Infection Control in Suction and Oxygen Therapy

Disinfection and Sterilization

• The Spaulding Approach categorizes patient care equipment into three categories: Critical, Semi-Critical, and Non-Critical Items.
• Critical Items: enter normally sterile tissue or the vascular system, requiring sterilization as processing, e.g., surgical devices, intravascular catheters, and dialysis components.

Categories of Patient Care Equipment

• Semi-Critical Items: come into contact with mucous membranes or nonintact skin, requiring high-level disinfection using chemical disinfectants, e.g., most respiratory equipment.
• Non-Critical Items: come into contact with intact skin, requiring detergent washing and low to intermediate level disinfection, e.g., face masks, blood pressure cuffs, and ventilators.

Cleaning and Disinfection

• Cleaning is the first step in reprocessing equipment, involving removing dirt and organic material, usually by washing, following the manufacturer's instructions.
• Disinfection destroys the vegetative form of many or all pathogenic organisms except spores on medical equipment or other inanimate objects.

Suction Systems

• Tracheal suctioning increases the risk of infection, but proper hand hygiene and gloving help minimize this risk.
• Use a fresh, sterile, single-use catheter on each patient, and only sterile fluid to remove secretions from the catheter.

Oxygen Therapy Devices

• Contaminated condensate in ventilator circuits can transmit microorganisms to patients via healthcare workers' hands.
• Ventilator circuits should not be changed routinely for infection control purposes, but rather when visibly soiled or malfunctioning.
• Nondisposable bag-mask devices should be sterilized or high-level disinfected between patients.

Humidifiers

• Sterilize or high-level disinfect reusable breathing circuits and humidifiers.
• Periodically drain tubing condensate away from patients and discard.
• Wash hands after draining tubing condensate or handling the fluid.

Equipment-Handling Procedures

• Bag-Mask Devices: clean, disinfect, and maintain according to manufacturer's instructions.
• Nebulizers:
  • Clean, disinfect, rinse with sterile water, and air dry between treatments on the same patient.
  • Store in a manner that prevents contamination.
  • Do not share small volume nebulizers between patients without performing sterilization or high-level disinfection.
  • Use only sterile fluids for nebulization and dispense aseptically.