Prolonged exposure to high-concentration aerosols in a relatively closed environment may have the transmission of aerosols. The ventilator is prone to spreading of droplets or aerosols carrying pathogens during use, which invisibly increases the risk of infection probability. Now let Pigeon Medical introduce the infection prevention and control measures when ventilators are used for COVID-19 patients.
Virus is sensitive to ultraviolet rays and heat, so it can be effectively inactivated under 56°C for 30 minutes, or by some fat solvent such as ether, 75% (v/v) ethanol (alcohol-containing hand disinfectant＞60% (v/v), compound products can be based on product instructions.), chlorine disinfection agent (bleaching powder ≥20%, sodium dichloroisocyanurate ≥55%, 84 disinfectant according to the product specification, usually 2%～5%), peracetic acid (peroxyacetic acid (calculated as C2H4O3) mass fraction 15%～ 21%) and lipid solvents. Chlorhexidine cannot effectively inactivate viruses and should be avoided.
For confirmed or suspected patients, in order to avoid problems such as incomplete cleaning and disinfection, it is recommended to use disposable medical products, such as disposable pipeline; The water collecting cup is adopted an in-line device with a one-way valve; a disposable filter can also be installed; both inhalation and exhalation ends should be installed; passive humidification (heat and moisture exchanger with bacterial filtration function) is recommended for invasive ventilator (including transfer ventilator); or active humidification (heating humidifier with double heating guide wire) can be used; it can be considered to use the humidification tank with closed automatic water supply function, or use the self-made semi-automatic humidification tank water filling device. When using the non-invasive ventilator, the disposable exhalation valve should be used as far as possible instead of the mask integrated valve and platform valve. A filter can be added between the mask and the exhalation valve. When using the expiratory valve during non-invasive ventilation, the air leakage hole should not face the operator to avoid increasing the risk of aerosol transmission.
During the use of medical respiratory equipment, the external surface of the ventilator should be cleaned routinely, and it can be wiped and disinfected with 75% alcohol with good compatibility or disinfection wipes that meet the requirements; regarding the question of tube replacement, it is not recommended to replace the ventilator tube regularly, and it should be replaced in time when there is contamination or mechanical failure. When disposing of condensate in use, care should be taken to avoid accidental splashing of condensate, contaminating nursing staff or pouring into the patient’s airway. It is recommended to suspend ventilation according to the instructions of the ventilator before operation, and then directly disconnect the ventilator near the outlet end of the ventilator before operating. As the condensate contains high concentrations of pathogenic bacteria, it should be removed regularly. Regarding the suction device, the closed suction device can be the first choice, and the second choice can be the suction extension tube. Others such as the establishment of a cleaning and disinfection system as well as the adoption of hand hygiene can also promote the prevention and control of ventilator infection.