Decontamination is the combination of processes, including cleaning, disinfection and/or sterilization, used to render a reusable medical device safe for further use. It is important because of the risk of transmission of hospital acquired infections and transmissible spongiform encephalopathies. The recommendations of the Department of Health are clear and detail that single use disposable airway equipment should be used where possible. Where this is not possible, equipment should be sterilized by heat (autoclave) and where this is not possible cold, chemical sterilization or disinfection by an automated process should be used. The term disinfection means the elimination of all vegetative pathogenic organisms such as bacteria and viruses, and sterilization indicates the elimination of all pathogens including spores. For a terminally sterilized medical device to be labelled sterile, the theoretical probability of there being a viable microorganism present on the device should be equal to or less than 1 × 10–6.

An additional infective agent, the abnormal prion protein PrPSc, has great public health implications as it is the probable mechanism of transmission of variant Creutzfeldt–Jakob disease (vCJD). This prion protein cannot be eliminated by chemical means or temperatures reached in the standard autoclave. Temperatures approaching those required for incineration are needed. Reusable equipment should never be used in patients known or suspected of having vCJD unless the equipment is to be destroyed after use. In the case of flexible fibrescopes, dedicated endoscopes may be obtained from the National CJD Surveillance Unit in Edinburgh. All trusts should have Infection Control Committees and Teams which are responsible for preparing infection control policies to conform to all national and international standards and recommendations.

Single use, disposable

Single use equipment eliminates the risk of cross infection between patients through the airway device.