How to Disinfect Ambulances to Help Prevent Spread of Coronavirus

4/1/2020 (Permalink)

How to Disinfect Ambulances During COVID-19

In recent months, information about Coronavirus has been circulating at dizzying speed. Accurate information must be readily available for frontline emergency medical management to be able to put together the most proactive and effective plans. More than ever, we look to trustworthy sources like the Centers for Disease Control and Prevention (CDC) for reliable information on how to respond.

What the CDC says about the spread:

• There is no vaccine for COVID-19.
• The most common way the virus spreads is person-to-person contact (proximity within 6 feet).
• When a virus carrier sneezes or coughs, infected droplets are released into the air. The spread advances when another person takes in these droplets through the mouth or nose. 

CDC directives (or prevention guidelines) are based on how the Coronavirus behaves. 

Recommended daily actions for spread prevention from the CDC:

• Frequent handwashing, cleansing hands vigorously for at least 20 seconds.
• When hand washing is not available, use hand sanitizer with at least 60% alcohol as needed.
• Avoid touching your eyes, nose, and mouth with unclean hands.
• Maintain distance from others, especially from those who have the symptoms or have been recently ill.

As the number of confirmed cases of the Coronavirus rises in Texas (you can find the updated case count for Texas here), so do the odds any particular ambulance may come into contact with a COVID-19 patient. 

For the protection of EMS personnel, their families and all patients who require that same ambulance after it is used to transport a patient infected with COVID-19, an ambulance needs to be kept sanitary.

Process of Cleaning and Disinfecting Medical Vehicles and Ambulances

In the medical industry, we trust that our providers follow a proactive protocol that ensures everyone’s safety. It is for this reason that, until recently, we wouldn’t think twice about going to a hospital after being injured or feeling unwell. Everything changed when society learned how easily COVID-19 spreads. Concerns about COVID-19 in a workplace, even without a positive test, have led to work-from-home policies in many industries.

Updates to standard operating procedures in response to the pandemic should include the consistent use of personal protective equipment (PPE), special instructions on handling patients who have (or may have) the Coronavirus, and diligent sanitation procedures. 

Recommended PPE for emergency medical services (including fire fighters, police, and emergency medical technicians), according to the CDC, include:

• Disposable exam gloves that should be changed after contamination
• A disposable isolation gown to protect the body
• Respiratory protection (for example, the N95 filtering respirators that have been in shortage lately)
• Eye/face protection (goggles/disposable face shield that covers the front and sides of the face)

Before we move to the next section, let’s iron out the concept of “PUI,” which stands for “Person Under Investigation.” 

According to the CDC, a PUI is anybody who is either exhibiting symptoms of COVID-19, or somebody who may be at high risk as a result of being in contact with a confirmed COVID-19 patient or recent travel to a high-risk area. With that out of the way, let’s take a look at some of the CDC’s recommendations for keeping people safe when EMS transport comes into play. 

The Recommended EMS transport procedure for a COVID-19 patient (PUI), as outlined by the CDC, are as follows:

• Notify the destination healthcare facility, so they can prepare for the arrival of the infected person.
• The patient’s family/companions should not travel in the ambulance.
• If possible, prevent airflow from the patient compartment to the driver’s area.
• Provide thorough and detailed documentation on the patient with any other required or relevant information.

As we all work together to make it through this challenging time, it helps to be mindful of the added responsibilities upon our medical personnel (including our ambulance medics). 

One of the chief concerns about the rate of the Coronavirus spread is the capacity of our healthcare system to support the demand. In support of our medics in being available to help those in need, please only call for emergency services when necessary.

Process of Cleaning an Ambulance or Medical Vehicle

Perhaps the most important step in transporting patients who have or are suspected to have the Coronavirus (in other words, a person under investigation) is cleaning up afterward. This includes proper handling of PPE and thorough sanitation of the inside of an ambulance.

Cleaning procedures based on recommendations from the CDC:

• Step 1 - Leave the rear doors open to ventilate and completely air out the patient cabin. By the time the first responders complete the necessary paperwork, the exchange between outside air and inside should be sufficient.
• Step 2 - Bioremediation technicians tasked with cabin cleanup should wear complete PPE. As discussed previously, this should include a full-body gown, double pairs of disposable gloves, and a full-face respirator with the appropriate filters.

• Step 3 - Ensure the cabin is properly ventilated during cleaning, especially when using chemicals.

• Step 4 - Pre-clean the surfaces. Next, sanitize target areas with an EPA-registered, hospital-grade disinfectant formulated for coronavirus 2 (SARS-CoV-2) pathogens. The target areas are “high touch” areas and any other areas in contact with the patient/bodily fluids. Keep these areas in mind when disinfecting:
• stretcher
• rails
• control panels and switches
• floors
• walls
• seats
• work surfaces
• cabinets

• Step 5 - Include the standard operating procedure cleaning regimen as directed by your management.

