[Helen Truscott]

Hi Giulietta,
I would be interested in learning more about our risks too as we are using the cardboard spacers for our recruit medicals , although these individuals are usually fit and healthy, I guess the risk is fairly low.
Not sure if we should be ordering a fresh container of ventolin for each user , (which may be more costly , especially if the applicant is no longer using Ventolin at home ), or should we be using a washable spacer ?

Many thanks for raising this .

Regards
Helen
Helen Truscott RN, RM, MPH
Team Leader-Health and Medical
Health & Safety Branch

[Fire & Rescue NSW]

Hi lung function units
Could I ask how other facilities with lung function test centre manage the use of multi dose ventolin inhalers where the patient only gets one single dose via spacer re-use inhalers for multiple patients. The spacers are single use but the ventolin is multi dose use.
I think the risk is low but the new disposable spaces do not have a large dead space and wonder if other think this could be a risk.
Many thanks for your support
Giulietta Pontivivo CICP RN/RM/MPH| CNC/NM Infection Prevention Management and Staff Health Services- St Vincent’s Hospital (Unit Level 6, DeLacy Building), 390 Victoria Street Darlinghurst NSW 2010
Contact Details: t: 61 2 8382 3284 | f: 61 2 8382 3892 |M-0457 533 452 e: Giulietta.Pontivivo@svha.org.au

______________________________________________________________________
For the purposes of protecting the integrity and security of the SVHA network and the information held on it, all emails to and from any email address on the “svha.org.au” domain (or any other domain of St Vincent’s Health Australia Limited or any of its related bodies corporate) (an “SVHA Email Address”) will pass through and be scanned by the Symantec.cloud anti virus and anti spam filter service. These services may be provided by Symantec from locations outside of Australia and, if so, this will involve any email you send to or receive from an SVHA Email Address being sent to and scanned in those locations.
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[Helen Truscott]

HI Meryl,
I would also be interested to hear of any updates on this topic, as we regularly use an inhaler with cardboard spacer for our recruits having spirometry .
There may be some months between use of the inhaler , but each person gets a new spacer.

Regards
Helen
Helen Truscott RN, RM, MPH
Team Leader-Health and Medical
Health & Safety Branch

[Fire & Rescue NSW]

E Helen.Truscott@fire.nsw.gov.au | T 02 9265 2976| F 02 9265 2986 | M 0417 677 802
http://www.fire.nsw.gov.au
Level 8, 227 Elizabeth Street, Sydney, NSW 2000

[Fire Safety Message]

Hi Meryl

My concern would not be so much who has handled the inhaler (as these can be wiped over easily), but what are the risks of contamination within the inhaler by children coughing or blowing into them (despite the use of spacers, this could still be a real risk). Spreading RSV or influenza virus, as just two examples, is a real risk in my view from this possibility. Because children are the ones having these inhalers used on them, the risk of this may actually be higher than for adults (less likely to correctly follow instructions).

Just my thoughts. Not sure there are any definitive guidelines around this.

Cheers
Michael

Michael Wishart
Infection Control Coordinator

A 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
[cid:image001.png@01D01926.61F1C2B0]
P Please consider the environment before printing this email

Good morning everyone,

I have been approached our ED to find out the risks of cross-infection through use of an inhaler with a spacer. To put this into context, the use of spacers is restricted to individual patients, but the inhalers are currently used for multiple patients. My concerns are as follows:

* Children in ED are usually undifferentiated as and such we do not know what infection they have or what kind of additional transmission-based precautions might be required.

* The valve in the spacer is a valve not a filter thus there is the possibility of contamination of the inhaler through the valve of the spacer.

* The inhaler sits at the patient’s bedside before moving to the medication room and then on to another patient’s room, being handled by children, parents and nursing staff along the way.
Thus far I have not been able to find any literature on this but was wondering if anyone could inform me what their local practice is and the rationale behind it.

