Disinfection is measures aimed at destroying pathogens of infectious diseases in the external environment, in other words, disinfection. Disinfection aims to destroy pathogenic microorganisms. This differs from sterilization, which destroys all types of microorganisms and their spores.
All products that do not have contact with the wound surface, blood or injectable drugs must be disinfected.
There are preventive and focal disinfection.
1. Preventive disinfection is carried out constantly in order to prevent diseases in the family or any team. For example, disinfection of drinking water, wastewater, boiling milk. Preventive disinfection is carried out in children's and medical institutions.
2. Local disinfection is carried out in the event of infectious diseases occurring or suspected. Subdivided:
To the current one;
Final disinfection.
Current disinfection is disinfection in the immediate environment of a patient or bacilli-releasing agent, carried out with the aim of dispersing the causative agent of infectious diseases in the environment. Routine disinfection is carried out as necessary as long as the patient poses a danger to others as a source of infections. Routine disinfection is organized by a medical-prophylactic or sanitary-preventive institution, carried out by the patient’s relatives or by the patients themselves and supervised by employees of the SES and disinfection station.
Final disinfection is the prevention of the spread of pathogens of infectious diseases through objects that have been in contact with the patient. Unlike current disinfection, it is usually carried out once after recovery, isolation of an infectious patient, and also in the event of his death at home. In the event of his death in a hospital, final disinfection is also carried out. The duration of final disinfection should be reduced as much as possible. It is advisable that it be carried out immediately after removing the source of infection. Final disinfection is carried out by the disinfection station.
Methods and means of disinfection.
I. The physical method of disinfection is based on the destruction or removal of pathogenic microorganisms from the surface of objects to be disinfected by exposure to a number of physical factors.
1. Actions high temperatures: burning, calcination; boiling, pasteurization; action of hot air, drying.
2. Actions of radiant energy: ultraviolet radiation; radioactive and ionizing radiation; ultra-high frequency current.
3. Mechanical disinfection methods are based on the removal of pathogenic microbes by washing, shaking out, rinsing using soap and synthetic detergents.
Disinfection of products made of glass, metals, heat-resistant polymer materials, rubber is most often used by boiling in a disinfection boiler in distilled water for 30 minutes, with the addition of 2% soda - 15 minutes. If products have internal channels, such as syringes, then they are washed in containers with water to remove residual blood, serum, other biological fluids and medications. Water is disinfected by boiling for 30 minutes and covered with dry bleach for 60 minutes at the rate of 200 g of bleach per 1 liter of water.
II. The chemical disinfection method is based on the use of various chemicals. Aqueous solutions are most often used. Chemical disinfection methods are used for glass products, corrosion-resistant metals, polymer materials, and rubber. Completely immerse in a disinfectant solution or wipe twice with a calico napkin moistened with a disinfectant solution at intervals of 15 minutes.
Bleach is a white, fine powder with a pungent odor of chlorine. When stored in the light, it decomposes over time and loses some of the active chlorine, so it should be stored in a place protected from light, in a tightly closed container. Chloride of lime is produced in three grades - 35, 32, 28% active chlorine. Even with proper storage, bleach loses up to 3% of active chlorine per month. Chlorine containing less than 15% active chlorine is unsuitable for disinfection.
Methods of use: in dry form, they are used to disinfect patient secretions (feces, urine, sputum, vomit), food debris, outhouses, garbage cans. It should be remembered that dry bleach has a disinfecting effect only on moistened surfaces. 10% and 20% solutions are also used for disinfection before disposal of dressings, cotton wool, and gauze wipes.
To prepare 10 liters of a 10% solution of bleach, you need 1 kg of dry preparation, to which a small amount of water is added and thoroughly mixed until it becomes pasty. Then, continuing to stir, add water to a volume of 10 liters. The use of chlorine-lime milk solutions is carried out immediately after its preparation. They are also used in the form of clarified solutions.
