Medical Bag Research Articles

Estimation the Properties of Polymer Matrix Reinforced with Plants Extract Used for Medical Fluid Bags

Abstract The utilize of polyvinyl chloride in the manufacturing of blood bags responsible for preserving blood. It attains an extensive range of performance and processing requirements such as flexibility, transparency, physical, antibacterial and non-hemolysis properties. So, in the present flax-seed gel was incorporated in PVC matrix at various concentration (1, 2 and 3) %. Then wheat extract was added to samples has better properties in two percentage (0.5 and 1) %. The obtained results show, a significant change in the properties of the composite produce, where the tensile strength increased with increasing concentration of extract from flax seed gel, but it decreased when wheat extract was added, and when both extracts were added, the inhibition zone increased against bacterial activity for two types of bacteria (S. aureus and C. albicans). Also, the ability to absorb water and wettability increased with increasing concentration of plant extracts. On the other hand, the transparency decreased with increasing concentration of flaxseed gel, but when wheat gel was added to it increase of transparency. All samples were non-hemolytic in hemolysis test.

Management of Sideline Medical Emergencies.

Sideline medical care is typically provided by musculoskeletal specialists and orthopaedic surgeons with varying levels of training and experience. While the most common sports injuries are often benign, the potential for catastrophic injury is omnipresent. Prompt recognition of sideline emergencies and expeditious medical management are necessary to minimize the risk of calamitous events. Paramount to successful sideline coverage are both preseason and game-day preparations. Because the skillset needed for the sideline physician may involve management of injuries not commonly seen in everyday clinical practice, sideline providers should review basic life support protocols, spine boarding, and equipment removal related to their sport(s) before the season begins. Before every game, the medical bag should be adequately stocked, location of the automatic external defibrillator/emergency medical services identified, and introductions to the trainers, coaches, and referees made. In addition to musculoskeletal injuries, the sideline orthopaedic surgeon must also be acquainted with the full spectrum of nonmusculoskeletal emergencies spanning the cardiopulmonary, central nervous, and integumentary systems. Familiarity with anaphylaxis as well as abdominal and neck trauma is also critical. Prompt identification of potential life-threatening conditions, carefully orchestrated treatment, and the athlete's subsequent disposition are essential for the team physician to provide quality care.

Novel High-tech, Low-cost Ventilation for Military Use, Mass Casualty Incidents, Stockpiling, and Underserved Communities.

Despite the significant need for mechanical ventilation in- and out-of-hospital, mechanical ventilators remain inaccessible in many instances because of cost or size constraints. Mechanical ventilation is especially critical in trauma scenarios, but the impractical size and weight of standard mechanical ventilators restrict first responders from carrying them in medical aid bags, leading to reliance on imprecise manual bag-mask ventilation. This is particularly important in combat-related injury, where airway compromise and respiratory failure are leading causes of preventable death, but medics are left without necessary mechanical ventilation. To address the serious gaps in mechanical ventilation accessibility, we are developing an Autonomous, Modular, and Portable Ventilation platform (AMP-Vent) suitable for austere environments, prolonged critical care, surgical applications, mass casualty incidents, and stockpiling. The core system is remarkably compact, weighing <2.3 kg, and can fit inside a shoebox (23.4 cm × 17.8 cm × 10.7 cm). Notably, this device is 65% lighter than standard transport ventilators and astoundingly 96% lighter than typical intensive care unit ventilators. Beyond its exceptional portability, AMP-Vent can be manufactured at less than one-tenth the cost of conventional ventilators. Despite its reduced size and cost, the system's functionality is uncompromised. The core system is equipped with closed-loop sensors and advanced modes of ventilation (pressure-control, volume-control, and synchronized intermittent mandatory ventilation), enabling quality care in a portable form factor. The current prototype has undergone preliminary preclinical testing and optimization through trials using a breathing simulator (ASL 5000) and in a large animal model (swine). This report aims to introduce a novel ventilation system and substantiate its promising performance through evidence gathered from preclinical studies. Lung simulator testing was performed using the ASL 5000, in accordance with table201.105 "pressure-control inflation-type testing" from ISO 80601-2-12:2020. Following simulations, AMP-Vent was tested in healthy 10-kg female domestic piglets. The Children's Hospital of Philadelphia Institutional Animal Care and Use Committee approved all animal procedures. Swine received 4-min blocks of alternating ventilation, where AMP-Vent and a conventional anesthesia ventilator (GE AISYS CS2) were used to titrate to varied end-tidal carbon dioxide (EtCO2) goals with the initial ventilator switching for each ascending target (35, 40, 45, 50, 55 mmHg). During ASL 5000 simulations, AMP-Vent exhibited consistent performance under varied conditions, maintaining a coefficient of variation of 2% or less within each test. In a large animal study, AMP-Vent maintained EtCO2 and SpO2 targets with comparable performance to a conventional anesthesia ventilator (GE AISYS CS2). Furthermore, the comparison of minute ventilation (Ve) distributions between the conventional anesthesia ventilator and AMP-Vent at several EtCO2 goals (35, 40, 45, 50, and 55 mmHg) revealed no statistically significant differences (p = 0.46 using the Kruskal-Wallis rank sum test). Preclinical results from this study highlight AMP-Vent's core functionality and consistent performance across varied scenarios. AMP-Vent sets a benchmark for portability with its remarkably compact design, positioning it to revolutionize trauma care in previously inaccessible medical scenarios.