Many thanks in advance,

Meryl

Meryl Jones
Clinical Nurse
Infection Management and Prevention Service

Children’s Health Queensland Hospital and Health Service
Level 12
Lady Cilento Children’s Hospital, South Brisbane QLD 4101

T: 07 3068 4145.
E: meryl.jones@health.qld.gov.au
W: http://www.childrens.health.qld.gov.au

[cid:image001.png@01D08E34.09FD4060][cid:image002.png@01D08E34.09FD4060][cid:image003.png@01D08E34.09FD4060][cid:image004.png@01D08E34.09FD4060]
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For the purposes of protecting the integrity and security of the SVHA network and the information held on it, all emails to and from any email address on the “svha.org.au” domain (or any other domain of St Vincent’s Health Australia Limited or any of its related bodies corporate) (an “SVHA Email Address”) will pass through and be scanned by the Symantec.cloud anti virus and anti spam filter service. These services may be provided by Symantec from locations outside of Australia and, if so, this will involve any email you send to or receive from an SVHA Email Address being sent to and scanned in those locations.
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For the purposes of protecting the integrity and security of the SVHA network and the information held on it, all emails to and from any email address on the “svha.org.au” domain (or any other domain of St Vincent’s Health Australia Limited or any of its related bodies corporate) (an “SVHA Email Address”) will pass through and be scanned by the Symantec.cloud anti virus and anti spam filter service. These services may be provided by Symantec from locations outside of Australia and, if so, this will involve any email you send to or receive from an SVHA Email Address being sent to and scanned in those locations.
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[Helen Truscott]

Thanks Glenys,
Yes I agree , I will see if anyone had contacted the manufacturer ( Drager) at the onset and to request some information about the cleaning and disinfection recommendations.
Kind regards
Helen

Thanks Helen,

In the first instance I would ask the manufacturer /supplier for their cleaning and disinfecting recommendations. They are obliged to provide this information to you as you are not necessarily familiar with reprocessing procedures the item (Self Contained Breathing Apparatus) will be able to tolerate.

Once you have this information you will need to review it in terms of its validity (i.e. ability to clean and/or disinfect between each officer use) or if not suitable look at alternative methods that the manufacturer or supplier will need to endorse (on company letterhead).

Regards

Glenys

Glenys Harrington
Consultant
Infection Control Consultancy (ICC)

PO Box 5202
Middle Park
Victoria, 3206
Australia
H: +61 3 96902216
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426

[Description: ICC Diagram ICCversion]

Hi Glenys,
Thanks for your reply.

The instructions are included in our current infection control manual, we are trying to also determine where the initial supporting information was sourced from.
We do know that the HAZMAT team was consulted , but this was more about the operational use of the masks.

Kind regards
Helen

Hi Helen,

I’m a bit unclear:

* Are the details provide below the instructions of the manufacturers/supplier for the reprocessing of the “Self Contained Breathing Apparatus” between each fire officer use or

* Are the details below the current practice of the “Fire Brigade Unit” you are consulting too?

Can you clarify?

Regards

Glenys

Glenys Harrington
Consultant
Infection Control Consultancy (ICC)

PO Box 5202
Middle Park
Victoria, 3206
Australia
H: +61 3 96902216
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426

Dear AICA members
I have been asked to review the need for twice daily disinfection of Self Contained Breathing Apparatus for Fire fighters. (Made of rubber and moulded plastic).

Currently this is being done twice a shift and after each use.

Cleaning product use is Instrumax – Benzalkonium Chloride
Following instructions:

* Perform hand hygiene. Don disposable gloves.

* Disconnect the facemask or the extension facemask from the demand valve.

* Rinse the facemask in clean running water (not hot). Drain out excess water.

* Spray liberally with BA disinfectant (100%), paying attention to the facial seal and inside the orinasal cup. From the outside of the mask, open the flap below the demand valve connector and spray inside.

* Note: The facemask does not need to be completely dry before function checking and use.

* I would welcome your opinions as to whether cleaning the SCBA up to possibly three times a day is any more effective than simply after each use?

* The masks, once cleaned are stored in a calico bag, the masks still need to be inspected once per shift, but if the checker was wearing nitrile gloves, would this require re disinfecting?

