EMS
Effectiveness of Pulse Technology and a Hybrid Hydrogen Peroxide Decontamination System for EMS
Vince Battaglia
Emergency response organizations are a vital link to any community’s access to immediate medical response and care. During the COVID-19 pandemic and the resulting shortage of personal protective equipment (PPE), personnel of these agencies had a potential exposure level far beyond that of many other healthcare workers. Due to the high level of asymptomatic patients as well as the wide variety of COVID symptoms, many emergency responses thought to be for other causes, also led to exposure to SARS-CoV-2. For the sake of first responders, as well as for that of the larger community, it is crucial to create an environment free of biological contaminates as a staging
Non-Porus Material #1 Pre Post Reduction 530 0 530 312 12 300 532 0 532 301 1 300 957 0 957 272 13 259 59 0 59 Non-Porus Material #2 Pre Post Reduction 200 13 187 21 0 21 64 0 64 22 12 10 167 0 167 231 4 227 282 0 282
Porous Material Pre Post Reduction 842 397 445 1276 287 989 1485 184 1301 1567 187 1380 746 413 333 1889 202 1687 2511 270 2241 These three tables show reductions in ATP readings of porous and non-porous material.
Carolina Fire Rescue EMS Journal
Figure 1. HHP™ device orientation for treatment of cabin and cab of ambulance.
Figure 2. Validation Tools: Biological Indicators with tryptic soy broth medium, H2O2 Chemical Indicators, and ATP swabs with ATP meter.
ATP swab readings taken from the jump seat. Pre disinfection — 957 (Fig. 3). Post disinfection ‚ 0 (Fig. 4).
point for this vital work to occur. 1 Though cleaning and disinfection for ambulances is a routine part of emergency response, 2 these cleaning and disinfection protocols do not commonly have a consistent and reliable way to ensure a full disinfection has occurred. In an environment prone to contamination, even the best efforts can still leave germs behind. For this reason, there is a need for high level disinfection which is not prone to human error and can be validated. In this study, a portable disinfection device was used to enhance existing cleaning protocol. This automated device injects seven percent hydrogen peroxide to fill the interior space of the ambulance with disinfecting solution. As a measure of an effective treatment, pre and post ATP swabs were collected, and both chemical indicators and spore-based biological indicators were used to test for a 99.9999 percent kill in even the hardest to reach areas of the ambulance. This case study examines whether using this system significantly improves disinfection outcomes for emergency response ambulances.
Figure 5. Chemical indicators showing a color change indicating exposure to H2O2.
Figure 6. Biological Indicators (Geobacillus stearothermophilus 1 x 106) encased in a Tyvek/ myler pouch.
proprietary seven percent Hydrogen Peroxide (H2O2) solution which together are EPA registered for high-level disinfection. To calculate treatment time, the device is programmed for the cubic footage of the space being treated. As the target environment of this study was the interior of ambulances, the device was programed to treat the space of the forward cab and all compartments in the
Figure 7. Challenged chemical indicators showing the importance of opening cabinets, glove box, and other storage spaces to allow for complete migration.
rear cabin at one time. The device can be programmed manually using an onboard screen or remotely via APP. Once started, the system engulfs the space with Hybrid Hydrogen Peroxide™, a combination of vapor (VHP) and aerosolized hydrogen peroxide fog. Following the initial delivery, the device then intermittently injects solution via Pulse™ technology to maintain the
see PULSE TECHNOLOGY page 10
Methods Patented Pulse™ Technology The system used in this study is a mobile fogging device combined with a
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Fall • 2021 9
