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
Between uses on different patients, clean reusable components of the breathing system or patient circuit (e.g., tracheal tube or face mask) inspiratory and expiratory breathing tubing, y-piece, reservoir bag, humidifier, and tubing, and then sterilize or subject them to high-level liquid chemical disinfection or pasteurization
Pulmonary-function testing equipment
Do not routinely sterilize or disinfect the internal machinery of pulmonary-function testing machines between uses on different patients.
Change the mouthpiece of a peak flow meter or the mouthpiece and filter of a spirometer between uses on different patients