* Would there be an increase in mould on the facemasks, with this frequency of disinfection?

* Is storage in a Calico bag likely to pose any infection risk in itself ?

Regards
Helen
Helen Truscott RN
Team Leader-Health and Medical
Health & Safety Branch

[Fire & Rescue NSW]

E Helen.Truscott@fire.nsw.gov.au | T 02 9265 2976| F 02 9265 2986 | M 0417 677 802
http://www.fire.nsw.gov.au
Level 8, 227 Elizabeth Street, Sydney, NSW 2000

This message, and any files transmitted with it, is intended only for the addressee named and may contain confidential and/or legally professional privileged material. If you are not the intended recipient, please delete it and notify the sender immediately. Any retransmission, dissemination, reliance on or other use of this communication by people other than the intended recipient is prohibited. Views expressed in the message are those of the individual sender, and are not necessarily the views of Fire & Rescue NSW. Use of electronic mail is subject to FRNSW policy and guidelines. FRNSW reserves the right to filter, inspect, copy, store and disclose the contents of electronic mail messages, as authorised by law.
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[Helen Truscott]

Hi Glenys,
Thanks for your reply.

The instructions are included in our current infection control manual, we are trying to also determine where the initial supporting information was sourced from.
We do know that the HAZMAT team was consulted , but this was more about the operational use of the masks.

Kind regards
Helen

Hi Helen,

I’m a bit unclear:

* Are the details provide below the instructions of the manufacturers/supplier for the reprocessing of the “Self Contained Breathing Apparatus” between each fire officer use or

* Are the details below the current practice of the “Fire Brigade Unit” you are consulting too?

Can you clarify?

Regards

Glenys

Glenys Harrington
Consultant
Infection Control Consultancy (ICC)

PO Box 5202
Middle Park
Victoria, 3206
Australia
H: +61 3 96902216
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426

Dear AICA members
I have been asked to review the need for twice daily disinfection of Self Contained Breathing Apparatus for Fire fighters. (Made of rubber and moulded plastic).

Currently this is being done twice a shift and after each use.

Cleaning product use is Instrumax – Benzalkonium Chloride
Following instructions:

* Perform hand hygiene. Don disposable gloves.

* Disconnect the facemask or the extension facemask from the demand valve.

* Rinse the facemask in clean running water (not hot). Drain out excess water.

* Spray liberally with BA disinfectant (100%), paying attention to the facial seal and inside the orinasal cup. From the outside of the mask, open the flap below the demand valve connector and spray inside.

* Note: The facemask does not need to be completely dry before function checking and use.

* I would welcome your opinions as to whether cleaning the SCBA up to possibly three times a day is any more effective than simply after each use?

* The masks, once cleaned are stored in a calico bag, the masks still need to be inspected once per shift, but if the checker was wearing nitrile gloves, would this require re disinfecting?

* Would there be an increase in mould on the facemasks, with this frequency of disinfection?

* Is storage in a Calico bag likely to pose any infection risk in itself ?

Regards
Helen
Helen Truscott RN
Team Leader-Health and Medical
Health & Safety Branch

[Fire & Rescue NSW]

E Helen.Truscott@fire.nsw.gov.au | T 02 9265 2976| F 02 9265 2986 | M 0417 677 802
http://www.fire.nsw.gov.au
Level 8, 227 Elizabeth Street, Sydney, NSW 2000

This message, and any files transmitted with it, is intended only for the addressee named and may contain confidential and/or legally professional privileged material. If you are not the intended recipient, please delete it and notify the sender immediately. Any retransmission, dissemination, reliance on or other use of this communication by people other than the intended recipient is prohibited. Views expressed in the message are those of the individual sender, and are not necessarily the views of Fire & Rescue NSW. Use of electronic mail is subject to FRNSW policy and guidelines. FRNSW reserves the right to filter, inspect, copy, store and disclose the contents of electronic mail messages, as authorised by law.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

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The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

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MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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