home Heating options Requirements for installing a disinfection chamber. Basic rules of work

Requirements for installing a disinfection chamber. Basic rules of work

Work with disinfection chambers is carried out in accordance with current instructions. Before starting work, the technical condition of the disinfection chamber itself and instrumentation must be checked. Disinfection of items in faulty cells is not permitted. It is also not allowed to process wet items in the chamber. Such things must be pre-dried.

Before loading things, the chamber is cleared of foreign objects, then the holes in the floor intended for drainage of condensate and communication with the atmosphere are checked. Do not operate if these openings are closed, as excess pressure may build up and destroy the chamber. Next, you need to check the steam lines and the serviceability of the nozzle or evaporator, if leather and fur products are intended. Before loading the first batch of things, the chamber is warmed up (at behind closed doors) to t° 70-80° for 10 minutes. Loaded items are freed from matches, lighters, pens, money and other items that may be damaged during processing in the chamber.

Things are loaded into the chamber evenly. The loading density and heating temperature depend on the type of infection, the disinfection method, the material (wool, cotton, fur, etc.), and the number of people washing (in disinfection-shower units). When disinfecting and disinsection of cotton and woolen items, the loading rate per 1 m2 of usable floor area of the chamber is 10 sets (60 kg) in stationary disinfection chambers and 25 sets (125 kg) in mobile ones equipped with powerful steam boilers. The loading rate for leather and fur items is 4-5 sets (24-30 kg) per 1 m2.

The heating temperature is 80-98° for disinsection and disinfection of cotton and woolen items contaminated with vegetative and spore-forming forms of microbes, and 40-59° for leather, fur and rubber items. The duration of temperature rise is at least 5 minutes.

At a given temperature, things in the chamber are kept for a certain time (exposure), which depends on the form of microbes, material, and processing method. When disinsection of cotton and woolen items, the exposure time is 5 minutes; leather and fur - 30-90 min. depending on the temperature of warming things up. When disinfecting cotton and woolen items, the exposure time is 10-45 minutes. depending on the infection; leather and fur items - from 45 to 165 minutes. at a temperature of 57-59°.

Disinfection of leather and fur items is carried out with formalin introduced into the chamber after the temperature rises (before exposure). The norm of formalin per 1 m 3 of a loaded room is: 75 ml for disinfecting things contaminated with vegetative forms of microbes, and 250 ml for spore forms. These items are produced without formaldehyde.

Disinfection of clothing, bedding (pillows, mattresses, blankets), leather, fur and other products is carried out in special installations called disinfection chambers.

Disinfection chambers are available in the chamber disinfection departments of disinfection and sterilization centers, in hospitals for infectious patients, as well as in multidisciplinary hospitals and maternity hospitals. Mobile disinfection chambers are available in hygiene and epidemiology centers.

Carrying out final disinfection using disinfection chambers is indicated in the following cases: infectious diseases: plague, cholera, relapsing fever, epidemic typhus, Brill's disease, Q fever (pulmonary form), anthrax, viral hemorrhagic fevers, typhoid fever, paratyphoid fever, tuberculosis, leprosy, diphtheria, fungal diseases of hair, skin and nails (microsporia, trichophytosis, rubrophytosis, favus), scabies.

Chamber disinfection should be carried out on the belongings of not only the patient, but also those who were in contact with him. Items subject to chamber disinfection are sorted and placed in bags separately for disinfection in different types of chambers. For all things sent to the cell, a receipt is drawn up in two copies, one of which is left with the owners of the things, and the second is sent to the cell along with the things. Things placed in bags are taken out and loaded into an ambulance immediately after they are collected. Bags with things must be sprayed with a disinfectant solution on the outside before being removed from the fire.

The cells are manufactured in a factory and are built into the building on site in such a way that the cell doors open into different isolated rooms. One door is in the loading (dirty) half, where things intended for disinfection are delivered and sorted, and the second is in the unloading (clean) half, where things are unloaded after disinfection is completed.

Depending on the active (disinfecting) agent, chambers are divided into steam, steam-formalin, and hot-air chambers.

