Long before the events of the past few years put a worldwide emphasis on guarding against viruses and dangerous bacteria, health care providers well understood the virtues of cleaning surfaces and guarding against pathogens.
But believe it or not, not all cleaning is created equally. Some chemicals one would expect to create a safe, sanitary environment may unintentionally work against that purpose. Let’s examine the nuances of cleaning and how to best maintain and emergency health care environment.
Many people use “disinfect,” “sanitize” and “sterilize” interchangeably. To a lay person, they simply sound like synonyms to be describe the use of stronger solutions to eliminate harmful microbes. It’s true that using certain chemicals, such as bleach and alcohol, will kill more germs than cleaning with soap and water, but there are notable differences between solutions intended to sanitize, disinfect or sterilize.
- Traditional Cleaning: Removes dirt and organic matter from surfaces using soap or detergents.
- Sanitizing: Kills bacteria on surfaces using chemicals, lowering the amount of bacteria to a safe level; not intended to kill viruses.
- Disinfecting: Kills viruses and bacteria on surfaces using chemicals.
- Sterilizing: Kills all microorganisms; used often in hospitals and performed by professional services or trained personnel.
As those brief descriptions indicate, the results of how we clean will vary depending on the intent of the specific solution or base chemicals used. When it comes to cleaning emergency equipment and environments, that matters.
What to use
Disinfecting products are ideal for emergency environments, especially ambulance, which can become rife with harmful pathogens following a shift or even a specific call. For example, a portable suctioning unit may be covered by bacteria such as staphylococcus or streptococcus, and viruses such as influenza or COVID-19 can survive in bodily fluids that remain in the unit.
Additionally, antimicrobial cleaners are generally preferred over antibacterial cleaners. The latter can also kill the “good bacteria” that is beneficial to our health. Click here for a list and overview of disinfectants by the CDC.
Cleaning in emergency settings
It’s not revolutionary to say health care settings require regular cleanings — especially in places where emergency treatment occurs and patients are in vulnerable states — but there are specific strategies to ensure you’re thoroughly cleaning and disinfecting locations.
These are a handful of best practices for general environmental cleaning techniques provided by the CDC:
- Visual assessment: Review the area. If the patient is present, would they post a challenge to safe cleaning, such as if you were planning to use bleach? Are there obstacles in the way, or broken furniture or equipment that should be reported? Are extra supplies or PPE required?
- High-touch surfaces: Pay special attention to these areas, which include bedrails, IV poles, sink handles, doorknobs, call bells, light switches and patient monitoring equipment.
- Cleaner to dirtier: There might be an instinct to clean the messier areas first, but that just spreads dirt, organic fluids and microorganisms to the cleaner areas.
- High to low: Cleaning from high areas to lower prevents falling dirt or microorganisms from contaminating areas that have already been cleaned (i.e., bed rails before legs and walls before floors).
- Systematic cleaning: Don’t clean haphazardly, moving from one area to another without any real intention. Try moving clockwise (or counterclockwise) in a room or ambulance. This way, you won’t miss any areas.
- Ambulances: Specific to vehicles, don’t forget to clean the outside of an ambulance, including high-touch surfaces, such as door handles. These areas can easily spread harmful pathogens.
Equipment is often more intricate than other surfaces in an emergency treatment area, as devices tend to have smaller parts and crevices where microorganisms may be hiding.
There should be manufacturer guidelines to explain how to best clean a specific piece of equipment. For example, these steps generally apply for portable suction devices:
- Disconnect the unit from its power source.
- Disconnect the battery from the PC board when cleaning the interior chassis.
- Discard all disposable parts, including the canister, tubing, and catheters.
- Dispose biohazardous materials appropriately.
- Use a mild detergent or a mixture of bleach and water (1 part bleach/10 parts water) and rinse thoroughly.
- Follow the instruction manual when disinfecting the mechanics of the unit.
- Never submerge the suction unit.
- Use disinfectant wipes to clean all outer surfaces, including control knobs, screens and handles.
Cleaning and disinfecting can be a rather tedious task, but it is vital to the proper management of a health care facilities or vehicles, as well as the health of patients and providers. With a proper plan and supplies in place, the task can be completed thoroughly and efficiently.