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EBME have got two ventilators (B&D Nippy & Philips V60) that have been used without patient bacteria filters in place.

Are there any companies that can decontaminate these machines?

Regards Barry


Barry

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Hello Barry

The Nippy's that I have dealt with have a continuously pressurised output to the patient, the patient's exhaled breath does not go back to the unit's input (other than what is sucked in to the unit's compressor along with all the other possible pathogens in the room's air); have a word with your Infection Control their may decide that decontamination of the unit is not necessary and to only decontaminate or replace the mask/valve assembly.

I've not come across the Philips V60 (but if it is as good as their Trim 3s ECG recorders I have a few suggestions what to do with it).

Many moons ago we used to decontaminate the odd ventilator; we would push an air flow with nebulised 3% Hydrogen Peroxide through the unit for several hours. To clear any residue the flow was run for twice as long without the Peroxide and a litmus paper was used to verify the all clear.

I can't remember any more details; perhaps our friend Geoff or one of the other Sages can fill in the blanks.

Lee


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I can't really add to anything that you've said there, Lee ... except to reinforce:-

1) What makes Barry believe that the kit is actually contaminated?
2) What do the manuals (manufacturers) say?
3) What does the CSSD say?
4) What does Infection Control say?

"If it were me" I would pass the buck to Infection Control, and (after no doubt waiting a while for them to respond) simply follow their advice. smile

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You could try these people, they are based in Germany so you would have to ship the vents

http://www.medizinservice-sachsen.de/


Catharina Biedermann

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Remember that most people breath the air without a bacterial filter all day every day. OK we get the odd cold or "man flu" but it is usually without any harmful effects. The only real problem is with infected patients.
I too do not know the Philips machine but often these sort of vents have an expiratory valve close to the patient, so assuming you have thrown away the single patient use tubing, none of the remaining parts have had any breath in them.
As has been said take advice from infection control, I expect you will have nothing to worry about.
Robert.


My spelling is not bad. I am typing this on a Medigenic keyboard and I blame that for all my typos.
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Hello

Back in the "dim" past but not quite as far back as our Hydrogen Peroxide days; we use to send off bits (pressure transducer and associated tubing I think) of our Bird ventilators to "Birmingham" for gas sterilisation. Sorry I'm not sure which Hospital I suspect it was the QE, might be worth a try.

Lee


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Would I not be right in saying that these machines fall under the classification of NIV* (non-invasive ventilators) ... which could, in essence be thought of as regulated (controlled) blowers? Sophisticated blowers, no doubt; but still basically positive pressure generators.

So am I right in guessing that the bacterial filter in the patient tubing is simply there (usually) to protect the patient from whatever crud may be blasting (OK, puffing, then) out from the machine?

Surely the primary protection (from any infection point of view) is brought about by the use of single-use patient tubing?

So ... I'm still wondering:- as no exhaled air is ever pushed back into them, how can these machines become contaminated by anything that the patient may be carrying? think

* No intubation, for example. In fact I believe that the name "Nippy" came about from "non-invasive positive pressure ventilation" (NIPPV) - which can (or does) also include continuous positive airway pressure (CPAP) and bi-level positive airway pressure (BiPAP).

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Are you aiming for disinfection or clean?
the later is easy with wipes etc.
The former is a bit complicated for these devices, i seem to remember something from FDA a while ago stating something like heat the airways in the device to min 87 degrees C for a minimum 30 minutes then swab it and get results back before using it again, a bit complicated for every day use and i only know of F&P who recomend anything like this on their Airvo device. For which they supply a dedicated kit with a special tube and filters etc.

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I'm imagining something like this:-

1) Remove the inlet filter
2) Place device in a "sealed" cabinet (safety cabinet, fume cupboard; even an old out-of-use oven, 'fridge or chest-freezer)
3) Rig up an extension cable to power the device
4) Bung a few gas pellets in there
5) Have the device run merrily away for a few hours
6) Remove device
7) Run it in fresh air for a while

... best leave the windows open, though!

But:-

1) How many hours?
2) Which gas?

Answers:-

1) As long as needed (some trial and error may be required here)
2) Would depend upon the nature of the "contamination" (that is, what it is - which spore, pathogen etc.)

But I wonder if a CS pellet would sort it (them) out? think

Actually, I suspect that something a bit more "gentle" would suffice in most cases involving NIV's of this type. Especially as:- the trouble with a gas (vapour, whatever) that kills "all known pathogens" is that it is very likely to be a bit ... err, deadly. frown

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Thank you all your help.

I have sent email to the http://www.medizinservice-sachsen.de/

Infect control asked me to decontaminate the machine.
CSSD scratch there heads
Manafactury said you should of used a filter.

regards Barry


Barry

Be not afraid of greatness; some are born great, some achieve greatness, and others have greatness thrust upon them
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