Development of an ELISA-based device to quantify antibody adsorption directly on medical plastic surfaces

Monoclonal antibodies (mAbs) encounter numerous interfaces during manufacturing, storage, and administration. While protein adsorption at the solid/liquid interface has been widely explored on model surfaces, a key challenge remains – the detection of very small amounts of adsorbed mAb directly on real medical surfaces. This study introduces a novel ELISA-based device, ELIBAG, a new tool for measuring mAb adsorption on medical bags. The efficacy of this device was highlighted by successfully confirming the adsorption of an IgG1 on two medical bag types: a polypropylene IV administration bag and a low-density polyethylene pharmaceutical manufacturing bag. We also investigated IgG1 adsorption on plastic model surfaces, revealing a similar range of mAb bulk concentration for surface saturation on both model and bag surfaces. This innovative device, characterized by its high-throughput and rapid approach, paves the way for extensive investigations into therapeutic proteins, such as mAbs, adsorption on a variety of medical or pharmaceutical surfaces, diverse adsorption conditions, and the influence of excipients employed in mAb formulation, which could enhance the knowledge of mAb interactions with plastic surfaces throughout their lifecycle.

FIFA Initiatives Improved Survival After Loss of Consciousness During Football Games.

Loss of consciousness (LOC) during football games is associated with very high mortality rates. In order to address football medical emergencies, in 2013 FIFA implemented the "FIFA 11 steps to prevent sudden cardiac death" program and distributed the FIFA Medical Emergency Bag. The purpose of this work was to identify independent survival factors after LOC on the pitch and to investigate the effectiveness of the FIFA initiatives. An internet search was performed to identify football players suffering LOC on the pitch between 1990 and 2021. A total of 268 cases could be identified and were dichotomized according to the implementation date of the FIFA medical emergency bag. There was 55% mortality after LOC, while cardiogenic LOC was more often (82% vs. 20%) fatal than traumatic LOC. Mortality in developing countries was higher than in developed countries. From the year 2013 survival improved significantly for both traumatic and cardiogenic cases. The location of the LOC significantly influenced survival (OR: 0.20 and p<0.001). LOC on the football field is associated with increased mortality and requires separate monitoring based on a traumatic vs. non-traumatic cause. FIFA initiatives significantly reduced mortality after LOC but significant differences were identified between developed and developing countries.

Investigating the Crash Protection Performance of a Medical Carrier Bag for Drone Transport

Background: Drone transport regulations in Europe require a crash-protected container (CPC) to be used for the carriage of dangerous goods. With increasing interest in the use of drones for medical logistics, the motivation behind this research was to investigate whether the existing approved medical carriers could also pass as CPCs. To date, there has been little practical experimentation on or theoretical research into the crash protection performance of medical containers. Methods: Addressing this gap, this paper reports findings from a series of drop test experiments to investigate the crashworthiness of a standard medical carrier bag used by the National Health Service (NHS) in the UK. Th drop tests were performed from heights of up to 122 m using standard medical carriers containing bags of dyed saline to examine the robustness of the carrier and whether it could contain any leakages, a key requirement for transporting dangerous goods. Results: The tests found that the medical carrier failed on some drops, with the zipped lid being identified as the main weakness. Conclusions: A new understanding of the carrier’s terminal velocity, impact acceleration, and failure mechanisms were gained and subsequent strengthening and waterproofing remedial measures recommended. New insights and practical recommendations are provided relating to performing formal drop tests and how to conduct these using a drone.

