Edit By Yasser Okeal

Hypochlorites are widely used in healthcare facilities in a variety of settings. 328 Inorganic chlorine solution is used for disinfecting tonometer heads 188 and for spot-disinfection of countertops and floors. A 1:10–1:100 dilution of 5.25%–6.15% sodium hypochlorite (i.e., household bleach) 22, 228, 553, 554 or an EPA-registered tuberculocidal disinfectant 17has been recommended for decontaminating blood spills. For small spills of blood (i.e., drops of blood) on noncritical surfaces, the area can be disinfected with a 1:100 dilution of 5.25%-6.15% sodium hypochlorite or an EPA-registered tuberculocidal disinfectant. Because hypochlorites and other germicides are substantially inactivated in the presence of blood 63, 548, 555, 556, large spills of blood require that the surface be cleaned before an EPA-registered disinfectant or a 1:10 (final concentration) solution of household bleach is applied 557. If a sharps injury is possible, the surface initially should be decontaminated 69, 318, then cleaned and disinfected (1:10 final concentration) 63. Extreme care always should be taken to prevent percutaneous injury. At least 500 ppm available chlorine for 10 minutes is recommended for decontaminating CPR training manikins 558. Full-strength bleach has been recommended for self-disinfection of needles and syringes used for illicit-drug injection when needle-exchange programs are not available. The difference in the recommended concentrations of bleach reflects the difficulty of cleaning the interior of needles and syringes and the use of needles and syringes for parenteral injection 559. Clinicians should not alter their use of chlorine on environmental surfaces on the basis of testing methodologies that do not simulate actual disinfection practices 560, 561. Other uses in healthcare include as an irrigating agent in endodontic treatment 562 and as a disinfectant for manikins, laundry, dental appliances, hydrotherapy tanks 23, 41, regulated medical waste before disposal 328, and the water distribution system in hemodialysis centers and hemodialysis machines 563.

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