To obtain working solutions of bleach, it is necessary to prepare a basic 10% stock solution. Stock and working solutions are prepared in dark glass bottles with ground stoppers, in enamel or plastic containers. The prepared solution is stored closed in a dark container. The mother liquor is prepared as follows: a freshly prepared 10% bleach solution is left for 24 hours in a dark, cool place, in a sealed container. During the first 4 hours, stir the mixture three times. After a day, the solution is carefully drained without shaking the sediment. The clarified solution can be stored for 10 days. When the content of active chlorine in dry bleach decreases, it is necessary to increase the amount of dry preparation.
The average amount of active chlorine in dry bleach is taken to be 25%. You can use the following formula:
X = 25 x 1000/s,
where c is the concentration of active chlorine in the dry preparation, 25 is the average content of active chlorine in the dry preparation.
Chloramine. White crystalline powder containing 25-29% active chlorine. Chloramine preparations are highly soluble in water. Solutions of 0.2-0.5% concentration are used to disinfect linen, dishes, toys, patient care items, furnishings in residential and hospital premises. Unlike bleach, chloramine is more resistant to environmental factors and, when properly stored, loses 0.1-0.2% of active chlorine per year.
Methods of use: in dry form, like bleach, and in the form of ordinary solutions. Since chloramine dissolves in water without residue, it can be used without prior settling or clarification. The shelf life of solutions is up to 15 days.
The required amount of chloramine is stirred in water, preferably heated to 50-60 ° C, and the solution is adjusted to the required volume. Chloramine is also used in the form of activated solutions when activators are added. At the same time, the rate and completeness of the release of active chlorine sharply increases, which makes it possible to reduce both exposure and concentration. The respiratory tract and mucous membranes of the eyes of persons involved in preparing and working with these solutions must be protected. Activated solutions are used immediately after preparation. They are recommended to be used for disinfecting workwear, linen, and for general cleaning in operating rooms, dressing rooms, and treatment rooms. Ammonium sulfate or nitrate in a ratio of 1:1 or 1:2 or ammonia (ammonia) are used as activators. Activators are added to the chloramine solution.
DTSHC (two-thirds calcium hypochlorite salt) contains 47-52% active chlorine. The main clarified 5% solution is prepared by diluting 500 g of dry calcium hypochlorite in 10 liters of water at room temperature; mix, leave for 30-45 minutes in a dark glass or plastic container with a stopper, then pour into a similar one. Can be used to prepare working solutions. Shelf life - 10 days. DTSGK is used for disinfection:
In dry form - to disinfect secretions and food debris, but in this case the amount of DTSGC used is 2 times less than bleach;
In the form of unclarified solutions of 3.5% and 10% concentration. Used to irrigate the surface of premises, to disinfect toilets, and liquid secretions of the patient. These solutions are prepared at the rate of 350 g or 1 kg of DTSGC per 10 liters of water;
Clarified solutions are used in the same cases as working solutions of clarified bleach.
Chlorhexidine (hibitan). The drug is odorless, mixes well with water, has a cleaning effect, and is shelf stable. Has pronounced antimicrobial activity. Gibitan is intended for current and final disinfection, disinfection of the hands of a surgeon, medical staff, and surgical instruments. Gibitan is prepared in the form of aqueous and alcohol solutions. Aqueous solutions are prepared in any container by mixing it with water. An alcohol solution of hibitan is prepared by diluting it in 70% alcohol in a ratio of 1:40. Aqueous solutions are used for routine disinfection, for disinfection of wards, dressing rooms, operating rooms, for disinfection of equipment, linen in a concentration of 0.5-1%, exposure 30-60 minutes. Alcohol solutions are used to disinfect hands and instruments. Surgical instruments and endoscopic equipment are disinfected with a 0.5% alcohol solution by immersing in the solution for 30 minutes, with the exception of the optical part, which is disinfected by wiping with a solution of the same concentration. Then the instruments and equipment are washed twice in distilled water. When preparing hibitan solutions, you must use rubber gloves.
