Docstoc

o O o O doc scalding

Document Sample
o O o O doc  scalding Powered By Docstoc
					   About Disinfection




Infectious Disease Control Department
    Osaka City Public Health Office
                             Wash your hands well.

Important!
                    Hand washing is the basis for the prevention of infectious diseases.
                                                             effect.          cleaning
                    Soap itself does not have a disinfection effect. However, cleaning
                    your hands may get germ and virus off your hands and fingers.
                                                           your
                        let’
                    So, let’s wash your hands well.


 When should you wash hands?

          When coming home.
          After using a toilet.
          Before cooking.
          Before eating.
          When looking after a sick person with vomiting and
          diarrhea.
          After changing a diaper.
          After taking off disposable gloves.

 The parts we usually miss.

   Back                                                                                                               Palm




                          Dirt remains most frequently.                      Dirt remains frequently.

             Source: Manual for Preventing Hospital Infection 2001, under the editorship of Japanese Society of Environmental Infections

 Where dirt may remain.
    Fingertips                              Between fingers                                  Around thumbs
    Wrist                                   Line on hands

                                                                      1
How to wash




  Remove your watch,   Make the lather     Wash palms and the
  ring, etc.           with running        back of hands.
                       water and soap.




   Wash between        Wash thumbs         Wash fingertips and
   fingers.            as well.            nails.




   Wash wrists.        Wash the tap with    Rinse well with
                       soap.                running water.


                                 2
              Acute infectious gastroenteritis with norovirus

Why is it so infectious?
Feces and vomit from infected persons contain a lot of
virus, and you may get infected with a relatively
                 virus.
small amount of virus.
Therefore, if you touch the hands and fingers of an
infected person or some contaminated object, you
may get infected orally through your hands.
Even after the symptoms resolve, norovirus can
survive in the body from a week to a month, come out
with feces, and infect people later.


     Key points about disinfection
 Disinfection effective in killing norovirus includes chlorine disinfectant
 (sodium hypochlorite) and heating (at 85 for more than 1 minute).
                                                       effect.
 Alcohol for disinfection and/or cationic soap has no effect.



     How to dispose of feces and vomit
 Required materials

          Disposable gloves and a mask              Paper towels, newspapers or
                                                    disposable towels




          1,000 ppm chlorine disinfectant           Two plastic bags which can be tied
        (See p. 10 for the procedure for diluting   up
        the disinfectant.)




                                               3
                        Your trash bag should be opened wide for
                        easy operation.

                        It is a good idea to use a bucket or a trash
                        can.




 Remove your watch, ring, etc. and put on
 gloves and a mask.



                     Cover feces and vomit with newspapers or
                     paper towels, and pour 1,000 ppm chlorine
                     disinfectant on top. Then, wipe off gently.


                        When feces and vomit are dried, viruses
                        may drift in the air and infect you. You
                        should dispose of soiled material as
                        quickly as possible before they get dry.



                         Chlorine   disinfectant   may   decolorize
                        objects.



Wipe dirty floors and walls with paper
towels socked in 1,000 ppm chlorine
disinfectant.

  Chlorine disinfectant may rust metal.
  When cleaning metal, wait for about 30
  minutes and then wipe it off with water.




                               4
                      Put paper towels and other material with
                      feces and vomit (see Fig. 3 and 4) into a plastic
                      bag at once.




Pour 1,000 ppm chlorine disinfectant into the
plastic bag so soiled matters inside are soaked
well. Then tie the bag at the top.




                                      Put the plastic bag with the
                                      top tied up into another plastic
                                      bag (see Fig. 1). Take off gloves
                                      inside out and put them into
                                      the same bag, being careful not
                                      to touch the dirty side of the
                                      gloves. Then tie the bag at
                                      the top and throw it out.




 Finally, wash your hands well.