Environmentally benign, bright luminescent carbon dots from IV bag waste and chitosan for antimicrobial and bioimaging applications

Luminescent carbon dots have gained significant attention in various fields due to their unique optical properties and potential applications. Here, the study was aimed to propose a novel and sustainable approach for the synthesis of luminescent carbon dots (ICDs) using IV (Intravenous) medical bag waste. The ICDs were synthesized through a facile and cost-effective method that involved the carbonization of IV bag waste followed by surface functionalization with chitosan. The synthesized ICDs were characterized using UV–Visible spectrum (UV–Vis), Fourier Transform Infrared Spectroscopy (FT-IR), X-Ray Diffraction analysis (XRD), Scanning Electron Microscopy (SEM) and Transmission Electron Microscopy (TEM). The size of the ICDs is between 2 and 8 nm. The ICDs effectively inhibited the growth of both gram positive and gram negative bacterial strains with the inhibitory activity in the range of 11–14 mm and 12–18 mm, respectively. Results of antibiofilm activity of ICDs varying concentrations (50 and 100 μg/ml) showed that it effectively distorted the biofilm architecture and thereby validated its promising potentials. In vitro antioxidant activity showed remarkable DPPH radical scavenging potentials of ICDs (33.4%–70.1%). Results of MTT assay revealted that ICDs showed potent cytotoxic effect on HeLa cells in a dose dependant matter (25–400 μg/ml). Furthermore, when HeLa cells were excited at wavelengths of 380 nm, 440 nm and 540 nm, cell-imaging experiments using ICDs revealed the presence of blue, green, and red fluorescence. This innovative method not only addresses the issue of IV bag waste in a sustainable manner but also opens up exciting possibilities for the advancement of versatile carbon-based materials in the field of biomedicine.

Improved Faster R-CNN Network for Liquid Bag Foreign Body Detection

The production quality of medical fluid bags is closely related to patient health. In this paper, we used medical fluid bags to detect whether they contained foreign bodies. A visual acquisition system for the fluid bag was built. Vignetting correction was performed on the acquired images, and a foreign body recognition detection method based on an improved Faster R-CNN model was proposed. The feature extraction network of Faster R-CNN was discussed and studied regarding the characteristics of small foreign objects in liquid bags, and the ResNet152 network replaced the VGG16 network; furthermore, the feature fusion and attention mechanism were added to the feature extraction, and CIoU replaced the IoU loss function; the anchor box parameters were optimized and improved using the K-means clustering algorithm, and ROI Align replaced the ROI Pooling module. The improved network in this paper was compared with the Faster R-CNN model, which is a modification of feature extraction networks, such as ResNet50, ResNet101, and ResNet152, and the original VGG16 feature extraction network. The results show that the ResNet152 network had the best feature extraction effect among the feature extraction networks, and other optimizations were performed in this paper based on the use of ResNet152. In the precision−recall curve, the network in this paper showed the best effect. The improved algorithm presented in this paper was significantly improved compared with the original algorithm, with a detection accuracy of 97% and an average accuracy improvement of 7.8% in foreign object recognition.

Toxicological impact of microplastics and nanoplastics on humans: understanding the mechanistic aspect of the interaction.

Plastic is a pervasive material that has become an indispensable part of our daily lives and is used in various commercial products. However, plastic waste has significantly impacted the environment, accumulating in water and land ecosystems and harming all forms of life. When plastic degrades, it breaks down into smaller particles called microplastics (MPs), which can further breakdown into nanoplastics (NPs). Due to their small size and potential toxicity to humans, NPs are of particular concern. During the COVID-19 pandemic, the production of plastic had reached unprecedented levels, including essential medical kits, food bags, and personal protective equipment (PPE), which generate MPs and NPs when burned. MPs and NPs have been detected in various locations, such as air, food, and soil, but our understanding of their potential adverse health effects is limited. This review aims to provide a comprehensive overview of the sources, interactions, ecotoxicity, routes of exposure, toxicity mechanisms, detection methods, and future directions for the safety evaluation of MPs and NPs. This would improve our understanding of the impact of MPs and NPs on our health and environment and identify ways to address this global crisis.