Sulfochloranthine is a cream-colored powder with a moderate chlorine odor, contains 15.0 active chlorine, retains chlorine activity for 1 year. Store in a dark place. Working solutions remain active for 24 hours from the moment of preparation. The activity of sulfochlorantine solutions is 5-10 times higher than the activity of chloramine. Working solutions are prepared in any container by dissolving the drug in water. Used for disinfecting linen, dishes, toys, patient care items, for current and final disinfection. The premises are irrigated at the rate of 300 ml/meter of surface or wiped with a rag soaked in the solution. Bathtubs, sinks, toilets are irrigated twice with an interval of 15-30 minutes or treated with a clean dry preparation and then washed with water.
Dichlor-1 is a white or slightly yellowish powder with a faint odor of chlorine. It has a high bactericidal effect against gram (+) and gram (-) microorganisms, has a tuberculocidal effect at a concentration of 1-3%, 1-2% solutions are used for current and final disinfection in foci of intestinal and droplet infections, with these same purposes - in surgical departments, maternity hospitals. Working solutions are prepared in any container by diluting in water until completely dissolved. When preparing the solution, you should use respirators and safety glasses.
Chlordesin is a white powder with a mild chlorine odor. Contains 10-12% active chlorine, dissolves well in water. The solutions are colorless, do not spoil the objects being treated, and have high antimicrobial activity. Solutions are prepared in any container by dissolving in water.
Desam is a white powder with a faint odor of chlorine. It contains 50% chloramine, 5% oxalic acid, 45% sodium sulfate. The product contains 13% active chlorine. Desam is highly soluble in water, its solutions are colorless and do not spoil the objects being treated. Shelf life is about a year. Has high antimicrobial activity. Working solutions are prepared in any container by dissolving it in water. All work with chlorine-containing preparations is carried out in rubber gloves, goggles, an anti-dust or universal respirator, in gowns and an apron. At the end of work, wash your hands with soap. In case of contact with skin or mucous membranes, immediately wash the affected area with clean water.
2. Other disinfectants.
Hydrogen peroxide belongs to the group of oxidizing agents. The liquid is colorless and odorless; when stored open, activity decreases. The liquid preparation perhydrol made from it contains 29-33% hydrogen peroxide. A 3% solution of hydrogen peroxide has bactericidal properties, and a 6% solution has sporicidal properties. Apply a solution of hydrogen peroxide in pure form for disinfection of glass products and corrosion-resistant metals. 3% solution - exposure 180 minutes, 4% solution - exposure 90 minutes, 6% solution - exposure 60 minutes. Hydrogen peroxide solutions can be used with “Astra”, “Lotos”, “Progress” detergents at a 0.5% concentration. In this case, they are used during ongoing disinfection. When preparing the working solution, hydrogen peroxide is added to the solution detergent.
Dezoxon-1 is a colorless liquid with the smell of vinegar. Contains 5.0-8.0% peracetic acid. The drug is highly soluble in water and alcohol. Dezoxon solutions corrode low-grade steel products. Store it in glass or polyethylene containers at a temperature not exceeding 30 °C. Aqueous solutions are used immediately after preparation, as it quickly loses its active properties. Shelf life 6 months. Has high bactericidal activity. Used for routine, preventive and final disinfection, sterilization of medical products made of plastic, glass, and corrosion-resistant metals. Working solutions are prepared in any container by dissolving it in water. Packaging and preparation of working solutions are carried out in a fume hood or in a separate ventilated room. Solutions and processed objects kept in them are stored in closed containers equipped with gas vents. All work with dezoxon-1 is carried out in a respirator, safety glasses, rubber gloves, oilcloth apron.
Ampholan is a mixture of cationic and ampholigic surfactants. The drug is brown, contains 30% active substance, highly soluble in water. It has bactericidal properties against gram (+) and gram (-) bacteria. Aqueous solutions in 0.025% concentration have a detrimental effect on Staphylococcus aureus, typhoid and coli, enterococcus, Proteus vulgaris within 5-15 minutes, Pseudomonas aeruginosa dies within 25 minutes. Ampholan is intended for routine disinfection of infections of bacterial etiology (except tuberculosis) and preventive disinfection in medical institutions of various profiles. The drug is recommended for final disinfection using immersion, soaking, and wiping methods. With a solution concentration of 0.5%, the exposure is 60 minutes, with a 1% concentration - 30 minutes. All work with ampholan is carried out in special clothing using personal protective equipment. The temperature of the disinfectant solution must be at least 18 °C. All disinfectants are used once.
