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Maintenance to a TEE

April 28, 2023

Transesophageal echocardiography (TEE) probes are vital to cardiologists when evaluating the structure and functionality of the heart. Likewise, proper handling and care of TEEs is vital to maintaining the integrity and functionality of the instrument. Follow the guidelines below to perform your maintenance to a tee


Low-Level Disinfection 
It is recommended that the end user of the TEE perform Low-Level Disinfection (LLD), which involves a non-corrosive wipe or spray. Performing LLD not only disinfects the instrument by killing harmful bacteria, viruses, and fungi, but it also allows the department to inspect the TEE for any damage and, if necessary, to perform corrective actions to prevent further damage.

Electrical and Leakage Safety Testing
After LLD is performed, electrical and leakage safety testing can be administered. The Intersocietal Accreditation Commission (IAC) requires that each TEE probe pass electrical leakage and safety testing before each use. Leakage testing ensures the electrical integrity of the device and verifies that the device is safe to use on patients. Testing can be completed with the use of a stand-alone ultrasound leakage tester with pass/fail indications, a numerical value of <100µA (IEC 60601), or an alternate value provided by the manufacturer. In the event of a leakage failure, test again to confirm. If there is a confirmed failure, remove the TEE from the solution and perform a corrective action. Passing TEEs can proceed to the High-Level Disinfection (HLD) process recommended by the manufacturer.

High-Level Disinfection
HLD is the final step in proper TEE maintenance. The IAC requires that each TEE probe pass HLD before each use. HLD consists of soaking the insertion tube in an approved disinfection solution, followed by a rinse and proper storage. It is important to note that you should not exceed the recommended soak time or submerge the entire TEE. The soaking solution should not reach the end of the insertion tube at the strain relief end. These actions may lead to damage of the TEE. The control housing, strain reliefs, cable, and connector should be cleaned by wiping thoroughly with an approved cleaning solution or approved wipes. 

Once HLD is complete, perform a rinse to remove any residue and dry the instrument with a clean, dry cloth. When possible, store the probe in a TEE-specific storage container or vertical hanging storage cabinet.

Consult the manufacturer for an approved list of solutions and recommended soak times. 

TEE Transport
TEE maintenance is often handled by sterile processing departments. The transport of TEEs between departments has added potential issues that could be detrimental to the instruments. Unfortunately, TEE transport has been known to take place in pillowcases, storage bins, and even by hand. Improper transportation can lead to unintended damage to the TEE. It is vital to put procedures in place to document the current disinfection stage in conjunction with a TEE-specific storage and transportation container. The process protects both the asset and the employees who handle it.

Moving TEE Maintenance Forward
Understanding proper TEE maintenance, educating all departments, and initiating a standard process will reduce the cost of ownership, minimize downtime, increase efficiency, and allow your institution to provide outstanding care to your patients. For more information about TEE probes and other medical equipment and services, call (800) 958-9986 or visit 

About Avante Health Solutions
Avante Health Solutions is moving healthcare forward. We are an industry-leading provider of diagnostic imaging, medical-surgical, patient monitoring, and ultrasound equipment. As a comprehensive provider, we partner with our customers from consultation and installation to service, repair, and ongoing technical support.