How to Clean Up Blood and Other Potentially Infectious Fluids

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

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?

 

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  • Bill Slocum

    Very surprised at the stand times for solution after making. These are very similar to the “let stand on waste” times before contact with instruments that I learned.

    I am very sure that just using these solutions without giving them time to do their work is missing in this discussion, Doc!

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Bill,

      Here’s an excerpt and a link to the cdc/osha recommendations

      An important issue concerning use of disinfectants for noncritical surfaces in health-care settings is that the contact time specified on the label of the product is often too long to be practically followed. The labels of most products registered by EPA for use against HBV, HIV, or M. tuberculosis specify a contact time of 10 minutes. Such a long contact time is not practical for disinfection of environmental surfaces in a health-care setting because most health-care facilities apply a disinfectant and allow it to dry (~1 minute). Multiple scientific papers have demonstrated significant microbial reduction with contact times of 30 to 60 seconds46-56, 58-64. In addition, EPA will approve a shortened contact time for any product for which the manufacturers will submit confirmatory efficacy data.

      http://www.cdc.gov/hicpac/Disinfection_Sterilization/3_4surfaceDisinfection.html

      Do you disagree? I could be misinterpreting.

      However, I did find this more recent recommendation (10/14) from osha regarding ebola. Here they recommend soaking for 30 minutes, so that may be the new norm.

      https://www.osha.gov/Publications/OSHA_FS-3756.pdf

      • Bill Slocum

        Well, I am only writing from my experience with infectious disease at the University of Virginia with Avian Flu around the year 2001. Additionally, I worked for the Federal Gov’t as a Technical Writer and believe an editor may have edited this for lack of understanding of the subject or what the writer intended.

        As we know, the CDC has been saying different things about the same thing throughout this almost epidemic. I’m very glad that these things are getting corrected over time, but both the CDC’s failure to prescribe proper PPE and possibly the hospital’s failure to provide prescribed PPE has caused a lot of problems for the American Public.

        As always, my writings are only my opinion from experience, study and perception of the nature of our world.

        • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

          Thanks, Bill.

  • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

    Hi, Vic, sorry if I missed your question before. If SHTF I would think, most likely, things that were common in the past or some still common in undeveloped countries would be best bets at coming back. I have posts on many of these. Just type the name in “google custom search” or click on the “Topics” tab at the top of this page and, then, click “infectious diseases.” I’m going to put a * by the ones below that I have posts on. I’ll have posts on some of the others in the future. Bad water and poor sanitation could cause cholera, typhoid fever*, giardiasis*, cryptosporidiosis, e.coli and many others. Crowded conditions could lead to lice-borne typhus*, respiratory diseases such as tuberculosis, the flu*, diphtheria. Mosquitoes could easily bring back malaria* and yellow fever. Prevention would be to try to always drink clean water*, proper hand washing, universal precautions*, and an N95 mask*. Of course good nutrition would help you fight any disease off. Prevention is so key because so many of the infections we can easily treat well (strep, staph, others) now, will become deadly due to scarcity of care. Essential oils? Tea tree is a good one for topical use against a lot of fungi and bacteria, Raw honey* is great for bacterial skin infections. Fish antibiotics? You would use same kind and dosage as regular antibiotics. If you sign up for my newsletter, you’ll get my recommended medical supplies. And there’s a post on antibiotics here http://www.thesurvivaldoctor.com/coloradocollege/

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  • jancieb

    Thank you, this is very helpful. How long would you process instruments if you were using a conventional pressure cooker, rather than the automatic unit specified here?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      I haven’t been able to find any official times but I would think 20 minutes at high pressure would more than suffice in austere situations.

      • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

        Here’s some info for autoclaves from the cdc which can give you some insight when using a pressure cooker. http://www.cdc.gov/hicpac/disinfection_sterilization/13_0sterilization.html

        When the instruments are wrapped, it suggests a minimum of 30 minutes at 250 degrees F. but times vary in whether it’s rubber or metal (For me, I wouldn’t try heating rubber in a pressure cooker) and whether it’s wrapped or unwrapped. I assume unwrapped takes less time.

  • Debbra W

    I use 1/3 cup ammonia, and 1/8 cup of alcohol in a spray bottle. I could increase the amounts for a large yucky area. Would ammonia work okay? The chlorine bleach smell makes me woozy.

    • jancieb

      Debbra, I agree with Dr. Hubbard. The combination of chlorine and ammonia produces chlorine gas which is toxic. Maybe that was the cause of your feeling woozy?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Well, the worst would be if you had some serious reaction. Just don’t ever mix ammonia and bleach. Ammonia should work. However, I don’t trust it as much as chlorine in blood spills or something with a high risk of infection. Whatever you use, soap and water first would help. And be sure to wear gloves and a mask with any chemicals. It would be nice to air out the room also.

      • Debbra W

        I didn’t say I mixed ammonia and bleach. I already knew you shouldn’t. I just mix ammonia and alcohol to use instead of bleach. The smell of bleach alone is enough to make me woozy. Thank you Dr. Hubbard and jancieb for being concerned. Survival folks look out for each other. ;-)

  • obxster

    Is all this in your book?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Using bleach as a disinfectant, yes. I don’t believe the exact directions for cleaning up a sick/trauma room is in the book, however.

  • Bobbi

    Liquid chlorine bleach does have a short shelf life. Store powdered bleach used to shock pools.

    • Penny Pincher

      What is the ratio for the pool shock to water?

      • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

        Penny, you’re making me do math here. Please, anyone with math skills, please check my figures. OK, a 1:10 solution for 5% liquid chorine bleach is 0.5 percent and a 1:100 is 0.05 %. Pool bleach is around 78 percent hypochlorite (bleach). 1 cup equals about 28 gms. So if I took 1/4 cup (7 gms) of 78 percent hypochlorite, that’s 5 gms of pure bleach. And if mix it in 1 liter (about a quart) of water that would be 5/1000 = 0.005 or 0.5 percent bleach. So, to make a 1:10 solution of bleach, you’d mix 1/4 cup of the 78% hypocrite powder into 1 liter (or quart) of water. To make a 1:100 solution, you’d mix 1/4 cup into 10 liters (10 quarts, or 2 1/2 gallons) of water. I’m going to run that by my Facebook fans also.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      True, Bobbi. Thanks.