III. Air method of disinfection.
Used for glass and metal products. Disinfection occurs with dry, hot air in an air sterilizer (dry heat oven) in trays without packaging. At a temperature of 120 °C - exposure 45 minutes.
IV. Steam disinfection method.
Used for products made of glass, metal, rubber, latex and heat-resistant polymers. It is produced centrally, using saturated water steam under excess pressure in an autoclave in sterilization boxes. Pressure - 0.05 atmospheres, temperature - 110 ° C, exposure 20 minutes.
Disinfection of disposable plastic medical devices
1. Disinfection is carried out using rubber gloves.
2. Before disinfection, syringes are washed in containers with water, the rinsing water is disinfected by boiling for 30 minutes or by adding a dry disinfectant for 1 hour in a ratio of 5:1.
3. When immersed in a disinfectant solution, the needle is actively filled with a disinfectant solution, disposable systems and catheters are cut into small pieces.
4. To ensure that the channels are filled with disinfectant solution, the product must be immersed using a lid of a smaller diameter.
5. The following means are used for disinfection: 6% hydrogen peroxide solution; 5% chloramine solution; 1.5% solution of neutral hypochlorite; 0.5% sulfochloranthine.
How is disinfection carried out?
Disinfection is the implementation of special comprehensive measures aimed at eliminating various types of bacteria and viruses.
Information on how disinfection is carried out is divided into the following chapters:
The main purpose of viruses or bacteria is to destroy various pathogens and microorganisms that cause infectious diseases.
There are several types of disinfection:
- Preventive.
- Focal.
Preventative - aimed at preventing the occurrence of a disease. There are two types of it: planned and unplanned. It is carried out everywhere and always. It consists of fairly simple things - washing hands, washing food, processing objects using special products with bactericidal additives. Conducted directly by the individual himself.
Focal disinfection is divided into two more options: current and final. 
Ø Current – carried out directly near the patient’s bed and around him. The purpose of this is to prevent the spread of an infectious disease to other residents of the premises. It is often used in hospitals, infectious disease units, or in apartments when one of the family members is sick in the house. This type of disinfection can be carried out by the person himself, doing regular wet cleaning. Get rid of the spread of infection by boiling clothes and bedding, airing, etc.
Ø Final disinfection - carried out in a room when, for some reason, a person infected and spreading an infectious disease is no longer in it. For example, after hospitalization, or discharge of the patient from a medical institution, or in case of death. It is carried out to completely get rid of the unwanted spread of infection and is done directly by specialists.
Note!
The best protection option is to prevent the spread of microorganisms from the very beginning. It is worthwhile to approach the issue of preventive disinfection carefully and not neglect it.
Several methods are used to carry out the procedure:
In order to carry out high-quality disinfection of the room, if necessary, it is worth first preparing it. If this is a living space, it is worth starting with a general cleaning, since after treatment it will not be possible to wash, wash, or clean for a certain time. All things and objects should be tightly locked in the closet. Food, cutlery and personal hygiene items are hermetically covered and packaged, and they should be stored in a safe place. Pets should be given away to friends or relatives for a period of time.
Important to remember!
Animals themselves are often carriers of infections, so when keeping a pet in your house or apartment, do not forget about hygiene procedures, vaccinations and regular visits to the veterinarian for the purpose of prevention.
It is worth taking these procedures seriously. It is best to seek help from professionals from the company SES SERVICES. They will recommend exactly the type of lesion treatment that will help in your case. At the same time, high-quality consultation and measures will get rid of unwanted “residents” in the premises. The company chooses not only new and modern equipment for its work, but also monitors the latest developments, while working with the safest substances for people and the most effective for pathogenic microorganisms.
