorter reprocessing times equates to big time savings. A study conducted at Detroit Medical Center compared the turnover time for conventional bronchoscopes, which require at least 30 - 45 minutes of reprocessing between patients, and a PrimeSight scope using the EndoSheath protective barrier. The difference was stunning. According to the study, the average turnover time for the PrimeSight scope was 5:44. In an ICU, saving that kind of time can literally save lives.
A Cost Effective Approach
In addition to turnaround time, the study also compared cost per tracheal intubation between the conventional bronchoscope and the PrimeSight scope with the EndoSheath barrier. The cost difference was significant: $158.50 per intubation with a conventional scope, compared to $81.50 when using the EndoSheath barrier. This represents a potential savings of $77 per case for facilities using the Prime-Sight bronchoscope with EndoSheath barrier.
By dramatically reducing equipment turnaround time, the ICU can meet ever-fluctuating bronchoscopy demands without having to invest in a large inventory of endoscopes. Inventory is not just impacted by the abbreviated reprocessing of PrimeSight scopes.
Since the EndoSheath product is available with different working channel sizes, a single PrimeSight scope can be configured with no working channel, a 1.5 mm working channel or a 2.1 mm working channel. This means a bronchoscope can be configured for use, right before the procedure. The flexibility of the PrimeSight system is unlike conventional scopes that require capital purchases of different scopes for each working channel size.