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Medical Simulation Equipment Cleaning Protocols

Tuesday, April 7, 2020  
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by SimGHOSTS Vice President Nick Brauer

Over the past couple weeks and months the world has been scrambling to get ahead of COVID-19.  Hospitals and clinics alike are scrambling for PPE, supplies and medical equipment.  Many of us may feel there is not much we can do as we are not able to contribute supplies and or equipment. With this in mind, what role can you play during this epidemic to help improve the wellbeing of sim “customers?”  Besides staying at home and/or distancing ourselves from others, vendors/manufacturers have guidelines to cleaning and disinfecting simulation equipment, static/VR/AR trainers and manikins.

What procedures are being followed or have been implemented to kill bacteria and viruses?  Do you know what the protocols are?  Every online source is selling the “magic bullet.”  Many may be legitimate, but in fact, the chemicals are likely much too harsh for sim products.  Simulation manufacturers have specific guidelines for maintaining and cleaning and a few have distributed recommendations for COVID viruses.  

Below are cleaning protocols provided by many manufacturers: 

CAE

https://caehealthcare.com/covid19/
CLEANING SIMULATORS - Tips for Cleaning CAE Healthcare Simulators: Use a mild detergent and warm water to remove most marks and stains. Gently rub the soiled area with a soft cloth. Do NOT use ABRASIVE soaps or pads.

Operative Experience
https://operativeexperience.com/support/
Cleaning Simulators can be wiped clean with a simple solution of mild soap and water. Insert the vent plugs into the ventilation openings to protect the electronics when washing the unit.

BluePhantom
http://info.bluephantom.com/blue-phantom-user-guides
Much of the BluePhantom line can be cleaned using the following directions -
Cleaning Your Training Model After each use, your training model can be easily cleaned using mild soapy water. For best results, mix one part liquid soap with one part tap water. Gently rinse the model with the soapy water to remove any accumulated debris. Use a clean, soft, lint-free cloth to dry after cleaning. Dry the model using a dabbing motion, rather than wiping or rubbing the model.

Laerdal
https://www.laerdal.com/us/downloads
Nursing Anne
External Skin Use a lint free cloth to remove dirt and dust. Clean skin with mild soap and water. Do not submerse.

SimMan 3G
“Never perform mouth-to-mouth or mouth-to-nose rescue breathing on the Patient Simulator. The simulator’s airways are not designed for cleaning or disinfection.”
Clean the outside of the Patient Simulator with manikin wipes

Gaumard
https://www.gaumard.com/downloads

Pediatric Hal 5 year old
Remove all traces of any lubricant from the simulator. Do not clean it with harsh abrasives. The simulator should be cleaned with a cloth dampened with diluted liquid dish washing soap. The simulator is “splash-proof” but not water-proof.  Do not submerge or allow water to enter the interior of the simulator. Dry the simulator thoroughly and apply baby powder to return the simulator's skin to its lifelike feel.

Victoria
The simulator should be cleaned with a cloth dampened with water and dry thoroughly. Remove all traces of any lubricant. Do not clean with harsh abrasives. Do not use povidone iodine. The simulator is “splash-proof” but not water-proof. Do not submerge or allow water to enter the interior of the simulator.

Tory
The simulator should be cleaned with a cloth dampened with diluted liquid dish washing soap. Remove all traces of any lubricant. Do not clean with harsh abrasives. Do not use povidone iodine on the simulator. Dry thoroughly. The simulator is “splash-proof” but not water-proof. Do not submerge or allow water to enter the interior of the simulator

Limbs and Things
GENERAL CLEANING INSTRUCTIONS FOR LIMBS & THINGS PRODUCTS: https://mcusercontent.com/c0c9789bee54a009feadce82d/files/4ad3c609-a982-401c-964f-043af2c545bd/Care_of_L_T_Products.pdf

Prompt Flex Birthing Simulator
Mother - Skin washable with soap and water
Baby - To remove the lubricant, wipe clean with a soft, damp cloth and use mild detergent only. We do not recommend running under the tap, as there is the possibility of water ingress via the arm and leg spigots. Don’t use harsh chemicals (such as alcohol, benzene, or thinners) to clean your baby or charging dock.

Tru Corp
https://www.trucorp.com/Content/files/GenCart/ProductPdfs/UserManual/AirSimComboX.pdf
AirSim airway heads
Thoroughly wash the AirSim airway in warm water. Please use warm soapy water or something similar until all visible foreign matter and residue is removed. Mild detergents or enzymatic cleaning agents may be used on the airway in accordance with the manufacturer's instructions and at the proper dilution. The detergent must not contain skin or mucous membrane irritants. Please do not use any of the following when cleaning the AirSim product range • Germicides, disinfectants, or chemical agents such as glutaraldehyde (e.g. Cidex®), • Ethylene oxide, phenol-based cleaners or iodine-containing cleaners

Cardionics
www.cardionics.com 
SAM / PAT
Clean with soap and water

Simulaids
https://www.simulaids.com/page/instruction
Flexible Rescue Randy
The manikin should be washed with hot, soapy water (do not immerse in water).  The vinyl is porous and will hold stains.  The use of solvents or strong cleaners is not recommended.  However, an “all-purpose” cleaner (i.e. 409 or Fantastic) may be used.  Do not immerse the manikin in water or other fluids as the foam interior will hold moisture and become infested with biological growth that you cannot remove.

Oculus Quest
Oculus VR Head Sets
https://uploadvr.com/sanitize-clean-vr-headsets-oculus/ 

VRmagic
https://www.vrmagic.com/
Eyesi Direct Opthalmoscope

 

  • None of the components should be immersed or sprayed with cleaning liquid directly. Always use a smooth cloth with little cleaning agent or water.
  • The painted surfaces (e.g the glossy parts of patient interfaces, hand pieces, hat units) should not be treated with aggressive cleaning agents, light alcohol should be possible though. Please spare lenses, infrared windows and transparent plastic windows.
  • Powder coated surfaces can be cleaned and disinfected normally, using a slightly soaked cloth or prepared wipes (e.g. Lysol, Clorox, Sagrotan etc.)
  • All components have been tested against the usual cleaning methods during development - however not for those special situations with disinfection after each training person. As a practical advice protective gloves could be used as well as a control pencil for the touchscreen (for newer models with resistive touch a pencil as for tablets or smartphones can be used, for older models of the Eyesi Surgical any blunt-ended stick will do).

While this list is definitely not comprehensive, it does cover a wide range of simulation equipment. One thing to note is most trainers only require soap and water to clean and several mention specifically NOT to use harsh chemicals.  My recommendation is to use common sense and always contact your vendor for detailed instructions when it’s not available online or in the manual.