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Sunday
Apr012018

VHF - 9 Disinfection in the Hot Zone

VHF – 9 Disinfection in the Hot Zone

When working in proper PPE/CPC inside the Hot Zone, which for your purposes is the isolation room/area of patient treatment, you have already satisfied the dress-out safety protocols and are now wholly concerned with actual VHF safety when treating these victims. Under ideal conditions, the highest area of contamination on your person should be the hands and feet. Since the feet/bootie concern is handled upon decontamination and Hot Zone exit, the hands present an additional issue from patient to patient contact if more than one patient is being treated in your theater.

If you likely do have more than one patient to care for, it soon is impossible to wear the number of glove layers to remove layers between patients for very long. During extended treatment, the solution is either to rinse/disinfect existing gloves, or cross contaminate between patients. Cross-contamination for many transmissible medical reasons is ineffective for proper patient care. Therefore, proper cleaning must be undertaken between patients while using the same medical gloves.

Install inside the isolation/treatment area an open bin container large enough to rinse and swirl gloved hands containing your original 1:10 bleach solution mixture. In between touching equipment or making contact with a different patient, rinse/swirl (slowly) your gloved hands in this mixture for one (1) minute before switching between patients. Repeat this procedure every time you change from patient to patient. This will eliminate cross-contamination between patients in your isolation ward.

This shall be an almost continuous process for you as the caregiver on an increasing basis. As patients become sicker they will require multiple contacts between your staff until they reach the stage where the illness creates the inability to move about and pain becomes overwhelming. During this time, blood and discharge is likely to increase and become higher in volume. This will become a challenge for your disinfection process.

When your treatment gloves are visibly soiled, they must be lightly washed in soapy water before the bleach solution is used. This means that a second vessel bin (containing soapy water) must be placed in the Hot Zone isolation/treatment area before patient treatment has begun. These “bins” can be accomplished within the isolation area by having multiple sinks if available.

Whichever system is used, when these bins/sinks become contaminated they must either be serviced by your bio-waste personnel or Hot Zone/isolation patient treatment personnel. If your facility has a chemical drain system for this continuum, treatment staff may safely drain the contaminated sinks and re-fil them with fresh soapy water and fresh 10% bleach water solution.

The issue of drying gloves creates its own set of issues. If your staff decides to use paper towel, laundry towels, or a blow air dry system each has downsides. When using towels, paper one-use is recommended, however this creates a huge amount of waste that must be handled on-site. This may increase the work load on your waste handling staff. Be sure to account for this increase in work load to your personnel numbers and rotation system. Re-use toweling decreases waste but increases waste worker load as these towels now need to be appropriately laundered using the waste worker guidelines. Lastly, an air blow dry system alleviates these stresses, but may negatively affect your negative pressure isolation area. Depending on your location and operational set-up, each of these hand dry systems may fit into your operation. Choose wisely,

Haz Mat Mike

 

 

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