Steam chambers. In steam disinfection chambers, the active agent is saturated water vapor. When water vapor condenses, it gives off a large amount of heat, and also quickly and deeply penetrates things and warms them up evenly. In steam chambers, disinfection is carried out with flowing steam at normal or excess pressure up to 0.2-1 atm (technical excess atmosphere), which corresponds to a temperature of 100 to 120°C. The fluidity of steam and pressure contribute to faster penetration of steam into things. When carrying out disinfection in steam chambers, care should be taken to ensure that the air is completely expelled from the chamber, otherwise the disinfection regime will be disrupted. For these purposes, steam is supplied to the steam chambers from above, and the air is forced out through openings located in the lower parts of the chamber.

Stationary steam chamber of the Krupin system. The chamber has the shape of a cylinder located horizontally (Fig. 8). The volume is 1.5 or 2.76 m3. The doors are located at the ends of the chamber and open into the loading and unloading rooms. The doors are closed using a central lock, which ensures its tightness. The inside of Krupin's chamber is made of metal, and the outside has wooden lining for thermal insulation.

The heat main leaving the steam boiler when approaching the Krupin chamber is divided into three steam lines: 1) enters the chamber from below to supply steam to the heating batteries; 2) connects to the chamber from above and enters it in the form of a perforated pipe located longitudinally above the umbrella (through which steam is supplied directly to the chamber); 3) goes to the ventilation pipe located in the upper part of the chamber closer to the loading compartment (steam through it is supplied to the siphon (tube inside the ventilation pipe) to stimulate ventilation). Two pipes extend from the chamber below. The first removes air, steam and condensate from the chamber. A thermometer is installed on this pipe to measure the temperature of the exiting steam, and in its lower part there is a valve for releasing condensate. The second pipe drains condensate from heating devices into the condensation pot (Fig. 9).

An angular thermometer is installed in the door of the chamber, which opens into the unloading compartment, and a supply ventilation hole is located slightly lower. At the top of the chamber there is a pressure gauge and a safety valve.

Heating devices are located on the floor of the chamber. An umbrella made of galvanized iron is installed under the ceiling, protecting things from condensation and direct exposure to a jet of steam. The chamber has a trolley that extends in both directions. The things in it, depending on their nature, are hung or placed on a wooden grid.

In the steam chamber of the Krupin system you can process bedding (pillows, mattresses, blankets), cotton items, as well as woolen items that are firmly dyed and straightened. Contaminated laundry should not be disinfected in this chamber, since the stains formed after treatment cannot be washed off.

Operating procedure for the steam disinfection chamber:

1. Before starting work, the chamber is warmed up to 80°C; To do this, steam is released into it through a perforated pipe.

2. The chamber is cooled to 50°C and loaded with things intended for disinfection. Wearable items are hung in the cell at the rate of 10-12 sets of clothing per 1 m2 (6 kg set), bedding is loosely placed in a cart at the rate of 50 kg per 1 m3 of the cell. After loading, the doors are hermetically sealed using a central lock.

3. Things in the chamber warm up and air is forced out of it. To do this, small portions of steam are released into the chamber through a perforated pipe from above. The valve on the source pipe is kept completely open. When the temperature of the exiting steam reaches 100°C, this indicates that the air from the chamber is practically displaced.

4. Maintaining the disinfection regime during the exposure time (Table 12). If the processing of things is carried out at normal pressure, then the exposure time begins to count from the moment the exiting steam reaches a temperature of 100°C. If the treatment must be carried out at increased pressure, then the steam output is reduced, for which the valve on the outgoing pipe is slightly screwed in, but not completely closed, in order to maintain the movement of steam. Once the set temperature and pressure are reached, the exposure count begins. Pressure and temperature during exposure are maintained by regulating the supply and release of steam.

5. Reducing the pressure in the chamber after the end of the exposure time. To do this, stop the steam supply to the chamber and fully open the valves on the outgoing and ventilation pipes.

6. Ventilate the chamber and dry things. Upon reaching normal pressure, steam is released into the heating batteries, the ejector (siphon) and the ventilation inlet is opened. Ventilation of the chamber and drying of things continues for 10-15 minutes.

7. Unloading things at the end of drying through a door that opens to the clean half.

Table 12.

Disinfection and disinfestation regime options

in steam chambers

Disinfection chambers (installations) are stationary or mobile sanitary facilities designed for disinfection of clothing, bedding, shoes and other things.

Depending on the heat agent used, disinfection chambers are divided into steam-air (steam-formalin), steam and hot-air. In steam-air disinfection chambers, items are heated with steam to a temperature of 80-98° at atmospheric pressure (without air displacement). Chambers equipped with a spray nozzle or an evaporation apparatus are also steam-formalin disinfection chambers that allow the disinfection of leather, fur and other items at a temperature of 40-59°. In steam disinfection chambers, things are disinfected with steam at a temperature of 100° and above at atmospheric or slight excess pressure.

