Vesuv Blog
Protocols
Updated on
September 30, 2023
What is a sanitary disinfection?
Disinfection is an essential process that every paramedic must be capable of performing daily. This process must be implemented following certain well-defined steps.
Disinfection is a process of deliberate and temporary removal of certain germs in order to stop or prevent the risk of infection by pathogenic microorganisms or viruses or unwanted products.
Disinfection involves eliminating these microorganisms or inactivating pathogenic viruses from contaminated environments by modifying their structure or inhibiting their metabolism or certain stages of their vital functions.
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Description of a simple disinfection
It must be performed between each patient transport. It consists of changing the bedding: fabric or paper sheets. This bedding will be removed and confined in a sealed bag to limit the spread of germs and/or microorganisms. The stretcher will be disinfected on the surface using a disinfectant detergent and a wipe, taking care to use disposable gloves and follow product usage instructions.
These instructions are specific to each manufacturer (application time, dilution, etc.). The wiping will be done following the path of the letter 's' to avoid contaminating a cleaned area to another. Each element that may have come into contact with the patient will be disinfected (handle, barrier, walls of the ambulance…). This same procedure must be applied to any equipment used during the intervention: cervical collar, measuring device, etc...
The wipe and gloves used will be thrown into a closed bag intended to be disposed of as soon as the ambulance returns to its base or to the healthcare facility or establishment.
Description of a daily disinfection
This operation must be carried out every day, at the end of transports, when tidying up the ambulance, or between each crew change day-night. The same simplified disinfection method must be applied to all equipment: stretcher, walls, cabin. Each element that may have come into contact with the paramedic or patient must be cleaned.
This operation will be complemented by a floor cleaning operation. The technique of the two buckets, red and blue, well known to paramedics, will be applied.
The red bucket will be filled with water mixed with disinfectant detergent. Always pour in this order: water then the product. The dilution rate of the product, recommended by the manufacturer, must be respected. Under no circumstances should this rate be increased. Not adhering to these recommendations, whether upwards or downwards, would lead to a reduction or even ineffectiveness of the product.
When using a wipe, it is dipped in the bucket of product (red bucket) and then the product is applied from clean to dirty as seen previously (S-shape pattern). Do not return to a cleaned area to avoid re-contaminating it. The wipe is then rinsed in the blue bucket to eliminate germs and dirt before being dipped in the disinfectant solution bucket. Once the disinfection of the walls and equipment is completed, finish with a wet sweep of the floors. Start by vacuuming the dirt with the vacuum cleaner. Keep the motor of the device outside of the ambulance to avoid contamination from dust produced by the motor and filters.
Ambulances have washable interiors and coverings that are resistant to usual disinfection methods. For VSLs, the interior linings are also washable and resistant to classical disinfection processes.
Weekly disinfection with misting
This follows the same principle as the previous operations, with the difference that at least two or three people will be involved for at least an hour. First, completely empty the sanitary cell. All mobile equipment must be taken out.
The stretcher will be taken out for a complete disinfection. The two-bucket method will be implemented. Failing that, the use of a disinfectant detergent spray can be employed. The product used must remain in contact long enough to be as effective as possible. As previously mentioned, a poor dilution rate, whether too high or too low, also decreases its effectiveness. Care should be taken to use disposable gloves which will therefore be discarded at the end of the activity. Maintenance begins with cleaning the drawers and cabinets. Continue with fixed devices, then walls, and finally the floor. The driver's cabin must also be completely disinfected.
Everything must be disinfected. Not a single area should be forgotten. Once the wet sweeping is done, a disinfection operation by misting can be carried out. The misting technique sprays a disinfectant after a complete cleaning of the ambulance and its surfaces. The misting device is installed in the ambulance according to the manufacturer's instructions. The misting is started while respecting the indicated time for better effectiveness. The doors must be closed. Make sure not to stay in the vehicle. Once the operation is completed, the cell must be aired. The products used may be harmful, do not breathe them in. The misting operation is often performed using a "ladybug" (see description below).
During airing, take the time to clean the items removed from the cell before putting them back in their designated drawers or cabinets. Take this opportunity to check the proper functioning of the equipment, expiration dates. Misting is done after transporting a patient in isolation and systematically once every fifteen days.
Disinfection protocol by ladybug
The "ladybug" is the name of the misting device whose shape resembles the famous insect. It is particularly used by paramedics to achieve aerial decontamination. The machine sprays millions of micro-droplets over all targeted surfaces. Once the spraying operation is completed, the product must be allowed to act for 20 minutes. Then, the cabin must be aired for at least half an hour.
Cleaning emergency equipment
The equipment must be immersed in the disinfectant liquid for 30 minutes.
During this time, brush all clothing and accessories, not forgetting hard-to-reach areas, even if it means disassembling some pieces. In the tubes, a swab should be used for proper cleaning.
Then rinse and dry the parts and finally store them away from dust.
At the end, the liquid is disposed of, the basin is cleaned and dried. For fragile parts that cannot withstand the immersion protocol, a disinfectant detergent should be applied directly.
Finally, proceed to reassemble the various parts of the equipment (like the valve of the ventilator, for example) paying attention to the orientation. Then check the good working condition.
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List of mandatory equipment in ambulances and VSLs
Disinfection logs
To effectively combat the development of germs and guarantee patients a service of impeccable quality, cleaning and disinfection logs are mandatory. They must be monitored and traced, especially for the following operations:
- protocol implemented between each transport,
- weekly protocol for complete cleaning and disinfection,
- disinfection on request, for example before transporting a fragile patient or after transporting a patient reported as contagious.
The chronological recording of all cleaning and disinfection operations must be carried out in the company and kept for presentation during inspections by the competent authorities (ARS) or at the request of prescribers or even patients themselves.
The traceability of disinfection is mandatory. In the absence of a digital solution to record the operations carried out, the presence and completion of the disinfection log is mandatory. It is specific to each vehicle. It contains the note of each operation performed daily. The ARS has the authority to verify the traceability of these disinfection operations.
The digital platform Vesuv allows you to dematerialize your disinfection procedures and ensure long-term traceability of the documents and operations carried out.
For more information on this link: discover Vesuv
Specific COVID-19 procedure
In the ambulance, to avoid contaminating the equipment, it is necessary to seal the drawers and various equipment. It is also important to eliminate any physical communication between the