How do you select a method and substance for processing?
The conditions for selecting the required chemical are very simple:
Of course, when contacting the customer, he already roughly focuses on what he needs. But the company’s consultant will help you understand the problem more clearly and recommend the most optimal and effective option. And also how to prepare the room necessary for disinfection, what to do after the procedures, and further actions, in general.
Speaking about professional processing, we can consider several of the most common methods so that the customer knows approximately what he will have to go through. 
Disinfection with cold fog is a classic irrigation with antiseptic agents using pump sprayers. It reaches hard-to-reach places well and does not damage household items.
Carrying out hot fog treatment of the outbreak - using a special generator, the disinfecting solution is heated and sprayed under pressure. Thus, a steam cloud is formed, which softly lies on the surface, gradually processing them.
Important to know! If necessary, it is better to use complex processing, in which it is possible to combine these two methods. Then the treatment will give maximum effect, especially if there are any doubts about using one of the methods.
Cleaning the premises
After carrying out the procedure for cleaning the living space, you should pay attention to cleaning after treatment. Depending on the method used and the chemical substance, the specialist will tell you how many days it will take to start cleaning the room. Even though safe products are used, you still need to wash everything well.
Final disinfection- this is disinfection, which is carried out after hospitalization, recovery or death of the patient, that is, after removing the source of infection in order to completely free the focus from pathogens dispersed by the patient.
Final disinfection is carried out by disinfection and sterilization centers or disinfection departments of territorial centers of hygiene and epidemiology in epidemic foci for the following infectious diseases (or if this is suspected infectious disease): plague, cholera, relapsing fever, epidemic typhus, Brill disease, Q fever (pulmonary form), anthrax, viral hemorrhagic fevers, typhoid fever, paratyphoid fever, salmonellosis, tuberculosis, leprosy, ornithosis (psittacosis), diphtheria, fungal diseases hair, skin and nails (microsporia, trichophytosis, rubrophytosis, favus).
Final disinfection in areas of infectious diseases or suspected diseases viral hepatitis A and E, polio and others enteroviral infections, dysentery, rotavirus infections, intestinal yersiniosis, acute intestinal infections caused by unidentified pathogens, scabies, in addition to disinfection and sterilization centers, disinfection departments of hygiene and epidemiology centers, disinfectors of medical institutions, can be carried out under the guidance of a disinfection and sterilization center, a CSE employee or a disinfectant of a medical institution :
* medical personnel of treatment and preventive institutions;
* medical staff of children's and adolescent institutions;
* by the population in sparsely populated comfortable apartments or their own houses.
For other infectious diseases, final disinfection is carried out depending on the epidemic situation according to the decision of the epidemiologist of the territorial center of hygiene and epidemiology.
An application for final disinfection is submitted to the disinfection and sterilization center or the disinfection department of the territorial center of hygiene and epidemiology within an hour after isolation, hospitalization of the patient or change in diagnosis, by the medical worker who identified the infectious patient.
The final disinfection is carried out by disinfection teams, usually consisting of 2-3 people (disinfector and disinfector). The number of disinstructors and disinfectors can be increased depending on the volume of work (disinfection cases in dormitories, child care facilities, production, etc.). The doctor on duty or the paramedic of the focal disinfection department, upon receipt of the application for disinfection, begins to form a disinfection squad, hands the squad disinfector an outfit, instructs him, guided by the instructions for performing final disinfection for individual infections, and outlines a general plan for the upcoming work in the outbreak, taking into account the data, received from the doctor who made the application for disinfection.
Based on the instructions received, the disinfectant prepares a request for disinfectants, receives them and equips the disinfection team.
The main equipment of the disinfection squad includes: a hydraulic remote control, disinfectant, bags for disinfectants, a bag for taking things into the chamber, a flashlight, a rag holder, brushes for cleaning things, containers for disinfectants, an envelope for work clothes, a towel, soap, a brush for washing hands, a spray bottle for powder , bucket for disinfectant, first aid kit.