Hot air disinfection chambers are used to disinfect clothing, bedding and other items. The active agent in these chambers is dry hot air at a temperature of 80-120°.

Stationary disinfection chambers are used in medical institutions for disinfection and disinsection of outer clothing, bedding and shoes; are divided into steam-air (steam-formalin) and steam.

Stationary disinfection chambers equipped with trolleys for hanging (stacking) and transporting disinfected items, powerful ventilation and heating devices, electric lighting and alarm systems. The room in which the disinfection chamber is installed is divided by a solid partition into two compartments: loading (“dirty”) and unloading (“clean”).

Rice. 1. Stationary disinfection chamber KDF-3.

Rice. 2. Stationary disinfection chamber DKSK-1.8.

In a stationary chamber KDF-3 with a volume of 3.2 m 3 (Fig. 1), the items to be disinfected, placed on a special trolley, are heated by steam entering through perforated pipes located on the floor. The chamber is equipped with a ventilation and heating system used for drying processed items. The steam release valves and the funnel for pouring formaldehyde into the evaporator are located on the control panel.

The stationary chamber DKSK-1.8 (Fig. 2) is mounted on two separate bases: on one the chamber itself, on the other the steam boiler. The chamber is also available without a boiler for centralized steam supply.

The DKS-1.8 disinfection chamber is a body welded from sheet steel, which is surrounded by steel hoops. The cell has two doors for loading and unloading things. Clothes, previously put on hangers, are hung on strings stretched from the ceiling. The temperature inside the chamber is controlled with a mercury thermometer.

The stationary disinfection chamber KDFO-2 is produced with a steam boiler SZM-1, designed for pressure up to 0.7 kgf/cm 2 .

The main parameters and dimensions of stationary disinfection chambers manufactured by industry are given in Table 1.

Magazine "Home" nurse"
Topic: Organization of work of medical departments and services, Medical equipment, equipment, furniture, instruments
Source: Chief nurse No. 12-2008
Author: A.Yu. CHISTYAKOVA, Head of the Department of Epidemiology and Disinfectology, Ural-Siberian Center for the Prevention of Nosocomial Infections, Federal State Budgetary Institution ENIIVI Rospotrebnadzor, Yekaterinburg

In the complex of measures for the prevention of nosocomial infections in health care facilities, chamber disinfection performs one of the main tasks. It is one of the most effective and reliable methods for disinfecting dressings, bedding, linen, outerwear, and shoes.

Unfortunately, in most medical institutions, they do not pay due attention to chamber disinfection. Only maternity, infectious diseases and tuberculosis treatment departments carry out disinfection to a fairly complete extent. Almost no chamber disinfection is carried out from therapeutic departments.

Disinfection chambers are devices and special structures in which various things are disinfected and insects are destroyed using physical, chemical, or both, means.

Cameras are installed in health care facilities, sanitary and epidemiological institutions, baths, laundries, as well as in some industrial enterprises where the raw materials are contaminated materials.

According to their purpose, chambers are divided into disinfection and disinsection. The latter destroy only insects for which the critical temperature is lower than for various types bacteria.

According to the nature of the device, there are stationary, mobile, transportable (on a trailer) chambers, and by type - steam, steam-formalin, hot-air.

The designs of steam chambers provide for work using steam, steam-air and steam-formalin methods.

Stationary cameras are installed in special rooms - standard or adapted, called disinfection units.

The disinfection unit must have heating, water supply, lighting, and supply and exhaust ventilation.

The area of the disinfection unit must correspond to the dimensions and number of disinfection chambers in it (Appendix 1). The chamber hall consists of two compartments, isolated by a transverse partition. One half – “dirty” – is used for receiving, sorting and loading things subject to chamber disinfection (loading compartment), the other – “clean” – for disinfected items (unloading compartment).

The disinfection chamber is installed in the partition between the loading and unloading compartments in such a way that most of the chamber is in the unloading compartment, and only part of it remains in the loading compartment. most of, almost flush with the partition. With this arrangement of the camera, its control front, supply openings, fan and motor are located in the unloading compartment and are accessible for inspection and repair.

All camera control is carried out from the unloading compartment. The partition provides a hermetically sealed window for the transfer of documents, money and other items that are not subject to chamber disinfection, or a box with two doors.