Peculiarities of functioning of the medical supply system for troops (forces) during the operation to force Georgia to peace in South Ossetia (august 7–12, 2008)

The activities of providing medical equipment to the troops (forces) participating in the operation to force Georgia to peace in South Ossetia (August 712, 2008) are presented. The functioning features of medical supply institutions and units on the eve and after the invasion of the military contingents of Georgia into South Ossetia are shown. The chronology of the activities of units and institutions of medical supply in the combat zone is outlined. The features of providing troops (forces) with medicines and blood products, disinfectants, and medical products are revealed. The purchase procedure, delivery routes, and creation of a reserve of the most demanded medical equipment, as well as the dispatch and repair of mobile medical equipment in preparation for an operation and during hostilities, have been determined. Owing to the professionalism of the medical service specialists of the Armed Forces of the Russian Federation at all levels of military healthcare, a grouping of forces and means were quickly developed, including medical supply units, and institutions. The functioning issues on the system of providing medical supply to troops (forces) are indicated, considering the negative impact of objective and subjective factors and the characteristics of measures to optimize it based on the experience of medical support for troops (forces) during the operation to force Georgia to peace. The implementation of research and development improve the regulatory legal framework relating to the use of narcotic drugs and psychotropic substances in combat conditions and the creation of modern models of complete and standard equipment: first-aid kits, medical bags, medical equipment sets, and medical, and styling sets. In general, organizing the provision of medical equipment to troops (forces) during the operation to force Georgia to peace in South Ossetia allowed the involved institutions and medical supply units to cope with the tasks. Medical supply specialists of all levels of military healthcare selflessly performed their professional duties. With their efforts, military medical organizations, formations, and military units were almost completely provided with medical equipment, which contributed to the timely and complete provision of medical care and treatment of the wounded (injured).

Promising Mass-Productive 4-Inch Commercial SERS Sensor with Particle in Micro-Nano Porous Ag/Si/Ag Structure Using in Auxiliary Diagnosis of Early Lung Cancer.

The construction of commercial surface enhanced Raman scattering (SERS) sensors suitable for clinical applications is a pending problem, which is heavily limited by the low production of high-performance SERS bases, because they usually require fine or complicated micro/nano structures. To solve this issue, herein, a promising mass-productive 4-inch ultrasensitive SERS substrate available for early lung cancer diagnosis is proposed, which is designed with a special architecture of particle in micro-nano porous structure. Benefitting from the effective cascaded electric field coupling inside the particle-in-cavity structure and efficient Knudsen diffusion of molecules within the nanohole, the substrate exhibits remarkable SERS performance for gaseous malignancy biomarker, with the limit of detection is 0.1 ppb and the average relative standard deviation value at different scales (from cm2 to µm2 ) is ≈16.5%. In practical application, this large-sized sensor can be further divided into small ones (1 × 1 cm2 ), and more than 65 chips will be obtained from just one 4-inch wafer, greatly increasing the output of commercial SERS sensor. Further, a medical breath bag composed of this small chip is designed and studied in detail here, which suggested high-specificity recognition for lung cancer biomarker in mixed mimetic exhalation tests.

Functioning of the medical supply system of the troops (force) during operation to restore the constitutional order in the Chechen Republic (1994–1996): lessons and conclusions

The study presents the medical service activities in organizing the provision of troops (forces) with medical equipment during the operation to restore constitutional order in the Chechen Republic. To provide medical support to federal troops (forces), appropriate groupings of forces and medical services were created, functioning in three isolated areas. Thanks to the operational and professional work of military pharmaceutical specialists, a medical supply system was formed, involving the three main medical warehouses of the North Caucasus Military District. The paper also showed the work of medical supply units and institutions to provide federal troops (forces) with medical equipment. Issues of the functioning of the medical supply system, optimization of the composition of individual medical equipment of military personnel of the federal troops (forces), and peculiarities of storing medical equipment in the field were successfully resolved by involving the faculty of the Department of Military Medical Supply and Pharmacy of the Military Medical Academy of S.M. Kirov. Moreover, the paper presented the features of personnel provision and stages of medical evacuation with individual and group medical equipment, bags and sets of first aid, premedical, and medical kits. The system of supplying medical equipment to troops (forces) for special-purpose medical units operating in combat areas, evacuation centers, and military hospitals of the North Caucasus Military District was analyzed. Based on the medical support experience for the united grouping of troops (forces) during the operation to restore the constitutional order in the Chechen Republic, ways to improve the provision of complete equipment and technical medical service are proposed.