                                  5
      How to dispose of diapers
                              You should dispose of diapers in the same
                              way as feces and vomit. After changing a
                              diaper, fold it to wrap the contents inside
                              immediately with great care not to splatter
                              and put it into a plastic bag. In case you
                              change diapers for several persons, you
                              must change your gloves each time.


     How to dispose of dirty clothes with feces and vomit

Soak the clothes in 500 1,000
ppm chlorine disinfectant (dilute
50 – 100 times in case of 5%
concentration) for more than 30
minutes. After that, wash as you
usually do. However, you should
wash them separate from other
persons’ clothes.

Or, boil the clothes in scalding
water (at 85    for more than 1
minute).

  Chlorine disinfectant may
  decolorize.

   How to disinfect a toilet, doorknobs, etc.
                        Clean toilet seats, flushing levers, doorknobs,
                        floors and walls around toilet seats, handrails,
                        etc. using 500 1,000 ppm chlorine disinfectant
                        frequently.


                              Chlorine disinfectant may rust metal.
                              When cleaning metal, wait for about 30
                              minutes and then wipe it off with water.
        How to disinfect eating and cooking utensils


                                                After washing well with
                                                detergent, soak them in 200
                                                ppm     chlorine    disinfectant
                                                (dilute 250 times in case of 5%
                                                concentration) for more than 5
                                                minutes or boil them in
                                                scalding water (at 85         for
                                                more than 1 minute).




        Other instructions
       bathing
When bathing, wash your buttocks first.
If you are suspected of having an infection,
you should just take a shower. Take a
shower last in your family for about a week
after you have recovered.




                          Use towels and facecloths for your exclusive
                          use. Do not share them with other family
                          members.




         swimming,
 Before swimming wash your body well
 especially buttocks.
 When people are bathing in a wading
 pool, replace the water frequently. You
 should use fresh water every time.
 If you have diarrhea, never bathe in the
 water.


                                            7
            Enterohemorrhagic Escherichia coli infections, such as O157
             nterohemorrhagic
                    mor                                    such




Why so vulnerable to infection?

 You may get infected orally from contaminated
 foods or by touching objects contaminated with
 feces from an infected person. In this case, just
 100 of bacteria are enough to cause an infection.
 Therefore, enterohemorrhagic Escherichia coli
 is highly contagious.




      points       disinfection
  Key points about disinfection
Effective disinfectants are cationic soap, ethanol for disinfection,
chlorine disinfectant (sodium hypochlorite), ampholytic surface-active
agent and heating.


  How to dispose of dirty clothes with feces
                                        Remove your watch, ring, etc. and
                                        put on disposable gloves.

                                        Soak the clothes in 500 – 1,000
                                        ppm chlorine disinfectant (dilute
                                        50 – 100 times in case of 5%
                                        concentration) for more than 30
                                        minutes. After that, wash as you
                                        usually do. However, you should
                                        wash these clothes separately from
                                        other clothes.
                                        Washing clothes in scalding water
                                        is also effective.

                                             Chlorine    disinfectant     may
                                           decolorize.

                                    8
     How to disinfect toilets, doorknobs, etc.

                           Clean toilet seats, flushing levers, doorknobs,
                           handrails, etc. periodically and wipe them using
                           cationic soap or ampholytic surface-active agent
                           of 0.1 – 0.2% concentration.

                           Disinfectant spray and sprinkling are not
                           suitable.
              disinfect
       How to disinfect eating and cooking utensils
 Immediately after use, thoroughly wash kitchen knives, plates, utensils,
 chopping boards, dishcloths, scrubbing blushes, etc. with detergent and
 running water. After that, soak them in 200 ppm chlorine disinfectant
 (dilute 250 times in case of 5% concentration) for more than 5 minutes or
 pour scalding water on them. Or, soak them in scalding water at 80 or
 more for more than 10 minutes. Dry them well after disinfection.


                         Chopping board;
                          (1) Use separate chopping boards for meat and
                              fish and for vegetables, fruits and cooked
                              foods.
                          (2) Do not use flawed, old chopping boards
                              because the surfaces are difficult to clean.