The disinfection squad is delivered to the outbreak along with all disinfection equipment by transport intended for the evacuation of an infectious patient, if it is not possible to allocate a separate vehicle for these purposes.
Upon arrival at the outbreak, the disinfectant determines a place to place the outerwear of the disinfection squad, puts on special clothing, examines the outbreak and finds out all the circumstances that determine the scope and content of disinfection measures, according to which he outlines a plan for the final disinfection.
The main stages of final disinfection in an epidemic outbreak are:
* preparation of disinfectant solutions;
* according to indications, extermination of flies with closed windows, vents and doors;
* treating the door to the room where the patient was, the floor in the patient’s room with a disinfectant solution;
* disinfection of underwear and bed linen in a disinfectant solution or by boiling;
* disinfection of the patient's leftover food using disinfectants or boiling;
* disinfection of food utensils using a disinfectant solution or boiling;
* disinfection of secretions and dishes for secretions using a disinfectant solution or boiling;
* disinfection of toys using a disinfectant solution or boiling;
* collecting things for chamber disinfection;
* preparing walls and individual objects for disinfection;
* disinfection of paintings, figurines and polished items;
* disinfection of walls, windows, furniture, floors;
* disinfection of cleaning equipment, laying out work clothes, washing hands.
In addition to observing the above sequence of disinfection actions, disinfection should begin from more distant parts of the room and corners, sequentially moving towards the exit, after which the corridors, kitchen, and toilet are disinfected.
For chamber disinfection, things are taken from outbreaks of the following infectious diseases: plague, cholera, relapsing fever, epidemic typhus, Brill disease, Q fever (pulmonary form), anthrax, viral hemorrhagic fevers, typhoid fever, paratyphoid fever, tuberculosis, leprosy, diphtheria , fungal diseases of hair, skin and nails (microsporia, trichophytosis, rubrophytosis, favus), scabies.
Chamber disinfection should be carried out on the belongings of not only the patient, but also those who were in contact with him. Items subject to chamber disinfection are sorted and placed in bags separately for steam-air, steam and steam-formalin disinfection. For all things sent to the cell, a receipt is drawn up in two copies, one of which is left with the owners of the things, and the second is sent to the cell along with the things. Things placed in bags are taken out and loaded into an ambulance immediately after they are collected. Bags with things must be sprayed with a disinfectant solution on the outside before being removed from the fire.
When working with disinfectants, personnel are required to wear a respirator and ensure that the products used do not come into contact with the skin; before removing rubber gloves, you must wash your gloved hands with soap, wipe dry and carefully remove the gloves from your hands; disinfection equipment must be stored in a special room - cabinets, covers, containers, etc.
The final disinfection of the transport on which the infectious patient was evacuated is carried out by the disinfector of the hospital reception department, and the transport that delivered things from the outbreak for chamber disinfection and communicating people for sanitary treatment is disinfected by the personnel who brought the things and people.
The disinfectant solution for treating vehicles is taken at the same concentration as for disinfection in the outbreak. To disinfect vehicles, the hospital reception department must have disinfectant solutions and the necessary equipment.
Dermantin upholstery and oilcloth covers are wiped with rags, and soft sofas are wiped with brushes soaked in a disinfectant solution.
A railway rigid carriage is disinfected in the same way as living space: the floor and walls are irrigated with disinfectant solutions from a hydraulic console, followed by wiping with brushes or rags, blankets and mattresses are sent to a disinfection chamber, and napkins, curtains and bed linen are disinfected in a disinfectant solution, after which they are sent for washing.
In soft sleeping cars, airplane cabins and ship cabins, hard surfaces are disinfected by irrigation, soft surfaces are additionally cleaned with a brush or rags soaked in a disinfectant solution. Liquids used for these purposes should not be odorous, as ventilation will be difficult. Due to the fact that chlorine-containing preparations can cause damage to metal structures and devices for disinfecting the objects listed above, it is recommended to use 3-5% solutions of hydrogen peroxide or other products that do not cause corrosion of metals.