Your Disaster Decontamination Guide: Step-by-Step Mega Cleaning

by James Hubbard, MD, MPH

This is part 2 in the universal-precautions series. See part 1—your disaster fashion guide—here

Imagine there’s a long-term disaster. An infectious disease has broken out. It could be something as common as a stomach virus or as devastating as Ebola. When medical care is scarce, either could be deadly … and both involve the expulsion of infectious fluids, such as diarrhea (and, in Ebola’s case, blood).

Two of your family members have gotten the disease. It’s up to you to care for them.

So you put on your “personal protective equipment” and get to work. But when you get a break from your caregiving responsibilities, there’s another step you need to take to better protect yourself from the disease. It’s part two of the “universal precautions.”  (Part one was putting on that protective gear.) You need to disinfect your environment.

How to Clean Up Blood and Other Potentially Infectious Fluids

Disinfecting your surroundings means not just wiping up blood, vomit, and other fluids but cleaning them up in such a way that you kill all the contagious germs they’ve put into your environment.

Here are six steps to take toward doing that:


1. Dispose of supplies properly.

Got contaminated needles, blades, or other sharp objects? Immediately dispose of them in some sort of container thick enough that there’s no chance the needles and such will stick through it. You can buy commercial containers, but for makeshift, a large, thick plastic jar with a lid could do.

For anything else disposable, such as gowns, shoe covers, and bandages, immediately place in a plastic bag and tie, and burn if you can.

IMPORTANT: Disinfectant-Solution Precautions

After you mix the disinfectant solution, label the bottle with the ingredients and a warning that it’s only to be used for cleaning. You can put the solution in a spray bottle or just soak a rag and start cleaning, but use it in as much fresh air as you can. Wear gloves, and consider eye protection and a mask.


2.  Disinfect the area.

Put on clean protective equipment to protect yourself against the fluids and the cleaning solution.

Wipe anything obviously dirty with soap and water if you have enough.

Then wipe down counters, walls, floors, and upholstery with a 1:64 to 1:100 chlorine bleach solution. That’s one part 5 percent chlorine bleach (the kind you use for laundry) mixed with 64 to 100 parts water.

1:64 solution = 1/4 cup bleach + 1 gallon water

Let the solution sit for 30 minutes before using. Mix a fresh batch daily.


3. Spot disinfect with a stronger solution.

For areas where there’s direct evidence of vomit, diarrhea, blood, or other bodily fluids, use a 1:10 solution.

1:10 solution = 1 cup bleach + 10 cups water

Again, let it sit for 30 minutes before using, and mix fresh daily.


4. Dispose of cleaning supplies properly.

Dispose of all used cleaning solutions away and downhill from any possible water sources. Dispose of used cleaning materials as suggested in step one.

Cleaning Up Blood

These decontamination steps are useful not only with fluid-heavy infectious diseases but also when you’re caring for someone who’s injured and you don’t know whether they have a blood-borne disease such as HIV or hepatitis.


5. Decontaminate things you’ll reuse.

For bedding, clothing, or equipment you need to reuse, soak in a 1:10 bleach solution for a minimum of 20 minutes. Then separately launder the clothes as usual.


6. Sterilize instruments.

Unless you have a medical autoclave for sterilizing, hopefully you’ll never have to reuse needles or blades, but in an absolutely dire situation, clean any obvious debris off—with a brush if you have one. Boil the instruments for at least 20 minutes, preferably with a lid on the container. Better yet, use a pressure cooker.

>> Click here for more on sterilizing with a pressure cooker (PDF from the World Health Organization.)

>> Click here for more on other methods of sterilizing instruments.

 

These steps should be taken immediately anytime there’s been a possible contamination of any bodily fluid, whether you know the patient’s condition or not, and also on at least a daily basis in a room where a person with a possible contagious disease is staying.

Have I left anything out?