                                  knives;
                          Kitchen knives;
                             Use separate kitchen knives for meat, fish,
                             vegetables and fruits.




        Other instructions
Please refer to “Other instructions” on acute infectious gastroenteritis with
norovirus.
                           How to dilute disinfectant

         Please be sure to confirm the concentration of
                             diluting.
         disinfectant before diluting.
         ●
 In case of chlorine disinfectant

Concentration
                                1,000 ppm disinfectant                                        200 ppm disinfectant
of disinfectant

                  Dilute 10 times.                                             Dilute 50 times.
     1%
                   110 milliliters undiluted disinfectant in 1 liter water .    20 milliliters undiluted disinfectant in 1 liter water .

                  Dilute 50 times.                                             Dilute 250 times.
     5%
                   20 milliliters undiluted disinfectant in 1 liter water .     4 milliliters undiluted disinfectant in 1 liter water .

                  Dilute 60 times.                                             Dilute 300 times.
     6%
                   17 milliliters undiluted disinfectant in 1 liter water .     3.3 milliliters undiluted disinfectant in 1 liter water .

                  Dilute 100 times.                                            Dilute 500 times.
    10%
                   10 milliliters undiluted disinfectant in 1 liter water .     2 milliliters undiluted disinfectant in 1 liter water .

                  Dilute 120 times.                                            Dilute 600 times.
    12%
                   8.4 milliliters undiluted disinfectant in 1 liter water .    1.7 milliliters undiluted disinfectant in 1 liter water .

                                                                                       1 liter                      iliters
                                                                                                                milliliter
                                                                                                          1,000 milliliters
   Standard guide
    Use a 500 milliliters plastic bottle to dilute disinfectant in a bucket.

   [Example] Using 5% chlorine disinfectant
    (Usually marketed as bleach.)

                        (by
   200 ppm disinfectant (by diluting 250 times)

                                   A cap of a plastic bottle
                                                                                                                        2 plastic bottles of
                                   (about 5 milliliters)
                                                                                                                        water (500
                                                                                                                        milliliters each)


                          (by
   1,000 ppm disinfectant (by diluting 50 times)

                                     2 caps of a plastic                                                                A plastic bottle
                                     bottle (about 5                                                                    of water (500
                                     milliliters each)                                                                  milliliters)


                                                                  10
            Warning on using chlorine disinfectant
                             chlorine


      Be careful not to touch or get it in your eyes.
      Chlorine disinfectant may decolorize clothes.
      Iron and metal plating may rust or lose color.
      Ventilate well.
      Do not use with acid chemicals (such as mild acidic cleaner for
      toilets).This can produce a highly toxic gas.
      When stored for long periods, the chemical concentration may
      decrease. Use chlorine disinfectants as soon as possible. Store it in
      dark cold place out of the reach of children.
      Dilute each time you disinfect.



How to dilute disinfectants other than chlorine

  [Example] Diluting 10% cationic soap to make 1 liter of 0.2% soap
  solution.
  solution.

             10                   0.2
    10% =            ,   0.2% =       ,     and 1 liter = 1,000 milliliters.
             100                  100

  When using 10% cationic soap of A milliliters,

            10                            0.2
                        milliliters)
                       (milliliters
                   × A (milliliters)               1,000 milliliters
            100                           100
  Therefore,
               milliliters)
      0.1 × A (milliliters)
              (milliliters       0.002 × 1,000 milliliters
               milliliters)
      0.1 × A (milliliters)
              (milliliters       2
               milliliters)
              (milliliters
            A (milliliters)      2 ÷ 0.1
               milliliters)
              (milliliters
            A (milliliters)      20

  To make cationic soap of 1000 milliliters;
    1,000 milliliters        20 milliliters            milliliters)
                                                      (milliliters
                                                  980 (milliliters)
      Put 20 milliliters of 10% disinfectant in 980 milliliters of water.



