Oxygen concentrators have been high in demand in Apr & May 2021 in India with Covid Wave 2 hitting people hard. Many have purchased Oxygen Concentrators for personal use as there was shortage of hospital beds with oxygen supply in many cities. Along with Covid cases, there has been rise of black fungus (mucormycosis) cases too. One of reasons for this has been lack of infection control and care while using oxygen concentrators. In this article we cover cleaning, disinfection and proper maintenance of oxygen concentrators to avoid harm to patients.
Cleaning & Disinfection of Exterior Body
The exterior cover of the machine should be cleaned weekly & between two different patients use.
- Before cleaning, switch off the machine and disconnect it from the power source.
- Clean the exterior with a damp cloth with a mild soap or household cleaner and wipe it dry.
Disinfecting the Humidifier bottle
Never use tap water in a humidifier bottle; it may be cause for infection. There may be pathogens and micro-organisms that will straightaway go into your lungs through the nasal passage.
- Always use distilled/ Sterile water and change the water every day completely (not just top-up)
- Empty the humidifier bottle, wash inside and out with soap and water, rinse with a disinfectant, and follow with a hot water rinse; then refill the humidification bottle with distilled water. Note that some manufacturer’s instructions for use require the humidifier bottle to be rinsed daily with a solution of 10 parts water and one part vinegar as a disinfectant.
- Avoid touching the inside of the bottle or lid after it has been cleaned and disinfected to prevent contamination.
- Fill-up above ‘Min’ line and slightly below the ‘Max’ level indicated on the bottle. Excess water may result in water droplets being carried in the oxygen straight to nasal passage, harming the patient.
- At least once a week for same patient and between two patients, the humidifier bottle should be disinfected by soaking in antiseptic solution for 30 minutes, rinsed with clean water and dried completely in air before using again.
Unclean water and lack of proper sanitisation of humidifier bottles are said to be linked to increase in mucormycosis cases in Covid patients.
Avoiding Contamination of Nasal Cannula
Nasal cannula should be disposed-off after use. Even for the same patient care should be taken that the nasal cannula between uses while switching or adjusting, should not have direct contact with potentially contaminated surfaces.
The nasal cannula prongs often become contaminated when patients don’t properly protect the cannula between uses (i.e., leaving the nasal cannula on the floor, furniture, bed linens, etc.). Then the patient puts the contaminated nasal cannula back in their nostrils and directly transfers potentially pathogenic organisms from these surfaces onto the mucous membranes inside their nasal passages, putting them at risk of developing a respiratory infection.
If the cannula looks visibly soiled, change it immediately to a new one.
Replacing Oxygen Tubing & other accessories
Disinfection of used oxygen therapy consumables such as nasal cannula, oxygen tubing, water trap, extension tubing etc., are not practical. They need to be replaced with new sterile supplies at the frequency stated in the manufacturer’s instructions for use.
If the manufacturer has not specified a frequency, change the nasal cannula every two weeks, or more often if it is visibly soiled or malfunctions (e.g., becomes clogged with respiratory secretions or moisturizers placed in the nostrils or has kinks and bends).
If a water trap is placed in-line with the oxygen tubing, check the trap daily for water and empty as needed. Replace the oxygen tubing, including the water trap, monthly or more frequently as needed.
Filter Cleaning in Oxygen Concentrators
One of the most important parts of disinfection of oxygen concentrators is filter cleaning. The filter must be removed, washed with soap and water, rinsed and thoroughly air dried before replacing. All oxygen concentrators come with an extra filter which can be placed while the other one is drying properly. Never use a moist/ wet filter. If the machine is in regular use, the filter must be cleaned at least monthly or more frequently depending on how dusty the environment is. A visual check of the filter / foam mesh will confirm need to clean it.
A clogged filter may impact oxygen purity. Read more about technical problems you may face with oxygen concentrators.
Hand Hygiene – The most important Step in disinfection and infection control
Hand hygiene is essential to any infection control & prevention. Perform proper hand cleaning before and after handling or disinfection of any respiratory therapy equipment or else you may end up contaminating an otherwise sterile device.
Stay healthy! Stay Safe!
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