• Step 6 - Prepare reusable equipment prior to use with another patient by cleaning and disinfecting all of it per manufacturer instructions 

• Step 7 - Carefully prepare biohazardous items and disposable PPE for biohazard waste disposal by placing all affected items in the appropriate bags or biohazard burn boxes. 
• Step 8 - Do not shake the linens. Contain and launder used linen per standard operating procedure. 

The CDC put together Transport Unit Decontamination guidelines during the Ebola crisis. For more detailed instructions on how to mitigate the spread of infection with protocol specific to before, during, and after stages, consult this CDC guide.

How Long Does It Take to Clean an Ambulance?

Medics ordinarily follow strict safety protocol by wearing gloves, properly disposing of biohazards (like needles), and other practices meant to ensure the safety of everyone aboard the ambulance.

Transporting a potentially contagious patient means additional time decontaminating the cabin area. This process can take 45 minutes or more. Using an industry-appropriate decontamination sprayer may cut down on time.

Schedule breakdown:

• Airing out ambulance: 30 minutes
• Donning complete PPE: Around 10 minutes (to save time, it could be done concurrently toward the end of airing out the cabin)
• Cleaning of all surfaces and the stretcher: 10-15 minutes
• Doffing of PPE and proper disposal of materials: around 10 minutes.

The above is an example of approximately how long each task may take is based on a video demonstration by Superior Ambulance. The time spent all depends on your current standard operating procedure and the additional adjustments necessary to ensure safety when a patient has been exposed to the Coronavirus.

How Often Does an Ambulance Have to Be Cleaned?

An ambulance interior should be cleaned exactly as stated in your standard operating procedure and this frequency should be indicated in those instructions. 

For EMS infection control, according to the CDC, it is a best practice to begin a thorough sanitation process of the entire cabin area after transport of a patient confirmed to have Coronavirus (or a PUI).

Esporta Washing Machine for Materials That Have Been in Contact with COVID-19 Patients

SERVPRO of Richardson is prepared to perform commercial cleaning services including proactive decontamination services for soft goods. Our process involves the use of an industrial Esporta Wash System which is specially designed to restore contaminated materials back to their original state.

Laboratory testing has proven the Esporta Wash System to be effective in eliminating unhealthy bacteria as materials were restored to food-grade level or better. We expect this decontamination laundry process to have the same benefits in regard to virus pathogen removal.

The Esporta Wash System Process:

• Stage 1: An emulsifying detergent breaks down the food sheath layer of bacteria. This both deodorizes the material and removes harmful organic matter from the fibers.
• Stage 2: A special detergent both breaks down inorganic material and eliminates contaminants.
• Stage 3: Hydrogen peroxide sanitization kills any remaining molds or bacteria.

Along with its superior cleaning power, this machine uses an eco-friendly and hypoallergenic formula. This added benefit means less harm to the environment and no irritants to a patient’s sensitive skin.

We also ensure that contaminated materials are safely removed and transported for cleaning. We believe our soft goods cleaning service fits in well with an ambulance cleanup plan.

SERVPRO Can Provide Cleaning Services for Hospitals and Other Buildings

SERVPRO of Richardson realizes how inundated Dallas area hospitals and ambulances might become over the next few weeks, given the increasing number of COVID-19 infections across Dallas. We are fully prepared to support our area medical providers with safe and methodical cleaning services, including proper biohazard cleanup.

We’re your ally in this fight against COVID-19. Our team has the gear, the supplies, and the know-how to disinfect medical vehicles and buildings. We will thoroughly sanitize areas affected by Coronavirus pathogens. We’re here to support you. 

SERVPRO’s Commitment to Public Health:

• SERVPRO professionals are trained in adhering to the highest cleaning and sanitation standards.
• SERVPRO is performing all cleanup and bioremediation in accordance with the guidelines provided by the CDC and local authorities.
• SERVPRO’s proprietary cleaning agent, SERVPROXIDE, is an EPA-certified, hospital-grade disinfectant that has demonstrated effectiveness against viruses similar to Coronavirus (SARS-CoV-2/COVID-19) on hard, non-porous surfaces.

SERVPRO of Richardson stands behind our brave medical professionals to support them in putting forth the best efforts to fight the spread of COVID-19. We employ our years of experience and training in biohazardous situations, especially in the case of pandemic illness affected sites.

Our franchise is prepared and equipped to partner with our healthcare providers in assisting with cleaning procedures including the appropriate removal, transport, and cleaning of infected soft materials.

We continue to monitor the CDC website for any updated information or new instructions. We urge the public to stay current with information and directives from the CDC.

If you need additional support with the health maintenance of your facilities and vehicles or if you have any medical sanitation questions, call us anytime at (972) 690-1414 or complete our convenient contact form!