                                       11
                             Effectiveness of disinfectant and classification for use


Microbicidal spectrum of main disinfectant
                                                                Source: Infectious Diseases Manual issued by Tokyo Metropolitan Government

                                                                                                                   Virus
                                Viable         Pseudomon
 Class of                                                 Tuberculosis
             Disinfectant        bac-              as                        Spore       Fungus
effective-                      terium    MRSA aeruginosa bacterium                                    Envelope                  Hepatitis
   ness                                                                                                                   HIV    B virus
                                                                                                      Non-
                                                                                                              Existent
                                                                                                     existent
High Glutaral
             Sodium
             hypochlorite
       Ethanol for
Midium
       disinfection
             Povidone
             iodine
             Cresol and
             soap solution
     Ampholytic
     surface-active
     agent
     Quarternary
 Low ammonium
     salt

             Chlorhexidine
             gluconate

                   Effective,            Sometimes less effective,           Ineffetive,          Drug-resistant strain exists




Classification for use of main disinfectant
                                                 Source: Infectious Diseases Manual issued by Tokyo Metropolitan Government
                                                                            Instruments
   Class of                                                                            Finger Mucous Excretory
effective-ness               Disinfectant                  Environment
                                                                         Metal Nonmetal skin membrane substance


   High Glutaral
                 Sodium hypochlorite
                 Ethanol for disinfection
  Midium
                 Povidone iodine
                 Cresol and soap solution
                 Ampholytic surface-active agent
    Low          Quarternary ammonium salt
                 Chlorhexidine gluconate

                                                                   Usable,          Usable with caution,                 Unusable

                                                               12
                                         Guide to disinfection and sterilization
 Grouping
                                                                    Service
                   General name          Trade name                               Intended end-usage                   Remarks
                                                                 concentration
                 Glutaral              Sterihyde             2      3.5           Endoscopes                      Avoid liquid adhesion! (It
Aldehyde-based



                                       Steriscope                                 Medical instruments             may cause chemical
                 (Glutaric aldehyde)
                                       Cidex                                      contaminated with               damage.)
                                                                                                                  Avoid exposure to steam!
                                       Cleanhyde                                  virus
                                                                                                                  (It may irritate mucosa.)
                                       Glutohyde                                                                    Ventilate well.
                                       Stericorl                                                                    Use in a dipping bottle
                                       Sterisol                                                                     with a cap.
                                       Solesol L                                                                    Do not use it for wiping
                                       Denthyde                                                                     and spraying.
                                       Washlite                                                                   After application,
                                                                                                                  endoscopes need to be
                                                                                                                  rinsed well with water.
                 Sodium                Milton                0.01     0.0125      Feeding bottle              Soak for 1 hour after
Chlorine-based




                 hypochlorite          Purithan P            (100     125 ppm)    Prescription container      cleaning.
                                       Texant                                     Corrugated tube
                                       Hyporite                                   Cup for medical
                                       Purelox                                    solution
                                       Yakulax D             0.02                 Eating utensils,            Soak for more than 5
                                                             (200ppm)             chopping board              minutes after cleaning.
                                                                                  Linen                       Soak for more than 5 minutes
                                                                                                              after cleaning, and then rinse
                                                                                                              with water.
                                                             0.05         0.1     Linen and                   Soak for more than 30
                                                             (500         1,000   instruments                 minutes after cleaning.
                                                             ppm)                 contaminated with
                                                                                  virus
                                                                                  Environment                 Use for wiping. However,
                                                                                  contaminated with virus     after applying to vulnerable
                                                                                  (In case that no visible    materials, they need to be
                                                                                  blood contamination
                                                                                                              wiped with water.
                                                                                  exists.)
                                                             0.5    1             Blood contaminated          Wipe up using gauze
                                                             (5,000   10,000      with virus on floor, etc.   infiltrated with this
                                                             ppm)                                             chemical.
                 Ethanol for           Ethanol for           Undiluted            Hands                            Do not apply to mucosa
Alcohol-based




