Methodological Guidelines for the Use of Aqvasol

The guidelines are intended for personnel of healthcare institutions, employees of sanitary-epidemiological and disinfection services, as well as other organizations authorized to carry out disinfection activities.

1. General Information

1.1 Neutral Aqvasol (hereinafter referred to as Aqvasol), produced by the electrochemical treatment of an aqueous sodium chloride solution, is a colorless liquid with a chlorine odor containing highly active oxygen-containing chlorine compounds and other components.

Depending on its intended use, Aqvasol is produced and applied with an active chlorine concentration of 0.01%–0.05% and a pH value of 7.2–8.2.

Aqvasol is used undiluted and intended for single use.

1.2 Aqvasol possesses antimicrobial (virucidal, bactericidal, fungicidal, tuberculocidal, and sporicidal) as well as cleaning properties.

In the presence of organic contaminants (blood, feces, and other biological materials), the disinfecting effectiveness of Aqvasol decreases.

1.3 According to GOST 12.1.007-76, Aqvasol belongs to hazard class IV, meaning it is classified as a low-hazard substance in terms of its effect on the body. When ingested or applied to the skin, it is considered low-toxic. When administered parenterally, it does not cause local irritation of the skin or the mucous membrane of the eyes.

Evaporation of Aqvasol with an active chlorine concentration of 0.05% may cause mild irritation of the upper respiratory tract and the mucous membrane of the eyes. Repeated contact with the skin may cause dryness.

Aqvasol with active chlorine concentrations of 0.01%, 0.02%, and 0.03% does not cause irritation.

1.4 Aqvasol is used for disinfecting various types of objects in cases of bacterial, viral, and fungal infections.

2. Use of Aqvasol for Disinfection

2.1 Aqvasol is used for disinfecting various objects, including surfaces in buildings, patient-care items, dishes, linen, toys, and sanitary-technical equipment, in cases of bacterial infections, including tuberculosis; viral infections, including AIDS and hepatitis with a parenteral transmission mechanism; and fungal infections, including candidiasis and dermatophytosis. It is also used for pre-sterilization cleaning and sterilization of medical items made of glass, plastic, rubber, and metal, including titanium alloys (For sterilization, the period of use of Aquasol is 10 days, provided it is stored in tightly closed glass, plastic, or enamel containers (without damage to the inner surface), at room temperature, protected from direct sunlight).

2.2 Disinfection with Aqvasol is carried out by wiping surfaces in buildings and sanitary-technical equipment, or by immersion for medical devices, patient-care items, dishes, linen, toys, and cleaning materials.

2.3 Surfaces in buildings, including floors, walls, and furniture, as well as sanitary-technical equipment, are wiped once or twice at 15-minute intervals with a cloth thoroughly moistened with Aqvasol. The surface being treated must be evenly moistened.

The consumption rate of Aqvasol is 200 ml/m² for a single treatment and 300–400 ml/m² for a double treatment.

Heavily contaminated sanitary-technical equipment should first be thoroughly cleaned with a brush moistened with Aqvasol.

2.4 Disinfection of medical devices, including disinfection combined with pre-sterilization cleaning, is carried out in covered plastic or undamaged enamel containers. Disinfection modes are provided in Tables №1 and №2.

The items are completely immersed in Aqvasol. Using special tools such as a syringe or pipette, the channels and cavities of the item are filled with Aqvasol so that air bubbles are expelled. Disassemblable devices are processed in a disassembled state.

Locking instruments, such as scissors and forceps, are immersed in Aqvasol in an open position. After immersion, several working movements are performed so that Aqvasol penetrates the locking mechanisms.

After the disinfection exposure time has elapsed, the instruments are rinsed for one minute under running drinking water or placed for one minute in a basin of water so that all cavities and channels are thoroughly rinsed.

2.5 Patient-care items are completely immersed in Aqvasol and, after the disinfection exposure time has elapsed, are rinsed under running water until the chlorine odor disappears completely.