High-flow continuous hemodiafiltration successfully decreased blood pregabalin levels in a patient with severe pregabalin intoxication: a case report

BackgroundSevere pregabalin intoxication may cause serious symptoms, such as coma. Since pregabalin is a small molecule with no protein binding sites and has low volume of distribution, hemodialysis can be effective in eliminating pregabalin from the blood. However, in cases of emergency, it is not always possible to perform hemodialysis because of limited availability and time delay associated with using the plumbing equipment. Continuous hemodiafiltration (CHDF) can be performed without plumbing equipment; however, the knowledge on the effectiveness of CHDF in pregabalin elimination is insufficient.Case presentationA septuagenarian woman with normal renal function was found in a collapsed state with symptoms of coma and miosis. Empty medical bags of pregabalin (2350 mg), bepotastine besilate (600 mg), celecoxib (4600 mg), quetiapine fumarate (87.5 mg), clotiazepam (180 mg), and teprenone (50 mg) were found around her. During the patient's transfer to our hospital, her cognition worsened and she developed glossoptosis necessitating her emergent intubation upon arrival. We considered that the coma was mainly caused by pregabalin intoxication and were concerned about the consequent critical comorbidities. Thus, we performed CHDF in a high-flow setting in our intensive care unit for pregabalin elimination. After 8 h of CHDF, the patient regained consciousness, and after 6.5 h we extubated her. At a later date, we measured her serum pregabalin levels during the clinical course and estimated the blood pregabalin clearance levels depending on her metabolism as 76.8 mL/min and depending on CHDF itself as 65.1 mL/min. Based on these findings, we concluded that CHDF contributed to reducing blood pregabalin levels in this patient.ConclusionsOur case revealed that pregabalin clearance using CHDF is similar to metabolic clearance in patients with normal renal function, indicating that CHDF decreases blood pregabalin levels and can be a potential treatment for severe pregabalin intoxication.

Study on the Physical, Thermal and Mechanical Properties of SEBS/PP (Styrene-Ethylene-Butylene-Styrene/Polypropylene) Blend as a Medical Fluid Bag

The presence of DEHP in PVC-based medical bags poses a significant health risk to patients undergoing blood transfusion. In order to fabricate safer medical fluid bag materials, the use of SEBS/PP polymer blend as a potential material was investigated. Polymeric blends with varying weight percentages of styrene-ethylene-butylene-styrene/polypropylene (SEBS/PP) were fabricated by melt mixing using an internal Haake mixer. The physical properties of the SEBS/PP polymer blends were investigated using differential scanning calorimetry (DSC), X-ray diffraction (XRD), and inductively coupled plasma–mass spectrometry (ICP-MS). In addition, measurements of the mechanical strength (tensile strength and Young’s modulus) as per ASTM 638, polymer hardness was tested using a durometer and swelling was analysed through water absorption and compared with commercial PVC-based blood bags. The results indicate that the SEBS/PP 50/50 blend has approximately similar characteristics as PVC-based blood bags. The SEBS/PP polymer blend possesses approximate tensile strength and Young’s modulus with values of 23.28 MPa and 14.42 MPa, respectively, to that of the conventional PVC blood bags. The results show that the SEBS/PP polymer blends have negligible zinc and aluminium migration with values of 1.6 and 2.1 mg/kg, respectively, and do not elute any harmful leachates, while the thermal studies indicate that the studied SEBS/PP materials are capable of withstanding steam sterilisation at 120 °C and cold storage below −40 °C. The investigated material can be utilized for medical fluid bags and contributes towards sustainable development goals, such as SDG 3 to ensure healthy lives and promote well-being, as well as SDG 12 to ensure sustainable consumption and production patterns.

Risk Assessment of Phthalates and Their Metabolites in Hospitalized Patients: A Focus on Di- and Mono-(2-ethylhexyl) Phthalates Exposure from Intravenous Plastic Bags.

