Bougies

[mulld]

After cleaning and disinfecting Bougies, techs have "always" steri-peeled these items and returned to Endo area. We disinfect them with Cidex, we do not steam sterilize. Endo nurses are wanting the techs to return the bougies and place them in the case after disinfecting. I would like to hear how other hospitals are storing bougies in between uses. Thanks:)

[David Freeman]

After adequate cleaning and disinfection, we return Bougies to the case for storage. I don't like to "steri-peel" anything that is not sterilized. It may give someone the false impression that the item is sterile and put it on a sterile field. I know, everyone is supposed to check for chemical indicators, load stickers and other proof of processing but sometimes the planets all line up and "stuff happens".

[Harvey Johnson]

We clean, disinfect and peel pack the bougies, placing "disinfected / not sterile" labels at both ends of the pack.
Speaking of stuff happening.......
The core made the mistake, at the directions of a senior nurse, of trying to flash one of the stray older mercury filled, found in the case, (not found and disposed of during a mercury elimination sweep several years ago) bougies last year, the flash autoclave also contained a cysto set, you can imagine the toxic mess and expense when the bougie blew up!
From that point on we have closely monitored the bougies and their storage status.

[CSS TECH]

Which kind of bougies are you talking about? I know of so many types!

[Harvey Johnson]

Definately not the...."Don't try to lay that Bougie - Woogie on the king of rock and roll" type....

[CSS TECH]

Definately not the...."Don't try to lay that Bougie - Woogie on the king of rock and roll" type....
Does that answer my question? No! Are you trying to make fun of me or you are serious about the forum?

[David Freeman]

I'm talking about esophageal dilators. There are different types but at least one is commonly called Bougie Dilators. Some used to be filled with mercury though I don't recall why. Either way, I can't think of why they would be sterilized unless that is the hospital's method for achieving high level disinfection.

[Harvey Johnson]

Jeeez, lighten up...or is that a normal thin skinned response from someone in NY?
And since when has this been annointed a "serious forum"?
You need to read up on the "Fish" philosophy of the value of taking one's job seriously, but not one's self.
I don't think type of bougie is the issue, the question was what we do to process them.
OK CSS, I get it, apparently you have zero sense of humor today, simply googling "bougie" will give you the following serious answer, to save you more angst, here is your serious answer:
Enjoy!

Definition of Bougie

Bougie: A thin cylinder of rubber, plastic, metal or another material that a physician inserts into or though a body passageway, such as the esophagus, to diagnose or treat a condition. A bougie may be used to widen a passageway, guide another instrument into a passageway, or dislodge an object.

Bougies are available in a wide range of sizes and degrees of flexibility. They may consist only of a simple cylinder. The cylinder may be equipped with such devices as: (1) an inflatable balloon to apply pressure against obstructions or narrowed walls; (2) a gauge to measure the pressure applied by the balloon; (3) a wire that is positioned at the site of a stricture, blockage or another problem to guide other instruments into the passageway; (4) a channel through which dye can be injected so that a site can be identified on a fluoroscope and (5) a light to illuminate a passageway for examination.

Bougies may be used to treat strictures and blockages in the esophagus, the intestines, the rectum, the anus, the ureters (the tubes that transport urine from the kidneys to the bladder) and the urethra (the canal that transports urine from the bladder to the outside). A stricture is an abnormally narrow section of a passageway while a blockage is an obstruction within a passageway.

To remove an object lodged in the esophagus, a lubricated bougie may be used to dislodge the object and move it down into the stomach. The object then passes through the intestines. This procedure is feasible only if the object is unlikely to damage tissue as it moves through the intestinal tract.

Bougies equipped with balloons may be used to eliminate both strictures and blockages in the esophagus. In a typical procedure, a lubricated bougie may be inserted under local anesthesia. When the bougie reaches the site of the stricture or blockage, the balloon is inflated. The pressure from the balloon then can widen a narrowed passageway.

Bougies sometimes play a role in treating achalasia, a disorder in which there is abnormal function of nerves and muscles of the esophagus (swallowing tube) resulting in failure of the lowest-most part (lower esophageal sphincter) to open and allow passage of food. A bougie is used to stretch this sphincter.

Bougies equipped with lights are sometimes used in surgery involving the colon, rectum, abdomen and chest to help physicians view and identify internal structures.

"Bougie" is a French word meaning "candle." The French apparently derived the word from "Bugia," the name of a North African town that exported candles to France. Because a bougie resembles a candle, English-speaking physicians wrote it into medical lexicons to describe candle-shaped diagnostic and therapeutic instruments. It was an apt word, for such instruments originally consisted of waxed silk or cotton rolled into a cylinder. Today, the French word "bougie" can also mean "probe" and "sparkplug." Also, the English "word" bougie can sometimes be used to refer to suppositories like those inserted into the anus to treat hemorrhoids. Related terms include "bouginage" (also spelled "bougienage"), which refers to a procedure in which a bougie is used, and "bougie à boule," which refers to a bulb-tipped bougie.

[jrc]

Some used to be filled with mercury though I don't recall why.
Since it is so dense, filling them with mercury was an excellent way to add weight. This aided in getting the dilators down the esophagus. Unfortunately, it is also very unsafe. :(

[CSS TECH]

And since when has this been annointed a "serious forum"?

I didn't say "serious forum" but "serious about the forum". It's a big difference. Thanks for your lecture on "bougie".

[CSS TECH]

I'm talking about esophageal dilators. There are different types but at least one is commonly called Bougie Dilators. Some used to be filled with mercury though I don't recall why. Either way, I can't think of why they would be sterilized unless that is the hospital's method for achieving high level disinfection.
Oh! OK! In my facility we have the Maloney and the Hurst Dilators. They are tungsten-filled silicone dilators.