Handwashing Technique

Last spring, there was a report in the press that disinfectant wipes may contribute to the spread of drug-resistant bacteria in hospitals. This information originated with findings presented at the American Society of Microbiology's annual meeting. According to a report distributed by Reuter's, researchers at the Welsh School of Pharmacy at Cardiff University explained that "[w]hile the wipes killed some bacteria, a study of two hospitals showed they did not get them all, and could transfer the so-called superbugs," including methicillin-resistant Staphylococcus aureus (MRSA), "to other surfaces."

In greater detail from United Press International, a team led by Jean-Yves Maillard, Ph.D. observed intensive care unit (ICU) "hospital staff using surface wipes to decontaminate bed rails, monitors, tables and key pads, and other surfaces touched by patients and staff." According to the BBC, while the researchers visited the Welsh hospitals, they observed that "it was common for a single wipe to be employed on more than one surface." The "wipes were quite good at picking up bacteria from the first surface, but were unable to kill off the bacteria they picked up swiftly."

I would agree with these observations, because we have all observed the same in a health care setting. How many of us have used a disinfecting wipe, or other cleansing wipe, in the proper manner, that is to use it for a single surface, then discard it? It's so much easier to use it until it is caked with dust and grime, not thinking that it has probably lost its disinfection potential after the first swipe over a filthy surface.

The most blatant extrapolation I witnessed of this concept in the outdoors was during a trek to Pheriche in Nepal. We were on our way to visit the Himalayan Rescue Association medical outpost. The group of a dozen trekkers would take great care before each meal to wash hands in water that had been boiled and then colored purple for disinfection purposes with potassium permanganate, only to share the same towel in order to dry our hands. By the time the towel was used by the last person, who knew how many bacteria and viruses had taken residence amongst the shed skin, shared wash water, and other assorted flecks of dirt and plant material that had been rubbed into the cotton pile. The only way that we could have more effectively shared our germs would have been to rub all of our hands together at one time.

If disinfection of a liquid or surface (e.g., eating utensil, bowl, towel, wound dressing) is important, it must be done properly and with full knowledge of the limitations of the method used. For wiping things down with disinfectant wipes, the best method is "one surface per wipe," and to use as many wipes as are necessary to achieve a clean appearance. That is no guarantee of disinfection, but it is better than leaving obvious dirt (and presumably, infectious agents) in place, and certainly better than moving the germs from one place to another.

photo courtesy of www.i.ehow.com

Join me from January 24 to February 2, 2010 for an exciting dive and wilderness medicine CME adventure aboard the Nautilus Explorer to Socorro Island, Mexico to benefit the Wilderness Medical Society.

Tags: disinfection, hand washing, disinfecting wipes, wilderness medicine, outdoor medicine, healthline

Labels: disinfection, hand washing, wipes

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