Phthalate esters (PAEs) are plasticizers associated with multiple toxicities; however, no strict regulations have been implemented to restrict their use in medical applications in Lebanon. Our study aimed at assessing the potential risks correlated with phthalate exposure from IV bags manufactured in Lebanon. GC–MS analysis showed that di-(2-ethylhexyl) phthalate (DEHP) is the predominant phthalate found in almost all samples tested with values ranging from 32.8 to 39.7% w/w of plastic. DEHP concentrations in the IV solutions reached up to 148 µg/L, as measured by SPME-GC–MS/MS, thus resulting in hazard quotients greater than 1, specifically in neonates. The toxicity of DEHP is mainly attributed to its metabolites, most importantly mono-(2-ethylhexyl) phthalate (MEHP). The IV bag solution with the highest content in DEHP was therefore used to extrapolate the amounts of urinary MEHP. The highest concentrations were found in neonates having the lowest body weight, which is concerning, knowing the adverse effects of MEHP in infants. Our study suggests that the use of IV bags manufactured in Lebanon could pose a significant risk in hospitalized patients, especially infants in neonatal care. Therefore, Lebanon, as well as other countries, should start imposing laws that restrict the use of phthalates in medical IV bags and substitute them with less toxic plasticizers.

Post-stroke shoulder-hand syndrome of phlegm-stasis obstruction treated with the combined therapy of eye acupuncture, Tengliao and rehabilitation training: a multi-central randomized controlled trial

To assess the efficacy on relieving pain and improving the range of motion of shoulder joint in post-stroke shoulder-hand syndrome of phlegm-stasis obstruction in treatment of the combined therapy of eye acupuncture, Tengliao (Chinese herbal warm dressing technique) and rehabilitation training (eye acupuncture + Tengliao + rehabilitation) as compared with the combined treatment of Tengliao and rehabilitation training (Tengliao + rehabilitation) and the simple rehabilitation training (rehabilitation). A total of 356 patients with post-stroke shoulder-hand syndrome of phlegm-stasis obstruction were randomized into an eye acupuncture + Tengliao + rehabilitation group (group A, 122 cases, 2 cases dropped off), a Tengliao + rehabilitation group (group B, 120 cases, 3 cases dropped off) and a rehabilitation group (group C, 114 cases, 1 case dropped off). In the group C, the basic treatment was combined with routine rehabilitation training. In the group B, on the base of the treatment as the group C, Tengliao was exerted. A medical bag composed of over 20 Chinese herbal materials was heated and dressed at the affected area, 30 min each time, 5 times weekly. In the group A, besides the treatment as the group B, eye acupuncture was applied to heart region, kidney region, upper jiao region and lower jiao region, 30 min each time, 5 times weekly. The treatment lasted 28 days in all of three groups. Separately, before treatment, in 7, 14, 21 and 28 days of treatment, as well as in 14 days after treatment of follow-up, the score of visual analogue scale (VAS) for pain, the score of guides to evaluation of permanent impairment (GEPI) and the score of National Institutes of Health stroke scale (NIHSS) were observed in each group. The scores of VAS, GEPI and NIHSS were all improved with the treatment lasting in the three groups (P<0.000 1). In 7, 14, 21 and 28 days of treatment and in follow-up as well, VAS scores in the group A were all lower than the group C (P<0.05). After 14 days of treatment, GEPI score showed increasing trend, while NIHSS score showed decreasing trend in the group A compared with the group B. Before treatment, GEPI score was lower and NIHSS score was higher in the group A compared with the group C (P<0.05). It was suggested that the illness was slightly serious in the group A. After propensity score matching, in 14, 21 and 28 days as well as in follow-up, GEPI scores in the group A were higher than the group C respectively (P<0.05). Regarding NIHSS score at each time point, the difference had no statistical significance between the group A and the group C (P>0.05). The combined therapy of eye acupuncture, Tengliao and rehabilitation training obtains a better efficacy on post-stroke shoulder-hand syndrome of phlegm-stasis obstruction as compared with rehabilitation training.

Bacteria Associated with Healthcare-Associated Infections on Environmental Samples Obtained from Two Fire Departments.

(1) Background: Firefighters spend about 64% of their time responding to medical emergencies and providing medical care without a patient history, which can render them vulnerable to healthcare-associated infections (HAI). Infection prevention, control, and surveillance systems have been instituted at hospitals. However, the prevalence of firefighters’ exposure to HAI is unknown. The objective of this study was to document evidence of HAI on surfaces in fire stations and engines to inform disinfection procedures and identify which pathogens might contribute to occupational exposures. (2) Methods: High-touch or high-use surfaces of two fire departments were sampled during five separate occasions. One fire station from one fire department was sampled over a 4-week period, whereas four fire stations were sampled from a different fire department only once. Sampled surfaces included: entryway floor, washing machine, medical bag, back seat of engine, keyboard of reporting computer, engine console, and uniform pants. (3) Results: Multiple statistical models determined that bacterial contamination was similar between the two fire departments and their stations. Keyboards were the most contaminated surface for all fire stations and departments, E. coli was the most common bacteria detected, and C. difficile was the least detected bacteria. Adjustments for rates of contamination found that contamination rates varied between fire stations. (4) Conclusions: Comprehensive environmental sampling and clinical studies are needed to better understand occupational exposures of firefighters to HAI.

