High-level disinfection/sterilization of heat-sensitive devices: Which of the following are processed effectively with glutaraldehyde solutions (per manufacturer instructions)?

Introduction:
Glutaraldehyde is a high-level disinfectant/chemical sterilant used for heat-sensitive medical devices that cannot be autoclaved. Knowing which devices are appropriate for immersion processing is essential for reprocessing protocols.

Given Data / Assumptions:

• Devices listed (thermometers, bronchoscopes, cystoscopes) are heat-sensitive and have lumens or surfaces requiring liquid contact.
• Exposure time and concentration determine high-level disinfection versus sterilization claims.

Concept / Approach:
Glutaraldehyde solutions (e.g., 2% activated) provide broad antimicrobial activity, including mycobacteria and many spores with prolonged exposure. They are widely used (historically) for endoscopes and delicate instruments, alongside modern alternatives (ortho-phthalaldehyde, peracetic acid). Fabric items like surgical towels are not immersed in glutaraldehyde for routine processing; they are laundered and heat-sterilized instead.

Step-by-Step Solution:
Identify heat-sensitive, immersible devices among the options. Confirm that thermometers and flexible endoscopes are standard use-cases. Select the inclusive option covering all listed devices.

Verification / Alternative check:
Reprocessing guidelines historically include glutaraldehyde immersion for endoscopes with proper cleaning, contact time, and rinsing steps.

Why Other Options Are Wrong:

• Any single device alone: Incomplete; glutaraldehyde is used across these categories.
• Surgical towels: Typically processed by laundry/steam, not glutaraldehyde immersion.

Common Pitfalls:
Skipping meticulous pre-cleaning; organic soil reduces efficacy of liquid chemical disinfectants.

Final Answer:
All of these devices are commonly processed with glutaraldehyde when heat-sensitive.