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VHF 5 - Disinfectant Solutions

          What do we need to Disinfect? Disinfection kills almost all disease causing germs. It reduces the number of microorganisms to make all equipment and surfaces safer for use. Since VHF agents are “Splash” protective reagents and NOT “airborne” exposures, every object that could make contact with or be in the close proximity of the VHF agents must be disinfected to reduce cross-contamination.

Probably the most dangerous cross-contamination issue involving VHF incidents affects the entire crew at a health care facility. In addition to the medical treatment staff, which we speak of in detail, little focus is often given to the remaining staff that is frequently left out of the operations “lime-light”. These are the support personnel that keep the behind the scenes operation looking so good to outsiders. ALL operational STAFF should disinfect. These are;

1] Laboratory Staff

2] Cleaning/Laundry Staff

3] Waste workers (Staff or Contract)

1] The hospital facility laboratory staff is the operational personnel that receive little accolades, but perform the primary task of ID (Identification). Imagine attempting hazardous material mitigation without first identifying the hazard? Your operation would end before it began in most cases, and end in failure. These folks are the ones that give the medical staff the correct information to base their treatment decision making on. The Laboratory Staff is directly included in the emergency response and need notification at the same time Emergency Room Staff are. They have the need for an isolation area to perform needed tests, the same PPE/CPC dress-out procedure, Decontamination area and procedures, all BEFORE the sample arrives in the Lab to undergo testing analysis. Your Lab Staff need direct inclusion in all emergency response operational training. After the emergency room receives notification of an incoming VHF patient, before operations begin, the laboratory MUST be notified to begin a parallel operational set-up before the patient comes into the Emergency Room Entrance.

2] In a large scale contamination, which this type of exposure will quickly become, disposable support supplies will NOT be able to sustain the operation. Either the supplies will dwindle, or too much waste to handle effectively and safely, will be sustainable in a safe protocol to resist cross-contamination expectations. Therefore, The Cleaning Laundry Staff will soon be operating at a high rate of performance and include; Staff Manpower, Equipment, Disinfection supplies, and rotational replacement for these needs on an 8hour per shift basis. Their inclusion in the initial response notification and Training, should parallel the Laboratory Staff. Disinfection Solutions (which we will discuss in the coming weeks), shall be prepared BY THE CLEANING STAFF ON-SITE. This will facilitate replenishment, supplies, isolated area for preparation, as well as proper PPE/CPC by the cleaning staff. Not only will the cleaning staff need to handle waste and laundry from the ER, isolation rooms, and laboratory, but they will need to handle their own waste from their personnel operations. This frequently encompasses an area, staff, and disposal to contractors on an epic scale which surpasses the normal hospitals operation for the cleaning staff. Remember, normal hospital operations shall be happening at the same rate and time as your emergency operations. This may double the cleaning staff needs to handle this size of a work load. Each facility is different thus demonstrating the need for massive pre-planning of work space and personnel BEFORE any patients/waste are handled.

3] Waste workers are subject to these same guidelines whether they are on-site employees or outside contractors. On-site employees may be integrated into the cleaning staff, as this type of waste operation is closely linked to the cleaning staff duties. Contractors, on the other hand, may use portable facilities temporarily located on-site at your facility, or integrate into yours if they are providing services that integrate with cleaning staff and involve more than waste removal. Either way, they typically operate under more controlled situations and are not subject to time concerns. This could be a major issue with your normal functioning. Therefore careful consideration must be made to the particulars before integrating these contractor services with your personnel. Some may not be able to integrate with your Team operations on a short notice. If this is your option, then close training and exercise operations must include your contractor.

Disinfection includes;

1] Hands and skin after contact with a VHF patient or body fluids. *Appreciate that any skin contact now designates a health care worker as exposed and becomes an isolation patient.

2] Gloved hands after each VHF patient, or infectious bodily fluids. *If it can be integrated into your CPC “ensemble’” multiple glove pairs may be effective.

3] Any re-used medical equipment after each VHF patient. *mechanical devices only IF they are moved out of the initial isolation area to be used with non-infective patients.

4] Spills of infectious body fluids on walls and floors. *Increased time for disinfection next month.

5] Patient excreta & containers contaminated by patient excreta. *Same as above.

6] Re-usable supplies such as protective clothing, patient bedding, etc., *Shipped to Laundry Team.

7] Used needles/syringes/or any invasive technology used. *Disposable must be placed and held separate from hospital bio-waste containers and area for future waste disposal.

The end game of disinfection becomes, all health facility staff – including cleaning, waste disposal, and laundry staff – who handle, disinfect, or clean VHF – contaminated supplies and equipment should wear the same level of protective clothing as those health care workers delivering direct patient care. ALL related workers are at risk for the exposure to VHF!

Next month, we shall look at the actual Bleach solution preparations used in this procedure. Join us again.

Haz Mat Mike


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