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Endoscope reprocessing: taking the mystery out of high-level disinfection.

Flexible endoscopes used in otolaryngology are often unable to withstand heat sterilization. An acceptable alternative to heat sterilization for these devices used to examine the aerodigestive tract is high-level disinfection. A review of otolaryngology (ORL) nursing clinical practice indicates that there is confusion regarding the recommended disinfectant solutions to use and the proper manner in which to use them. This article describes a method that is useful in determining the level of risk of infection posed by ORL endoscopy, a description of appropriate levels of disinfection, points to consider for achieving high-level disinfection, and appropriate personal protective measures.