The dimensions of the cell room depend on the external dimensions adopted for this type of cell (table).

The width of the room is made up of the outer width of the chamber, the area required to install the electric motor with a fan, and the gap between the installations and the walls.

The length of the room is made up of the outer length of the chamber and the working rooms on the side of the loading and unloading compartments, 2500 mm each; when using a loading trolley, the length of the room increases by 2 chamber lengths.

The height of the chamber hall is at least 3.5–4 m, taking into account the high temperature of 25–30 °C that occurs in the unloading compartment.

At the loading section of the chamber hall, a sanitary lock for disinfectants is equipped, consisting of a dressing room with cabinets for outerwear, a toilet, a shower and a dressing room with cabinets for work clothes. A window and door will be installed to receive things.

In the departments of the chamber hall, supply and exhaust ventilation is equipped, ensuring the exchange of at least 8 volumes per hour, while in the unloading department the pressure predominates, and in the loading department there is an exhaust hood to prevent the penetration of infection into it.

The floor of the chamber hall is covered with Metlakh* tiles, the walls are painted with oil paint to facilitate cleaning and disinfection of the premises.

* Metlakh tiles – ceramic tile for floors - clay tiles fired until sintered with the addition of dyes. The front side of floor tiles can be corrugated, smooth, with a pressed pattern, etc. The tiles are laid on a cement-sand screed or special mastics.
Set and area of premises of the disinfection unit

Room
Area for hospital with number of beds, m2

100
200
300
500
800
1000
1200
1500

Receiving and sorting things
6
8
8
10
12
15
15
15

Issue of things
6
8
8
10
12
15
15
15

Pantry of disinfected items
–
4
5
8
8
10
10
10
Disinfection chamber premises

Loading compartment
10
24
24
24
56
56
56
58

Unloading compartment
15
36
40
40
98
98
98
98

Gateway between loading and unloading compartments
3
3
3
3
3
3
3
3

Bleach storage room
–
4
6
6
6
8
8
8

Storage room for disinfectants
–
4
6
8
10
10
12
12

Room for storing household equipment
4
5
6
8
8
8
8
8

Toilet for 1 toilet (with washbasin in the airlock), sanitary inspection room for staff with shower
4
5
6
6
6
8
8
8

According to existing standards, the disinfection unit must have the equipment listed below:
buckets (2 pcs.);
scales;
hangers (50 pcs.);
hydraulic remote control, chlorine-containing preparations;
log of chamber processing of things;
instructions for modes, passports of installed cameras;
fire extinguisher;
mittens (2 pairs);
special clothing according to standards;
racks for things on the “clean” and “dirty” halves;
stools, tables, chairs (2 pcs.);
external thermometers (1 straight and 1 angled);
containers for liquid;
alarm clock or timer;
cabinet for disinfectants;
hose 10 m long;
washbasin, brushes, rags, soap, towel;
suits for work at the OI;
germicidal lamps.
As a rule, all disinfection chambers consist of:
from the camera itself;
heat source; instrumentation;
equipment for introducing chemicals;
water supply and drainage systems;
condensate drainage systems in the sewer system;
supply and exhaust ventilation systems.

The number of positions for health care facility disinfectors depends on the number of beds in the hospital:
up to 100 beds – 0.5 rate;
100–250 beds – 1 position;
250–400 beds – 2 positions;
400–500 beds – 4 positions;
over 500 beds - an additional position is established for every 250 beds.

The operation of disinfection chambers must be controlled by technical and biological methods.

Technical control of disinfection chambers is carried out in order to establish the serviceability of both the chamber and its equipment (pressure gauge, thermometer, valves), as well as steam lines and air ducts.

The integrity of the disinfection chamber and its equipment can be determined visually. In addition, to check the operation of the valves, the tightness of the chamber or its parts, and the permeability of the steam lines, a test run of steam and test heating are used.

If, after closing the valve, the section of pipe located behind it continues to heat up, this indicates a defect in the valve (steam is leaking through). Such valves must be repaired or replaced.

The accuracy of the thermometer readings is checked as follows: the test thermometer, together with the control (calibrated) one, is immersed in water heated to 60–80–90 °C, respectively, while comparing the readings of the thermometers. The difference in readings between the tested and control thermometers should not exceed ±1 °C.