                 disinfection          disinfection          disinfectant         Skin                             and compromised skin.
                 70% isopropanol       Isopro solution for                        Skin subject to                  Do not apply to injured
                                       disinfection (70%)                         surgery                          or damaged fingers. (It
                                       Isopro solution                            Ampule/vial for                  may irritate.)
                                       (70%)
                                                                                  injectable solution              Please note that this
                                       Isopropanol
                                       solution (70%)
                                                                                  Doorknob, faucet                 disinfectant is
                                       Isopropyl alcohol                          Toilet seat                      flammable.
                                       solution (70%)                             Cart
                                                                                  Medical instruments
                 Povidone iodine       Isodine               Undiluted            Skin and mucosa                 Do not apply to abdominal
Iodine-based




                                       Neojodin              disinfectant         subject to surgery              cavity and chest cavity. (It
                                       Iodine                (10%)                Wound                           may cause shock.)
                                                                                                                  Do not apply to a burned
                                       Tokai povidone                             Burned skin
                                                                                                                  patient, (20% of body
                                       Negmin                                     Infected skin                   surface area burned ) or
                                       Haipopiron                                                                 patient with kidney
                                       Hisiiode                                                                   damage. (Heavy use may
                                       Hypojin                                                                    cause adverse effects.)
                                       Povidone                                                                   Do not generally apply to
                                       Povidoneiode                                                               low birth-weight babies.
                                       Popyiode                                                                   (Heavy use may cause
                                       Popiyodon                                                                  adverse effect.)
                                                                                                                  Use disinfectants
                                       Popyral solution                                                           sparingly in operative
                                       Polyiodine                                                                 fields. Otherwise,the
                                       Bongol                                                                     disinfectant may collect
                                                                                                                  between the patient and
                                                                                                                  the surgical bed. Contact
                                                                                                                  with the liquid for long
                                                                                                                  periods may cause
                                                                                                                  chemical damage.




                                                                          13
  Grouping
                                                                             Service
                                    General name      Trade name                           Intended end-usage             Remarks
                                                                          concentration
                                                    Isodine for          Undiluted         Hands, skin               For disinfection of
                                                    surgical purpose     disinfectant      Skin subject to           fingers, do not use too
                                                    Neojodin for         (7.5%)            surgery                   frequently. (To prevent
                                                    surgical purpose     (Containing                                 damage to skin.)
                                                    Popiyodon for        cleaning agent)                             Do not apply to mucosa
                                                    surgical purpose                                                 and wound. (Cleaning
                                                                                                                     agent has toxicity.)
                                                                                                                     Do not use for
                                                                                                                     disinfection for
                                                                                                                     operative field from
                                                                                                                     neck up. (If putting in
                                                                                                                     eyes or ears, cleaning
                                                                                                                     agent has toxicity.)
                                                                                                                     When using for
                                                                                                                     disinfection for
                                                                                                                     operative field, do not
                                                                                                                     use too much so that
                                                                                                                     disinfectant is collected
                                                                                                                     between a patient and a
                                                                                                                     surgical bed (Contact
                                                                                                                     with liquid for long
                                                                                                                     hours may cause
                                                                                                                     chemical damage.)
                                  Alkyl polyamino   Tego-51              0.01    0.05      Mucosa subject to
Ampholytic surface-active agent




                                  ethyl glychin     Usunon                                 surgery
                                                    LAG                                    Wound
                                                    Kinsal G             0.05    0.2       Hands, skin
                                                    Concnol
                                                    Satenidin
                                                    Nissan Anon
                                                    Hygieel
                                                    Hishipanchi
                                                    Fast I               0.1    0.2        Medical instruments,   Use 0.2 to 0.5%
                                                    <Fully-diluted                         environment (floor,    concentration for
                                                    product>                               etc.)                  tuberculo-field.
                                                    LAG (0.05, 0.1,
                                                    0.2 and 0.5%)
                                                    Satenidin (0.05,
                                                    0.1, 0.2 and 0.5%)
                                  Benzalkonium      Osvan                0.01              Infected skin           Pay attention to
Quarternary ammonium salt




