Sponsored by Decon7 Systems
By Rachel Zoch, EMS1 BrandFocus Staff
The COVID-19 pandemic has highlighted gaps in EMS protocols, especially when it comes to disinfecting the ambulance. Less than half of respondents in a 2018 EMS1 survey said the patient care compartment was decontaminated after every call or transport. In the midst of the coronavirus pandemic, it’s critical to disinfect thoroughly every time.
By May 29, 2020, more than 1.7 million people in the U.S. had tested positive for the virus, and more than 101,000 – including EMS providers and other first responders – had died from the disease. With an estimated reproductive number (R0) of 2.5, which means each infected person is likely to infect two or three more without intervention, it’s critical that EMS providers take precautions to protect themselves, as well as future patients, to avoid spreading the highly contagious virus.
Here are five keys to effectively disinfecting the ambulance after transporting a patient with COVID-19, based on guidelines published by the CDC in March 2020 [1]:
1. ESTABLISH AND FOLLOW A CONSISTENT PROCEDURE
An April 2020 survey of EMS providers across the U.S. revealed that inconsistent protocols could be contributing to the spread of the virus. The CDC recommends that EMS agencies establish environmental cleaning and disinfection procedures and ensure that they are followed consistently and correctly. This includes the use of chemical disinfectants with adequate ventilation. Doors should remain open when cleaning the vehicle to allow air exchange.
Standard operating procedures for decontaminating the patient care compartment between each patient should include thorough cleaning and disinfecting of all surfaces and reusable patient-care equipment that may have come in contact with the patient or been contaminated during the call (stretcher, floors, walls, monitors, etc.).
It’s important to remember that pathogens and contaminants can easily find their way into the front seat as well, so both compartments should be cleaned and decontaminated frequently as a key health and safety measure. Be sure to use an EPA-registered hospital grade disinfectant in accordance with the product label, such as D7 from Decon7 Systems, which has demonstrated effectiveness against viruses similar to the coronavirus that causes COVID-19.
2. WEAR PPE
Providers should wear full PPE from start to finish on any call where COVID-19 is suspected. The suggested COVID-19 PPE ensemble includes a disposable gown, N95 mask, eye protection, gloves and face shield. Providers should retain the full PPE ensemble while disinfecting the patient care compartment, as many disinfectants can irritate skin, eyes and mucous membranes.
Be sure all personnel know how to properly doff and contain contaminated gear. Remove the gown and gloves first, then facial protection. Place all PPE in a red biohazard bag, then seal and dispose of the soiled gear in a proper receptacle. Be sure to wash your hands early and often during this process.
3. PROVIDE VENTILATION
Light and air can be key allies in the fight against airborne virus particles. The CDC guidelines recommend leaving the rear doors of the ambulance open after transporting the patient to allow enough air exchange to remove potentially infectious particles. The time to complete transfer of the patient to the receiving facility and complete all documentation should provide sufficient air exchange.
But airborne particles are only a fraction of the threat. Airing out the patient care compartment does not address surface contamination, which requires the application of a broad-spectrum disinfectant.
4. USE AN APPROVED DISINFECTANT
It’s important to choose your disinfectant carefully. Not all cleaning products are suitable for this purpose. Some, like bleach, can create noxious fumes or damage equipment, and many are not effective in destroying infectious pathogens like the coronavirus.
The broad-spectrum D7 solution has proved effective for ambulance decontamination. The patented disinfectant formula can neutralize various contaminants, including viruses similar to those that cause COVID-19, within minutes when properly applied, because the detergents in the formula break down the outer shell of the viral particles so it can break down the genetic material inside.
Hydrogen peroxide is a key active ingredient of D7, and the detergents not only help the formula cut through grease, grime and biofilms like mucus, they also enable it to break easily into droplets that can get into contaminated nooks and crannies that are hard to reach and clean. Also, unlike bleach, the D7 disinfectant formula can be applied to a variety of surfaces, including plastics and metals, and it creates no noxious fumes or odors.
The three-part D7 formula, like most broad-spectrum disinfectant products, must be mixed at the time of use. The disinfectant can be applied on hard, nonporous and porous surfaces via foaming apparatus, low-pressure sprayers, mopping and soaking systems, and it is available in both bulk liquid and a ready-to-use unit.
Although D7 complies with environmental regulations, it is not FDA-approved for use on your skin. Users should wear gloves and goggles, plus a mask and protective clothing when applying the solution in close quarters.
5. MANAGE SOILED LINENS
D7 can also be used on soiled linens and uniforms, and unlike chlorine bleach, it is colorfast, biodegradable and will not degrade fabrics.
EMS agencies should review and follow standard operating procedures for containing and laundering used and soiled linens, including uniforms. The CDC recommends that you avoid shaking any soiled linen and instead carefully bag it like soiled PPE.
By taking these precautions to protect themselves, as well as future patients, EMS providers can avoid spreading this highly contagious virus.
Get more information from Decon7 Systems.
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REFERENCES
1. Interim Guidance for Emergency Medical Services (EMS) Systems and 911 Public Safety Answering Points (PSAPs) for COVID-19 in the United States, https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-for-ems.html, updated March 10, 2020.