GAMBARAN PENGELOLAAN LIMBAH MEDIS PADAT DI RUMAH SAKIT Hi MUHAMMAD YUSUF KALIBALANGAN KOTABUMI TAHUN 2019

Hi Muhammad Yusuf Hospital produces about 2.4 kg of solid medical waste per day. The initial survey results found that solid medical waste has not been appropriately managed, even though this waste can be a source of health problems for the community. This study aimed to describe the management of solid medical waste at the Hi Muhammad Yusuf Hospital, Kalibalangan, Kotabumi. This research describes the management of solid medical waste from source, type, weight, sorting, container, collection, and temporary storage. Data were collected through observation and interviews with medical waste management officers. Furthermore, the data is compared with Minister of Health Regulation No. 7 of 2019. Solid medical waste management is declared to meet the requirements if it is following the regulation. The process of sorting, storing, and transporting hospital waste does not meet the requirements. There is still solid medical waste mixed with non-medical waste. Hospitals need to provide medical bags in brown for pharmaceutical waste, red for radioactive waste, and purple for cytotoxic waste. Training for waste management officers is needed to improve understanding of solid medical waste management and the availability of SOPs as a guide for waste management officers.

See it, say it, sort it: to tell or not to tell?

> ‘Far more crucial than what we know or do not know is what we do not want to know.’ > > (Eric Hoffer, The Passionate State of Mind and Other Aphorisms , 1955) What do we want to know, and what not? This often seems ‘irrational’, even unnegotiable, to others. Three vignettes from different decades portray our conundrums. A crisp, bright autumn morning. It is only my third week in this poor, inner-city practice: almost everyone is still a stranger. The phone rings in the brief handwriting-of-notes interlude between two patients. This is fortunately timed because the receptionist’s voice explodes with urgency and without preamble: ‘Doctor, Mrs O has just rung; she’s really upset. She says there’s something really wrong with her husband, Alf. She wants you to go there now … I really think you should, doctor. They live just fifty yards away, at the other end of this block. You can see your remaining patients when you come back.’ In 1977 such a request is not so unusual: the family-doctor is quite as likely to be called as an ambulance. In my haste I take the remarkably slim Lloyd George envelope of notes of this 64-year-old man and slip them, unperused, into my well-checked medical bag. Speed and now is of the essence; history can wait. Mrs O is waiting at her open front door. She is dabbing at her eyes with a handkerchief and then holding it to her chest, as if for comfort. She is clearly fearful yet coherent. She says: ‘He suddenly sat up and started gasping and then he … Doctor, it’s terrible: you’ll see.’ She leads me into a sparsely furnished yet meticulously cared-for bedroom: this couple may be poor, but they are proud. Alf is lying in a vast pool of blood, emitted from his mouth and now haloing his thorax. The blood has not dried …

Investigation of potential safety hazards during medical waste disposal in SARS-CoV-2 testing laboratory

This study aims to investigate the potential safety hazards and provide reference for improving the medical waste disposal procedure in SARS-CoV-2 testing laboratory. Our SARS-CoV-2 testing group detected the RNA residue on the surface of medical waste with Droplet Digital PCR, and held a meeting to discuss the risks in the laboratory medical waste disposal process. After effective autoclaving, SARS-CoV-2 contaminated on the surface of medical waste bags was killed, but the average concentration of viral RNA residues was still 0.85 copies/cm2. It would not pose a health risk, but might contaminate the laboratory and affect the test results. When the sterilized medical waste bags were transferred directly by the operators without hand disinfection, re-contamination would happen, which might cause the virus to leak out of the laboratory. Furthermore, we found that sterilization effect monitoring and cooperation among operators were also very important. In summary, we investigated and analyzed the potential safety hazards during the medical waste disposal process in SARS-CoV-2 testing laboratory, and provided reasonable suggestions to ensure the safety of medical waste disposal.