To check the operation of pressure gauges, a pressure gauge being tested is attached to the flange of a three-way valve, a control pressure gauge is connected in parallel, and based on the difference in the readings of the pressure gauge being tested and the control one, a conclusion is drawn about its serviceability.

The faulty pressure gauge is replaced with a new one - tested and sealed.

The degree of heating in thermal disinfection chambers is determined by an objective method - thermometry. The graduated part of the external thermometer is located outside the chamber, its end with a mercury ball is inserted inside the chamber.

The entire disinfection process in the chamber is controlled using a psychrometer.

The temperature dynamics in the chamber are recorded in the following stages:
temperature before the chamber starts heating;
heating the camera to the temperature from which the exposure count begins;
maintaining a certain temperature during exposure.

All listed temperature readings are recorded in the chamber operation protocol (Appendix 2).

The readings of the external thermometers of the chamber indicate only the temperature of the air and steam in the chamber, but not the temperature that was in the things being disinfected in the chamber during this period of time. To determine the temperature in disinfected items that provides a bactericidal (insecticidal) effect, maximum thermometers are used.

The effectiveness of disinfection in disinfection chambers depends not only on the required temperature in the chamber, but also on its uniform distribution in things loaded into the chamber.

The uniformity of temperature distribution in things in different places of the chamber is determined both vertically (at the level of the collar of clothes and pockets) and horizontally (in things located in the front part of the chamber, in front of the door to the unloading room of the chamber; in things located in the middle part chambers, and in things facing the loading door of the chamber). The uniformity of temperature distribution inside things is determined using 9 or 15 maximum thermometers, depending on the volume of the chamber.

In the loading chamber, maximum thermometers must be placed in the thickness of things (under collars, in pockets or folds of clothing). To do this, thermometers are placed in special pouches together with test objects and placed at 9 points according to a pattern similar to the arrangement of stamps on an envelope, on two levels: in the upper and middle parts of the chamber.

Maximum thermometers are subject to systematic testing, which is carried out in the same way as external chamber thermometers.

The following cultures serve as standards for bacteriological control of the reliability of disinfection of things in the chamber:
when processing things from foci of infections caused by non-spore-forming microbes - Staphylococcus aureus (Staphylococcus aureus), strain 906;
when processing things from foci of tuberculosis - non-pathogenic mycobacterium (Mycobacterium), strain B-5;
when processing things from foci of infections caused by spore-forming microbes - the culture of Bacillus cereus, strain 96, in spore form (anthracoid).

Test cultures must have typical properties. Bacteriological control of the effectiveness of disinfection of things in the chambers is carried out using biological indicators NIK-ILC, folded in packaging tape. The media prepared in this way are numbered and placed in a bag measuring 10 × 15 cm, which has a special compartment for a maximum thermometer. The bags are placed in control points.

After testing the biological indicators NIR-ILC, they are removed from the bags, placed in a plastic bag and, with the appropriate direction, delivered to the laboratory for further research.

If growth of a biological indicator is detected in at least one of the crops, the operation of the chamber is re-monitored. At the same time, they more carefully check its technical condition, the rate of loading of things, and the correctness of their placement in the chamber.

Disinfection chambers, like other equipment, require repair and timely replacement. After 10 years of operation, the disinfection chamber can no longer work effectively enough, so it is unacceptable to purchase new disinfection chambers on a residual basis. These costs should be included in programs for the prevention of nosocomial infections in medical institutions.

It is very important to have an exchange stock of bedding for the timely implementation of chamber disinfection, which will allow to increase the volume of its implementation to 100% in all medical departments of health care facilities.

Carrying out complete chamber disinfection of bedding in health care facilities is regulated by the following regulatory documents:

1. SaNPiN 2.1.3.1375-03 " Hygienic requirements to the placement, arrangement, equipment and operation of hospitals, maternity hospitals and other medical hospitals.”

2. SP 3.5.1378-03 “Sanitary and epidemiological requirements for the organization and implementation of disinfection activities.”

3. Order of the USSR Ministry of Health dated September 3, 1991 No. 254 “On the development of disinfection in the country.”

4. The concept of prevention of nosocomial infections, approved by the Ministry of Health of Russia on December 6, 1999.

5. Order of the USSR Ministry of Health dated July 31, 1978 No. 720 “On improving medical care patients with purulent surgical diseases and strengthening measures to combat nosocomial infections.”

6. Order of the USSR Ministry of Health dated April 20, 1983 No. 440 “On additional measures to improve medical care for newborn children.”

