The proper maintenance of respiratory equipment

Clean medical inhaler
Photo by Mockup Graphics on Unsplash

When we talk about disinfection, we talk about the prevention and control of infection in the environment. Therefore, equipment used for respiratory therapy is considered semi-critical. The equipment must then be cleaned and disinfected properly between patients. The WHO gives us the proper maintenance of respiratory equipment in procedures to follow. The procedures are checklists in steps of a cycle. Let’s explore all the summarized steps up to the cycle finish. And yes, the cleaning step is before the disinfection step!

Checklists for care, cleaning, disinfection and sterilization of respiratory devices

1. Perform hand hygiene

The title and image say it all

2. Don appropriate personal protective equipment

The personal protective equipment to be worn during the disinfectant preparation includes surgical mask/respirator, googles/face shield, long-sleeved fluid resistant gown/gown plus apron, rubber gloves and boots or closed work shoes.

3. Wash with detergent and rinse with clean water

The external device surfaces must be wiped with a damp cloth or disposable wipe that is soaked in detergent and clean water. Then, remaining detergent residue must be wiped off with a dry lint-free cloth. A mechanical action (scrubbing/brushing) should be used to remove visible dirt deposits and calcifications.

4. Disinfect

4a. Physical disinfection – Heat for heat resistant equipement (steam/hot-water)

A high-level of physical disinfection can be achieved with steam (e.g. autoclaving at lower temperature) or hot-water at least 121°C. This is an inexpensive and effective method for sterilization or high-level disinfection.

4b. Chemical disinfection for plastic plus other parts that can be damaged by heat

b) If the disinfection needs to be with chemicals solutions, it should be performed in a well-ventilated area and away from patients. Use a disposable wipe or a fresh cloth that is soaked in a compatible disinfectant. Hydrogen peroxide 0.5% or ethanol 70-90%. Wipe from top to bottom and avoid contact with electrical connectors.

5. Dry equipment / Rinse equipment

a) Physical equipment often has a drying feature within the machine (e.g. washer, pasteurizer or autoclave). Following pasteurization, the wet equipment is typically dried in a hot-air drying cabinet or air-dried. Make sure to carefully inspect and ensure that no water is left in the equipment.

b) If a chemical solution was used for disinfection, rinse the equipment with sterile or clean water (i.e. water boiled for 5 mins and cooled down). It is preferred to use sterile water for rinsing off residual liquid chemical disinfectant from the respiratory device.

6. Store equipment in closed packages

Last step. Title says it all.

This was a summary of the Care, cleaning and disinfection of respiratory equipment in sterile services department’s article by World Health Organization.

This article is a free translation of WHO’s article.

Source:
World Health Organization
– https://www.who.int/publications/m/item/care-cleaning-and-disinfection-of-respiratory-equipment-in-sterile-services-department
– https://www.who.int/images/default-source/health-topics/coronavirus/care-cleaning-disinfection-of-respiratory-equipment.tmb-479v.png?sfvrsn=14530f0b_1

COVID-19 and the preventive measures.

2019-nCoV is making the headlines these days. What is the 2019-nCoV and what are the preventive measures? Up to now, we don’t fully understand the pathogenic potential and transmission dynamics of this new 2019 coronavirus.

Young woman with respiratory mask

What is it?

In a nutshell, it is part of the coronavirus family. It presents “80% of similarities” with the SARS (Severe acute respiratory syndrome) which killed hundreds of people in 2003. This virus does not spread as well as influenza and doesn’t evolve very quickly. The symptoms are the same as most flu cases: fever, cough, muscle aches, shortness of breath and difficulty breathing.

Last December, the coronavirus appeared in Wuhan, a city in central China. The cities of Wuhan and Huanggang have been quarantined. So far, it has killed 490 people in China and thousands of people have been infected. The virus has also been detected in 23 other countries. In order to limit its spread, measures are being taken in several countries. The WHO (World Health Organization) has declared this virus as an international emergency.

Yellow Crane Tower in Wuhan

What are the preventive measures?

Brief, here are some preventive measures for 2019-nCoV. As suggested by the WHO, the following are strategies for health care-associated infection prevention and control when a case of nCoV is suspected:

  1. Early detection and source control
    – Encouraging health care workers and managers to have a high level of clinical suspicion
  2. Application of standard precautions for all patients
    – Ensure that respiratory hygiene measures are taken by providing a medical mask in case of suspected nCoV infection for those who can tolerate it
    – Cover your nose and mouth by coughing or sneezing into a tissue or bent elbow
    Wash hands after contact with respiratory secretions
    – Wear personal protective equipment
    – Follow environmental cleaning and disinfection procedures consistently and correctly
  3. The implementation of empirical additional precautions
    – Wear a particulate respirator at least as protective as a NIOSH N95, EU FFP2 certified respirator or equivalent
    – Wear eye protection (goggles or face shield)
    – Use clean, non-sterile long-sleeved coveralls
    – Wear gloves and avoid contact with eyes, nose or mouth with potentially contaminated hands
    – Use disposable equipment or dedicated equipment to be disinfected after each use
  4. Administrative controls
    – Ensure sustainable infection prevention and control infrastructure and activities are in place
    – Provide training and education to health care workers and patients
  5. Environmental and technical controls
    – Ensure adequate ventilation and proper cleaning of the environment

So, do not hesitate to contact us for your needs and questions about our products or hygiene training.

For more details on 2019-nCoV, see the following sources:
https://ici.radio-canada.ca/nouvelle/1482141/coronavirus-chine-questions-reponses
https://ici.radio-canada.ca/nouvelle/1486752/coronavirus-chine-villes-quarantaine-transports
https://ici.radio-canada.ca/nouvelle/1482961/coronavirus-virus-chine-asie
https://www.cdc.gov/coronavirus/2019-nCoV/lab-biosafety-guidelines.html
https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200203-sitrep-14-ncov.pdf