Hospital-acquired pneumonia prevention

Pneumonia Main Page
Hospital-acquired pneumonia Microchapters
Home
Patient Information
Overview
Historical Perspective
Pathophysiology
Causes
Differentiating Hospital-Acquired Pneumonia from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
Diagnostic Algorithm
History and Symptoms
Physical Examination
Laboratory Findings
Chest X Ray
CT
Other Imaging Findings
Treatment
Medical Therapy
Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Hospital-acquired pneumonia prevention On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Hospital-acquired pneumonia prevention All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Hospital-acquired pneumonia prevention
CDC onHospital-acquired pneumonia prevention
Hospital-acquired pneumonia prevention in the news
Blogs on Hospital-acquired pneumonia prevention
Directions to Hospitals Treating Hospital-acquired pneumonia
Risk calculators and risk factors for Hospital-acquired pneumonia prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]

Prevention

Sterilization or Disinfection and Maintenance of Equipment and Devices

Preventive Measures	Description
General measures	Thoroughly clean all equipment and devices to be sterilized or disinfected. Whenever possible, use steam sterilization (by autoclaving) or high-level disinfection by wet heat pasteurization at >158 F (>70°C) for 30 minutes for reprocessing semicritical equipment or devices Use sterile water for rinsing reusable semicritical respiratory equipment and devices when rinsing is needed after they have been chemically disinfected. Do not routinely sterilize or disinfect the internal machinery of mechanical ventilators Wear gloves to perform the previous procedure and/or when handling the fluid Use sterile (not distilled, nonsterile) water to fill bubbling humidifiers
Mechanical ventilators	Do not routinely sterilize or disinfect the internal machinery of mechanical ventilators
Breathing circuits with humidifiers	Do not change routinely, on the basis of duration of use, the breathing circuit (i.e., ventilator tubing and exhalation valve and the attached humidifier) that is in use on an individual patient. Change the circuit when it is visibly soiled or mechanically malfunctioning Periodically drain and discard any condensate that collects in the tubing of a mechanical ventilator, taking precautions not to allow condensate to drain toward the patient
Ventilator breathing circuits with heat-and-moisture exchangers (HME)	No recommendation can be made for the preferential use of either HMEs or heated humidifiers to prevent pneumonia in patients receiving mechanically assisted ventilation Change an HME that is in use on a patient when it malfunctions mechanically or becomes visibly soiled
Small-volume medication nebulizers: in-line and hand-held nebulizers	Between treatments on the same patient clean, disinfect, rinse with sterile water (if rinsing is needed), and dry small-volume in-line or hand-held medication nebulizers Use only sterile fluid for nebulization, and dispense the fluid into the nebulizer aseptically
Other devices used in association with respiratory therapy	Respirometer and ventilator thermometer: between their uses on different patients, sterilize or subject to high-level disinfection portable respirometers and ventilator thermometers Resuscitation bags: between their uses on different patients, sterilize or subject to high-level disinfection reusable hand-powered resuscitation bags
Anesthesia machines and breathing systems or patient circuits	Do not routinely sterilize or disinfect the internal machinery of anesthesia equipment
Table adapted from CDC