7. Order of the Ministry of Health of Russia dated November 26, 1997 No. 345 “On improving measures for the prevention of nosocomial infections in obstetric hospitals.”

No. 15/6-20 "Prevention of nosocomial infections in newborns and children early age in children's hospitals."

9. Order of the USSR Ministry of Health dated August 4, 1983 No. 916 “Instructions on the sanitary and anti-epidemic regime and labor protection of personnel of infectious diseases hospitals (departments).”

10. Guidelines on the organization and implementation of a complex of sanitary and anti-epidemic measures in aseptic departments (blocks) and wards dated 04/30/1986 No. 28-6/15.

11. Control methods. Biological and microbiological factors. Control of disinfection chambers. Methodical instructions. MUK 4.2.1035-01.

Appendix 1 (for reference)

When organizing or major renovation(redevelopment) of the premises of the disinfection unit can be guided by the following documents: “The equipment sheet for hospitals and clinics”, approved by the USSR Ministry of Health on May 3, 1963 No. 201 and “Norms for the main planning elements of residential and public buildings”, section “Medical buildings. Hospitals. Disinfection departments” NP 6.1.1.11-83, approved by order of the State Civil Engineering of the USSR dated

03.25.1983 No. 81. Despite the fact that these documents have lost force, and new documents regulating the required area and capacity of disinfection chambers have not been approved, the data below can be used to organize the work of disinfection units.
Equipment for disinfection chambers and disinfection block areas
Number of beds in health care facilities
Volume of disinfection chambers*, m3
Brand of disinfection chamber**
Area of the disinfection unit, m2 (not less)

up to 199
3,0
VFS 2 or VFS 3
14,0

up to 299
5,0
VFS 2 + VFS 3
30,0

up to 599
7,0
VFS 2 + VFS 5
Depending on the type of disinfection chambers

up to 899
8,0
VFS 5 + VFS 3
Same

up to 2000
18,0
3 pcs. VFS 5+

VFS 3
Same

* The height of the disinfection unit is at least 3 m everywhere.

** Disinfection chambers, except VFS2 and VFS3, require a steam source.
Date of chamber processing (day, month, year)
1

Load serial number and brand of disinfection chamber
2

Chamber disinfection method (steam-air, steam-formalin)
2a

Address of owner, organization, institution, department of health care facility
3

Purpose of disinfection (prevention, etc.)
4

The texture of things, their weight, number of sets
5

Up to 80 °C using the steam-air method Up to 60 °C using the steam-formalin method

1 time at the beginning of the working day before loading things
Start
Warming up an unloaded chamber
6

Ventilation time after initial heating (min)
7

Administration of formaldehyde (% formaldehyde content) in ml

(per 1 m3 of disinfection chamber volume)
9

Time (min), temperature according to external thermometers
Start
Exposition
10

Time (min), temperature according to external thermometers
end

Ventilation time (+ drying) (min), heater
11

Time (min), temperature according to external thermometers
Neutralization of formaldehyde
12

Ventilation time after neutralization process (min)
13

Material unloading time
14

Signature of the disinfectant who carried out the treatment

Disinfection chambers are devices and special structures in which various things are disinfected and insects are destroyed using physical, chemical, or both, means.

Disinfection chambers are installed in health care facilities, sanitary and epidemiological institutions, baths, laundries, as well as in some industrial enterprises where the raw materials are contaminated materials.

↯ More articles in the magazine

The main thing in the article:

The importance of a disinfection chamber

Types of disinfection chambers

According to their purpose, disinfection chambers are divided into:

Disinfecting.
Disinsection.

The latter destroy only insects for which the critical temperature is lower than for various types of bacteria.

Disinfection chamber device

According to the nature of the device, they are distinguished:

stationary;
movable;
transportable (on a trailer) cameras.

Camera types

Cameras are divided into types:

steam;
steam-formalin;
hot air.

The designs of steam chambers provide for work using steam, steam-air and steam-formalin methods.

Stationary cameras are installed in special rooms - standard or adapted, called disinfection units.

The disinfection unit must have heating, water supply, lighting, and supply and exhaust ventilation.

The area of the disinfection unit must correspond to the dimensions and number of disinfection chambers in it.

Arrangement of a chamber hall

The chamber hall consists of two sections, isolated by a transverse partition:

loading compartment;
unloading compartment.