                                  chloride          Benzalkonium                                                   applicable concentration.
                                                    chloride                                                       (Disinfectant of 0.1%
                                                    Oronine K                                                      concentration has toxicity
                                                    Cathinone                                                      to eyes, 1% to mucosa and
                                                    Kanetol                                                        5% to skin.)
                                                    Cationic soap                                                  Be careful to avoid
                                                    Cremeal                                                        accidental ingestion.
                                                    Zalkonin                                                       (People tend to ingest
                                                    Germitol                                                       accidentally and its oral
                                                    Torizon                                                        toxicity is high.)
                                                    Hyamine
                                                    Hyamine T
                                                    Haidesin
                                                    Parasterol
                                                    Biocidol
                                                    Hoesumin
                                                    <Fully-diluted
                                                    product>
                                                    Zalkonin solution




                                                                                      14
 Grouping
                                                              Service
                     General name     Trade name                               Intended end-usage             Remarks
                                                           concentration
                                    (0.01, 0.025, 0.05,   0.01         0.025   Mucosa subject to
                                    0.1 and 0.2 )                              surgery
                                    Germitol (0.025                            Wound
                                    and 0.1%)             0.1                  Hands, skin
                                    Cationic soap
                                    (0.01, 0.02, 0.025,
                                    0.05 and 0.1%)
                                     Pribc (0.02,
                                     0.025, 0.05 and
                                     0.1%)
                                     Bezeton (0.02,
                                     0.025, 0.05, 0.1     0.1      0.2         Medical instruments,
                                     and 0.2%)                                 environment (floor,
                                     Others                                    etc.)




                   Chlorhexidine    Hibitane              0.02                 Skin of vulva and         Pay attention to
Biguanides-based




                                    Hibitane                                   external genitalia        applicable
                                    gluconate                                  Conjunctival sac          concentration. (In case
                                    Abiruten              0.05                 Wound                     of applying the
                                    Allcut                                                               disinfectant of 0.5% to
                                    Griggen                                                              disinfect wound, it may
                                    Chlorhexidine                                                        cause shock.)
                                    gluconate                                                            Use colorless
                                    Chlohexin                                                            Chlorhexidine (such as
                                    solution                                                             Hibitane Gluconate) for
                                    Chlorhexidine                                                        skin of vulva and
                                    Stericlone            0.1    0.5           Hands                     external genitalia and
                                    Neocremeal                                 Skin                      conjunctival sac.
                                    Fermajin                                   Medical instruments       Do not apply to bladder,
                                    Hexizac                                    Environment (floor,       vagina and ears.
                                    Benclosid                                  etc.)
                                    Maskin
                                    Rapotec
                                    <Fully-diluted
                                    product>
                                    Hibidil (0.05%)
                                    Stericlone (0.02,
                                    0.05, 0.1 and
                                    0.5%)
                                    Hexizac (0.02,
                                    0.05, 0.1 and
                                    0.5%)
                                    Maskin(0.02,
                                    0.05, 0.1 and
                                    0.5%)
                                    Others
                                    Hibiscrub             Undiluted            Hands                  Do not use too frequently.
                                    Maskin scrub          disinfectant                                (To prevent damage to
                                    Microshield            4                                          skin.)




        Note:
                                              from
        Information on this booklet is quoted from Infectious Diseases Surveillance
        Center of National Institute of Infectious Disease and Ministry of Health,
        Labour and Welfare (as of October 2005).
                                                                   15

				
DOCUMENT INFO
Shared By:
Categories:
Tags: scalding
Stats:
views:66
posted:7/26/2010
language:English
pages:16
Description: o O o O doc scalding