Decontamination

Infection control in Irish hospitals is a serious problem as the superbugs are constantly developing resistance to disinfectants. In spite of hospital cleaning regimens, the bacteria can form spores which survive for months or even years in the environment. When a serious outbreak occurs, preventing cross-infection and the further spread of endemic strains requires effective control measures.

disinfectant-cartoon

In years gone by, there was no range of sophisticated cleaning agents available to disinfect a room following a case of infectious disease. The room was sealed off and a combination of disinfectant and a formalin lamp was used to decontaminate the air.

Here’s another excerpt from Home Nursing in the early 1900’s…

Disinfecting the Sick-Room

Whenever possible the help of a Sanitary Inspector should be sought. If this is not available:-

1.  Open all cupboards and drawers, and hang up dressing-gown and blankets on a clotheshorse or on cords stretched across the room

2.  Paste paper over the fireplace, the framework of the windows, and all other crevices except those about the door.

3.  Paste ready for use the strips of paper required for the door and the keyhole.

4.  Place a formalin lamp on a metal tray (as a precaution against fire) raised from the floor; ignite it, and leave the room quickly. To disinfect a large room, several lamps placed about it will be required.

5.  Close the door; cover the crevices about the door and the keyhole with the prepared strips of paper.

6.  Keep the room closed for twelve hours.

7.  Re-enter the room, open the windows wide, uncover the fireplace, and allow the room to remain in this state for another twelve hours.

8.  Send the bedding and mattress to be dis-infected.

9.  Burn all books, letters, etc., which have been in the room.

After her duties are finished the home nurse must disinfect herself, taking precisely the precautions which has adopted for her patient.

8 Responses to Decontamination

  1. Annb says:

    God be with the days…..We’re so smug about our so-called progress. It’s like the e-voting fiasco, the pencils are having the last the last laugh.

  2. Steph says:

    Ann – I often find myself thinking “those were the good old days” but when you consider that many infections represented a death sentence, it puts a whole new light on that era. I’ve been told on several occasions that I wouldn’t be here if it weren’t for antibiotics but right now, I feel that antibiotics are doing me no favours. There’s a lot to be said for rest and fresh air.

  3. Grannymar says:

    When we were five, in other words before my sister was born, four of us got Scarlet Fever. the clear one was shipped to Granny’s house and we four sickies were put in one room for the duration.

    Once we were well again, the room was fumigated much as you describe above. It was only then we discovered that the carrier was the guy sent over to granny, his only symptom was peeling skin on the soles of his feet. This was considered to be the final stage of the fever.

  4. Steph says:

    Grannymar – What a memory! I’d forgotten about being put in the same room as my brothers, ‘the sick room’ when we were all ill with one of the childhood illnesses.

    Scarlet fever is the rash the accompanies a streptococcal throat but it’s treatable by antibiotics these days. Sufferers are no longer contagious after a few days on the antibiotic.

  5. Baino says:

    This is quite interesting actually. My mother nursed TB patients (considered infectious) in the early 50’s and actually contracted it herself. Hygeine comprised using things like chlorine bleach and phenol. After drastic lung resection surgery, patient’s were ‘cured’ prior to the release of penicillin in 1950 basically with little more than bedrest and sunshine!(Of course many died as a result!) My mum was lucky. . she was a recipient of early penicillin and after 2 years bedrest, never really looked back.

  6. Steph says:

    Baino – TB was rampant in Ireland in the 1950’s. I remember once meeting someone whose family had been torn apart by the scourge of TB. The children were all packed off to sanatoriums for several years, one parent and several siblings died and the family never recovered. We were lucky to escape that era.

    There’s a lot to be said for good old-fashioned bleach. I heard only yesterday of it being recommended for use in the bath, to clear-up severe eczema which was complicated by MRSA contamination.

  7. knipex says:

    ohhhh formalin. That’s a blast from the past. Unfortunately formalin (aka formaldehyde) has a few nasty side effects. Its a serious carcinogenic, it leaves a nasty toxic residue that has to be cleaned off (also carcinogenic). And Finally for years its efficacy against “bugs” was never questioned. Now however they are starting to recognise that it actually not that brilliant. In fact its pretty crap.

    The bigger issue is with the hanging of fabrics to allow them to be “fumigated”. Fabrics are porous and absorbed formalin keeping it close to the skin of the patient (remember its a carcinogenic). Even if washed after you are releasing formalin into the waste water and into the ground water (it last for years). The part about burning papers, books and files is a good one and something that should still be encouraged today.

    There are a number of modern alternatives. A bit more scientific that just boiling off formalin.

    Clorinox has been used for years but its very corrosive and leaves a toxic residue that needs to be removed manually (opening the possibility of reintroducing pathogens).

    Or Hydrogen Peroxide Vapour. Again this is corrosive (bot no where near as bad as the alternatives. The big issue is time. It doesn’t take 24 hours anymore, about 90 mins for a single room, about 4 to 6 hours for a large nightingale ward and about 12 hours for a full ward.

    When you are running at 100% occupancy its not easy free up rooms for this long. The other issue is that all fabrics have to be taken down, removed and fresh ones put up. The rooms also have to be cleaned of physical dirt in advance which also adds to the room down time.

    Bleach is a pet hate of mine. I’m am sorry but if it was up to me it would be banned from general sale.

    It is the most dangerous chemical in a home. At high enough concentrations it is an excellent biocide but its also toxic and can cause serious damage to skin. It should never ever be used with hot water as the fumes will destroy your lungs. When mixed with other chemicals it can release poison gas. Also when mixed weakly it can actually encourage the development of resistance to disinfectants.

    That’s aside from the environmental impact of the stuff. It destroys septic tanks, causes severe problems for sewerage systems and is gradually getting into our groundwater.

  8. Steph says:

    Thanks Knipex

    Sorry for lack of response, unwell at moment. Hopefully back in business soon. S.

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