One half – “dirty” – is used for receiving, sorting and loading things subject to chamber disinfection (loading compartment).

The other is “clean” – for disinfected items (unloading compartment).

With this arrangement of the disinfection chamber, its control front, supply openings, fan and motor are located in the unloading compartment and are accessible for inspection and repair.

All control of the device is carried out from the unloading compartment. The partition provides a hermetically sealed window for the transfer of documents, money and other items that are not subject to chamber disinfection, or a box with two doors.

Dimensions of the chamber hall

The dimensions of the cell room depend on the external dimensions adopted for this type of cell (table).

The width of the room is made up of the outer width of the chamber, the area required to install the electric motor with a fan, and the gap between the installations and the walls.
The length of the room is made up of the outer length of the chamber and the working rooms on the side of the loading and unloading compartments, 2500 mm each; when using a loading trolley, the length of the room increases by 2 chamber lengths.
The height of the chamber hall is at least 3.5–4 m, taking into account the high temperature of 25–30 °C that occurs in the unloading compartment.

At the loading section of the chamber hall, a sanitary lock for disinfectors is equipped, consisting of a dressing room with cabinets for outerwear, a toilet, a shower and a dressing room with cabinets for work clothes. A window and door will be installed to receive things.

Ventilation of the disinfection unit

Installation of the floor of the disinfection room

The floor is covered with metlakh* tiles, the walls are painted with oil paint to facilitate cleaning and disinfection of the premises.

* Metlakh tiles - ceramic floor tiles - clay tiles fired before sintering with the addition of dyes. The front side of floor tiles can be corrugated, smooth, with a pressed pattern, etc. The tiles are laid on a cement-sand screed or special mastics.

Set and area of premises of the disinfection unit

Room	Area for hospital with number of beds, m2
Room
Receiving and sorting things
Issue of things
Pantry of disinfected items
Disinfection chamber premises
Loading compartment
Unloading compartment
Gateway between loading and unloading compartments
Bleach storage room
Storage room for disinfectants
Room for storing household equipment
Toilet for 1 toilet (with washbasin in the airlock), sanitary inspection room for staff with shower

According to existing standards, the disinfection unit must have the equipment listed below:

buckets (2 pcs.);
scales;
hangers (50 pcs.);
hydraulic remote control, chlorine-containing preparations;
log of chamber processing of things;
instructions for modes, passports of installed cameras;
fire extinguisher;
mittens (2 pairs);
special clothing according to standards;
racks for things on the “clean” and “dirty” halves;
stools, tables, chairs (2 pcs.);
external thermometers (1 straight and 1 angled);
containers for liquid;
alarm clock or timer;
cabinet for disinfectants;
hose 10 m long;
washbasin, brushes, rags, soap, towel;
suits for work at the OI;
bactericidal lamps.

As a rule, all disinfection chambers consist of:

From the camera itself.
Heat source.
Equipment for introducing chemicals.
Water supply and drainage systems.
Condensate drainage systems in sewers.
Supply and exhaust ventilation systems.

The number of positions for health care facility disinfectors depends on the number of beds in the hospital:

up to 100 beds – 0.5 rate;
100–250 beds – 1 position;
250–400 beds – 2 positions;
400–500 beds – 4 positions;
over 500 beds - an additional position is established for every 250 beds.

Monitoring the operation of disinfection chambers

The operation of the device must be controlled by technical and biological methods.

Technical control is carried out in order to establish the serviceability of all equipment (pressure gauge, thermometer, valves), as well as steam lines and air ducts.

The integrity of the apparatus and its equipment can be determined visually. In addition, to check the operation of the valves, its tightness or components, the permeability of steam pipelines, a test start of steam and test heating are used.

If, after closing the valve, the section of pipe located behind it continues to heat up, this indicates a defect in the valve (steam is leaking through). Such valves must be repaired or replaced.

Indications of the operation of disinfection chambers in medical institutions

The faulty pressure gauge is replaced with a new one - tested and sealed.

The degree of heating in thermal devices is determined by an objective method - thermometry. The graduated part of the external thermometer is located outside, its end with a mercury ball is inserted inside it.

Temperature dynamics are recorded in the following stages:

temperature before heating starts;
heating to the temperature from which the exposure count begins;
maintaining a certain temperature during exposure.

All listed temperature readings are recorded in the chamber operation protocol (Appendix 2).

