Hello all ebme engineers,

Could you please share with us best practices departments have adopted in the current climate for safely working on EBME equipment, ie monitors, ventilators etc which has been used by a Covid-9 patient?

My advice would be to follow any guidance offered by whatever Infection Control staff you have nearby.

In the absence of such advice, I would follow the usual routine when dealing with any "suspect" machine:-

1) Endeavour to find out what the last patient was infected with
2) Use a well ventilated room (workshop)
3) Wear gloves and face-mask (maybe goggles as well) when working on the machine
4) Disinfect (or bin*) components as found necessary
5) Take plenty of tea-breaks (and fresh air)

* In accordance with whatever local policies are in force.

Contact your ventilator supplier/manufacturer and get the right information.

After getting in touch with the manufacturers recommendation and following them on cleaning the kit if there was issue with a piece of ventilator or patient monitor whilst being used by a corvid-19 patient, how should that be approached ?

So you've cleaned it as required ... and then it goes back into service. Then there is an "issue" (to be defined) when in use with a Covid-19 patient ... but now the machines is no longer "clean", is it?

So ... back to square on.

Anyway, any action taken will depend upon the "issue"; most will be rectified straight away by the staff in ICU. You only need to "worry" if the machine itself fails (that is, becomes faulty) and needs to be withdrawn.

Perhaps this may help (it is an extract from the MHRA RMVS document linked to earlier today at another thread):-

Morning Geoff,

Thanks for the MHRA information, my concern lies with the fact that a healthcare worker cleaning the equipment. I really would not trust that step.

Do you mean when the machine has been withdrawn for repair etc.?

If you are concerned at that stage, then you can (and probably should) take necessary precautions (protective clothing, etc.) and either disinfect or dispose of components yourself.

See my earlier post #75009.

just giving you a scenario, the user said the equipment is giving some error message. Therefore the equipment is say in ICU, the user says that they have cleaned it.

If you are the hospital biomed, you obviously carry an obligation to help in any way you can; certainly within your normal remit, if not beyond as circumstances dictate.

If possible - and they are not too busy (which they will be), get user staff to demonstrate the problem, and indicate what they have done to clear it. Then prompt them if you think they have missed something.

In general, try to limit your exposure in all departments (but especially in areas such as ICU); do not hang around (chatting), and keep your distance. Retreat to your workshop, and get the kettle on!

Otherwise, wear gloves, face-mask etc. as appropriate, and crack on!

Yep Geoff, good points and helpful tips please take note. When the whole hospital is under stress make sure you remain calm.

I have already seen so many hospital staff overwhelmed even before the storm has arrived. Inside every ward where covid-19 patients are located should be a station which will have PPE gear.

There is also a technique and method of wearing the PPE and it is worth knowing how should you wear and dispose off the PPE. Your hospital infection control team will be able to go through with you, ensure you familiar with it. Preparation is the key.....

"If you can keep your head when all about you
Are losing theirs and blaming it on you ..."*

PPE? Piff ... just continue smoking your pipe when striding around the wards (I recommend Ogden's St.Bruno)!

* © Rudyard Kipling

Mafi Hubbly bubbly.. Hannis,

Just a thought If someone was vaping and had corvid-19....could it be transmitted?

Good point ... droplets!

I'll fire off an email to Dom and Boris straight away ... in fact, whilst we're at it, why not take the opportunity to ban smoking in all its forms (forever)?

The other point to be careful is to bring kit back to workshop to fix, not only would that have to be corna free but any tools used must be maliciously clean. ideally you should have a designated corvid work space?

Morning everyone....

Just to let you know, any field engineers coming into hospitals to service or repair gear don't expect the poor old NHS to provide you with PPE (personal protective gear).

I know from the frontline the NHS does not have enough PPE for their own the Doctors and Nurses...and cleaners.

The onus would lie with the Company you represent!

Surely any machines would have been cleaned (disinfected) and moved to a safe (quiet) area anyway before letting a service engineer loose on them ... wouldn't they?

And what about all the "volunteers" currently being called for ... are they expected to fend for themselves, as well?

Some kit is mounted on pendants, secured so don't expect nurses to scrub the equipment and remove it !!

The service engineer would have to go in to do it unless it is serviced in house.

It rather depends what "it" (as in "do it") is.

Anyway, I'm not going to argue ... if I was the "service engineer" I would assess the situation (and then act accordingly) when I arrived at site - especially if I had been "called in" by the hospital (rather than just a routine PM-type visit).

Are you writing policy, or advising others? You need to remember Health and Safety at Work, Risk Assessment, Duty of Care ... and so forth.

Most Companies have stopped routine PPM's at the moment only breakdowns

Please find below a link to the UK Government's guidance on COVID-19: infection prevention and control. It includes a section on management of medical equipment.

https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control

We are not going into the Covid wards unless it's absolutely unavoidable i.e machine failure on a fixed machine. If a machine has failed that is removable it should be cleaned down by nursing staff who should then fill out the decontamination declaration and double bagged, then we would clean it in our decontamination area again wearing the correct PPE to ensure we're happy it's been cleaned.
If in doubt gown up and clean it again before you work on it, which I would say is 100% of the time at present!

We are fairly much following the same routine. You clean and bring to us unless it's bolted in place.

Morning all,

Good idea of double bagging the equipment Heather especially monitors, but more difficult with larger equipment vents..& anaesthetic machines....

Once the kit is in the "dirty" area of the workshop ... how do you actually clean (disinfect) it?

I was always a fan of common or garden "Clorox" liquid bleach (of the type generally available more or less everywhere)*.

No doubt these days more powerful (aggressive) - and expensive - products are de rigueur. I recall that Cidex was good for dealing with bacterium (such as TB), but heard a while ago that it is no longer (cannot be) used ... so, what products are folk using these days?

See also this earlier thread ... as well as this one. And here's yet another take on it all.

* It was certainly good (strong) enough for cleaning blood sampling valves on Coulter Counters.

Morning all,

Does any EBME department already have or managed to create designated self-contained decontamination in their workshop or near by as the crisis progresses and more defective contaminated equipment needs looking at?