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Handbook of COVID-19 Prevention and Treatment--Disinfection Procedures for Infectious Fabrics of Suspected or Confirmed Patients

Handbook of COVID-19 Prevention and Treatment--Disinfection Procedures for Infectious Fabrics of Suspected or Confirmed Patients

  • 2020-03-23
Disinfection Procedures for Infectious Fabrics of Suspected or Confirmed Patients
5.1 Infectious fabrics
(1) Clothes, bed sheets, bed covers and pillowcases used by patients;
(2) Ward area bed curtains;
(3) Floor towels used for environmental cleaning.
5.2 Collection methods
(1) First, pack the fabrics into a disposable water-soluble plastic bag and seal the bag with
matching cable ties;
(2) Then, pack this bag into another plastic bag, seal the bag with cable ties in a goose neck
fashion;
(3) Finally, pack the plastic bag into a yellow fabric bag and seal the bag with cable ties;
(4) Attach a special infection label and the department name. Send the bag to the laundry
room.
5.3 Storage and washing
(1) Infectious fabrics should be separated from other infectious fabrics (non-COVID-19) and
washed in a dedicated washing machine;
(2) Wash and disinfect these fabrics with chlorine-containing disinfectant at 90 °c for at least
30 minutes.
5.4 Disinfection of transport tools
(1) Special transport tools should be used specifically for transporting infectious fabrics;
(2) The tools shall be disinfected immediately each time after being used for transporting
infectious fabrics;
(3) The transport tools should be wiped with chlorine-containing disinfectant (with 1000
mg/L active chlorine). Leave disinfectant for 30 minutes before wiping the tools clean with

clean water.


Disposal Procedures for COVID-19 Related Medical Waste

{1) All waste generated from suspected or confirmed patients shall be disposed of
as medical waste;
(2) Put the medical waste into a double-layer medical waste bag, seal the bag with
cable ties in a gooseneck fashion and spray the bag with 1000 mg/L chlorine
containing disinfectant;
(3) Put sharp objects into a special plastic box, seal the box and spray the box with
1 ooo mg/L chlorine-containing disinfectant;
(4) Put the bagged waste into a medical waste transfer box, attach a special
infection label, fully enclose the box and transfer it;
(5) Transfer the waste to a temporary storage point for medical waste along a
specified route at a fixed time point and store the waste separately at a fixed location;
{6) The medical waste shall be collected and disposed of by an approved medical
waste disposal provider.


 Procedures for Taking Remedial Actions against Occupational Exposure to COVID-19


(1) Skin exposure: The skin is directly contaminated by a large amount of visible bodily
fluids, blood, secretions or fecal matter from the patient.
(2) Mucous membrane exposure: Mucous membranes, such as the eyes and respiratory
tract are directly contaminated by visible bodily fluids, blood, secretions or fecal matter
from the patient.
(3) Sharp object injury: Piercing of the body by sharp objects that were directly exposed to
the patient's bodily fluids, blood, secretions or fecal matter.
(4) Direct exposure of respiratory tract: Falling off of a mask, exposing the mouth or nose to
a confirmed patient (1 miter away) who is not wearing a mask.


Surgical Operations for Suspected or Confirmed Patients
8.1 Requirements for Operation Rooms and Staff PPE
(1) Arrange the patient in a negative pressure operating room. Verify the temperature, humid
ity and air pressure in the operation room;
(2) Prepare all required items for the operation and use disposable surgical items if possible;
(3) All surgical personnel (including surgeons, anesthesiologists, hand-washing nurses, and
charge nurses in operating room) should put on their PPE in the buffer room before entering
the operating room: Put on double caps, medical protective mask (N95), medical goggles,
medical protective clothing, boot covers, latex gloves, and powered air-purifying respirator;
(4) The surgeons and the hand-washing nurses should wear disposable sterile operating
clothes and sterile gloves in addition to the PPE as mentioned above;
(5) Patients should wear disposable caps and disposable surgical masks according to their
situation;
(7) The charge nurses in the buffer room are responsible for delivering items from the buffer
area to the negative pressure operating room;
(8) During the operation, the buffer room and the operating room shall be tightly closed, and
the operation must be carried out only if the operation room is under negative pressure;

(9) Irrelevant personnel shall be excluded from entering the operating room.

8.2 Procedures for Final Disinfection
{1) Medical waste shall be disposed of as COVID-19 related medical waste;
{2) Reusable medical devices shall be disinfected according to the disinfection
procedures of SARS-CoV-2 related reusable medical devices;
(3) Medical fabrics shall be disinfected and disposed of according to the disinfection
procedures for SARS-CoV-2 related infectious fabrics;
(4) Surfaces of objects (instruments and devices including device table, operating
table, operating bed, etc.);
G) Visible blood/bodily fluid pollutants shall be completely removed before dis
infection (handled in accordance with disposal procedures of blood and bodily fluid
spills).
@ All surfaces shall be wiped with a disinfectant containing 1000 mg/L active
chlorine and allowed to sit for 30 minutes with the disinfectant.
(5) Floors and walls:
G) Visible blood/bodily fluid pollutants shall be completely removed before disinfec
tion (handled in accordance with disposal procedures of blood and bodily fluid
spills).
@ All surfaces shall be wiped with a disinfectant containing 1000 mg/L active
chlorine and allowed to sit for 30 minutes with the disinfectant.
(6) Indoor air: Turn off the fan filter unit (FFU). Disinfect the air by irradiation by
ultraviolet lamp for at least 1 hour. Turn on the FFU to purify the air automatically for
at least 2 hours.

Procedures for Handling Bodies of Deceased Suspected or Confirmed Patients
(1) Staff PPE: The staff must make sure they are fully protected by wearing work
clothes, disposable surgical caps, disposable gloves and thick rubber gloves with
long sleeves, medical disposable protective clothing, medical protective masks
(N95) or powered air purifying respirators (PAPRs), protective face shields, work
shoes or rubber boots, waterproof boot covers, waterproof aprons or waterproof
isolation gowns, etc.
(2) Corpse care: Fill all openings or wounds the patient may have, such as mouth,
nose, ears, anus and tracheotomy openings, by using cotton balls or gauze dipped
in 3000-5000 mg/L chlorine-containing disinfectant or 0.5% peroxyacetic acid.
(3) Wrapping: Wrap the corpse with a double-layer cloth sheet soaked with disinfec
tant, and pack it into a double-layer, sealed, leak-proof corpse wrapping sheet
soaked with chlorine containing disinfectant.
(4) The body shall be transferred by the staff in the isolation ward of the hospital via
the contaminated area to the special elevator, out of the ward and then directly
transported to a specified location for cremation by a special vehicle as soon as
possible.

(5) Final disinfection: Perform final disinfection of the ward and the elevator.


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