The readings of external thermometers indicate only the temperature of the air and steam in the chamber, but not the temperature that was in the disinfected things inside during this period of time.

To determine the temperature in disinfected items that provides a bactericidal (insecticidal) effect, maximum thermometers are used.

The effectiveness of disinfection depends not only on the required temperature in the chamber, but also on its uniform distribution in the things loaded into it.

The uniformity of temperature distribution inside things is determined using 9 or 15 maximum thermometers, depending on the volume of the chamber.

In the loading chamber, maximum thermometers must be placed in the thickness of things (under collars, in pockets or folds of clothing).

To do this, thermometers are placed in special pouches together with test objects and placed at 9 points according to a pattern similar to the arrangement of stamps on an envelope, on two levels: in the upper and middle parts of the chamber.

Maximum thermometers are subject to systematic testing, which is carried out in the same way as external chamber thermometers.

The following cultures serve as standards for bacteriological control of the reliability of disinfection of things in the chamber:

When processing items from foci of infections caused by non-spore-forming microbes - Staphylococcus aureus ( Staphylococcus aureus), strain 906.
When processing things from foci of tuberculosis - non-pathogenic mycobacterium ( Mycobacterium), strain B-5.
When processing items from foci of infections caused by spore-forming microbes, culture Bacillus cereus, strain 96, in spore form (anthracoid).

The media prepared in this way are numbered and placed in a bag measuring 10 × 15 cm, which has a special compartment for a maximum thermometer. The bags are placed at control points.

After testing the biological indicators NIR-ILC, they are removed from the bags, placed in a plastic bag and, with the appropriate direction, delivered to the laboratory for further research. If growth of a biological indicator is detected in at least one of the crops, the operation of the chamber is re-monitored.

At the same time, they more carefully check its technical condition, the rate of loading of things, and the correctness of their placement in the chamber.

Disinfection chambers, like other equipment, require repair and timely replacement. After 10 years of operation, the disinfection chamber can no longer work effectively enough, so it is unacceptable to purchase new ones on a residual basis. These costs should be included in programs for the prevention of nosocomial infections in medical institutions.

Carrying out complete chamber disinfection of bedding in health care facilities is regulated by the following regulatory documents:

SaNPiN 2.1.3.1375-03 “Hygienic requirements for the placement, design, equipment and operation of hospitals, maternity hospitals and other medical hospitals.”
SP 3.5.1378-03 “Sanitary and epidemiological requirements for the organization and implementation of disinfection activities.”
Order of the USSR Ministry of Health dated September 3, 1991 No. 254 “On the development of disinfection in the country.”
The concept for the prevention of nosocomial infections, approved by the Russian Ministry of Health on December 6, 1999.
Order of the USSR Ministry of Health dated July 31, 1978 No. 720 “On improving medical care for patients with purulent surgical diseases and strengthening measures to combat nosocomial infections.”
Order of the USSR Ministry of Health dated April 20, 1983 No. 440 “On additional measures to improve medical care for newborn children.”
Order of the Ministry of Health of Russia dated November 26, 1997 No. 345 “On improving measures for the prevention of nosocomial infections in obstetric hospitals.”
Methodological recommendations of the USSR Ministry of Health dated September 28, 1989 No. 15/6-20 “Prevention of nosocomial infections in newborns and young children in children's hospitals.”
Order of the USSR Ministry of Health dated August 4, 1983 No. 916 “Instructions on the sanitary and anti-epidemic regime and labor protection of personnel of infectious diseases hospitals (departments).”
Guidelines for organizing and carrying out a set of sanitary and anti-epidemic measures in aseptic departments (blocks) and wards dated 04/30/1986 No. 28-6/15.
Control methods. Biological and microbiological factors. Control of disinfection chambers. Methodical instructions. MUK 4.2.1035-01.

When organizing or major repairs (redevelopment) of the premises of the disinfection unit, you can be guided by the following documents: “Certificate of equipment for hospitals and clinics”, approved by the USSR Ministry of Health on May 3, 1963 No. 201 and “Standards for the main planning elements of residential and public buildings”, section “Medical buildings. Hospitals. Disinfection departments” NP 6.1.1.11-83, approved by order of the State Civil Engineering of the USSR dated March 25, 1983 No. 81.

Despite the fact that these documents have lost force, and new documents regulating the required area and capacity of disinfection chambers have not been approved, the data below can be used to organize the work of disinfection units.

Equipment with disinfection chambers and disinfection block areas