2.6 Dishes are cleared of food residues and completely immersed in Aqvasol.

The consumption rate of Aqvasol is 2 liters per set, consisting of two plates and one cup or glass.

After disinfection, each dish item is rinsed separately for one minute under running drinking water, or the items are kept fully immersed in a basin of water for one minute.

2.7 Metal dishes are not subject to disinfection with Aqvasol.

2.8 Linen is completely immersed in Aqvasol. The consumption rate of Aqvasol is 5 liters per 1 kg of dry linen.

After disinfection, the linen is washed and rinsed in water.

2.9 Toys are completely immersed in Aqvasol and, after disinfection, are rinsed under running water until the chlorine odor disappears completely.

2.10 Cleaning materials, such as cloths, are completely immersed in Aqvasol. After the disinfection exposure time has elapsed, they are rinsed in water and dried.

3. Use of Aqvasol for Pre-Sterilization Cleaning of Medical Devices Without Disinfection

3.1 Aqvasol is used for pre-sterilization cleaning of medical devices without prior disinfection in accordance with the procedures specified in Table No. 3, following the same rules for the use of containers and immersion of items in Aqvasol as described in Section 2.4.

3.2 The quality of pre-sterilization cleaning of medical devices is monitored using the amidopyrine or Azopyram test, which detects residual blood contamination, in accordance with the methodology described in the "Methodological Guidelines for Pre-Sterilization Cleaning of Medical Devices" (No. 28-6/13, June 8, 1982) and the "Methodological Guidelines for Monitoring the Quality of Pre-Sterilization Cleaning of Medical Devices Using the Azopyram Reagent" (No. 28-6/13, May 25, 1988).

3.3 Quality control shall be performed on 1% of simultaneously processed medical devices of the same type, but on no fewer than three items.

Disinfection Modes for Various Objects Using Aqvasol:

Table No. 1

Note:

* — Disinfection is performed by wiping the surface twice with a 15-minute interval. The specified time includes the total disinfection period, including the 15-minute interval between treatments.

** — Except for items made of natural rubber.

Disinfection Modes for Medical Devices Using Aqvasol Combined with Pre-Sterilization Cleaning

Table No. 2

Note: During the soaking stage in Aqvasol, the following levels of disinfection are achieved:

* — For viral and bacterial infections, excluding tuberculosis.
** — For viral and fungal infections.
(3)* — For viral and bacterial infections, including tuberculosis.
(4)* — For viral, bacterial (including tuberculosis), and fungal infections.
(5)* — For viral, bacterial (excluding tuberculosis), and fungal infections.

Pre-Sterilization Cleaning Procedures for Medical Devices Using Aqvasol After Disinfection

Table No. 3

Sterilization Modes for Medical Devices Using Aqvasol

Table No. 4 4. Use of Aqvasol for Sterilization of Medical Devices

4.1 Sterilization of medical devices using Aqvasol is carried out according to the procedures specified in Table No. 4, following the same rules for containers and immersion of devices in Aqvasol as described in Section 2.4.

4.2 During sterilization, including the stage of rinsing the devices to remove residual solution, all procedures shall be performed in accordance with aseptic techniques. Sterile containers designated for Aqvasol shall be used for sterilization.

4.3 After the required sterilization time has elapsed, the devices are removed from Aqvasol using sterile forceps or dressing forceps, the solution is removed from channels and cavities, and the devices are transferred into a sterile container filled with sterile drinking water to rinse off any remaining Aqvasol.

Rinsing is carried out for 1 minute by completely immersing the device in water and filling all channels and cavities with water.

4.4 After removal of Aqvasol residues, the devices are taken out of the water, placed on a sterile drape, the remaining water is removed from the channels using a sterile syringe or another sterile instrument, and the devices are transferred into a sterile sterilization container lined with a sterile drape.

The storage period of sterilized medical devices shall not exceed three days.