items being cleaned must be fully immersed, hinged instruments must remain open during treatment, only use cleaning trays that do not obstruct the ultrasonic cleaning process or add mass, large surface bulky items such as kidney shaped bowls must be positioned not to create anechoic (shadow) zones that will block the efficacy of ultrasonic transducer waveform position such items vertically or put them on top of the other items, always sort instruments by similar metals to prevent corrosion, do not overload the ultrasonic cleaning tank with excessive mass as this will reduce the efficacy of cleaning, the soil being removed from devices being cleaned adds to the mass within the tank and decreases the efficacy of the ultrasonic cleaner. Review the level of soil and renew the ultrasonic bath as needed, ALWAYS follow ultrasonic cleaning with separate rinse treatments. Ultrasonic cleaning will fragment and loosen soil but will not necessarily remove the soil from the surface of the surgical instruments being cleaned.
Recommendations for detergents used for medical ultrasonic cleaning: a non-foaming detergent must used, the labeling of the detergent should recommend the use of the product for ultrasonic cleaning surgical instruments, always use enzymatic enzyme detergents carrying the 4 enzymes needed for surgical instruments soiled with proteinaceous bioburden (protein, fats, starch, carbohydrates), use detergents with 'surfactant' cleaning agents for removing stains and hard water mineral deposits, use the treatment cleaning time recommended by the medical device and detergent manufacturers, always cover the ultrasonic cleaner when is use to avoid inhaling the aerosols of cleaning concentrates containing enzyme detergents due to the risk of anaphylactic reactions.
Medical Ultrasonic Surgical Instrument and Scope Cleaners
Medical Ultrasonic Cleaner Time and Temperatures
Ultrasonic Cleaner Medical Enzyme Solution Cleaning Concentrates
Enzyme cleaning concentrates function more effectively at temperatures above room temperature. The optimal range begins as > 22C - 72°F with performance reaching it's peak at 58.3C - 137F. This is often referred to as the optimal temperature for the performance or activity of enzymatic action. The activity of enzymes does not stop at higher temperatures but the level of performance does begin to decrease. Enzyme cleaning concentrates enzyme-detergents and all-in-one cleaning concentrates, which include enzymes, should be used in accordance with the manufacturer's recommendations and the recommendations of the medical devices being cleaned. Because Ultrasonic Cleaners do not provide the complete "proper sequence of treatments" final rinses that are purified, purged between treatments, and/or have temperatures elevated to disinfection levels, they are not considered to be as clinically effective as automated washer-decontaminators- disinfectors. Ultrasonic Cleaning can effectively remove: long term encrustation and surgical cements or glues that have dried onto instrumentation. Always refer to the printed manufacturer recommendations when using Ultrasonic Cleaning.
Ultrasonic medical cleaning involves the use of high-frequency sound waves (above the upper range of human hearing, or about 18 kHz to 40 kHz ) to breakdown and fragment soil on the surfaces of reusable medical devices. Medical Ultrasonic Cleaners are most commonly used by healthcare facilities when the decontamination work area does not provide adequate space for an automated surgical instrument washer or when capital funds are limited. Also Medical Ultrasonic Cleaners have been designed specifically for cleaning temperature sensitive flexible scopes and provide a range of preprogrammed times and temperatures that are not available conventional ultrasonic cleaners. Note that there is a significant difference between the ultrasonic cleaners used for cleaning jewelry and those (more expensive) ultrasonic cleaners designed for cleaning medical devices. The Medical Ultrasonic cleaners designed for cleaning surgical instruments use ~ 8 to 12 transducers per tank and with total ultrasonic power rated at ~ 1,000 watts average output and 2,000 watts peak power per tank. The Performance Test for an ultrasonic cleaner simply involves suspending a piece of metallic (usually aluminum) foil in the tanks being compared and inspecting them for holes (more holes = more effective) following a time (usually 20 minutes) of ultrasonic cleaning. Gradually elevated temperatures, redundant purified water rinses, and hot air drying at temperatures above boiling point are options that are not typically available from an ultrasonic cleaner. The need for using an Medical Ultrasonic Cleaner can be important when the surgical instruments been subjected to repetitive cleaning that has been inadequate to maintain a truly clean surface. When surgical instruments are not properly cleaned they become gray in color and loose their 'new looking' shiny surface. When the passive layer of surgical instruments is not enhanced and maintained properly, via the process of redundant proper cleaning, the instruments appear gray and are more vulnerable to pitting and corrosion. It is important to note that Ultrasonic cleaners are not fully effective unless they are used with hot water temperatures as recommended by the medical device manufacturer and the temperatures recommended by the manufacturers of the enzyme and detergent cleaning concentrates being used.