Contingency Methods for Cleaning Single-Use Medical Equipment in Crisis, Disaster, or War
In brief
Basic cleaning eliminates detectable pathogens on nearly half of used airway devices
In an exploratory trial of 90 single-use items, ten-minute immersion with peracetic acid, 70% ethanol or dish detergent cut bacterial counts and removed all detectable Haemophilus influenzae and Staphylococcus aureus from 47% of contaminated endotracheal tubes and laryngeal masks, without harming device function. While not a substitute for sterilization, these low-tech methods may be the only feasible rescue option when supplies run out in disasters or conflict.
- Journal
- Prehospital and disaster medicine (Q1)
- Published
- 14 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Karl Chevalley, Knut Taxbro, Sara Mernelius, Peter Sigfridsson, Göran Sandström
- PMID
- 42734164
- DOI
- 10.1017/S1049023X26109066
Why clinicians should know about it
- Picked for Otorhinolaryngology (top studies of the week, 20 September 2026): Cleaning methods for single‑use devices in disaster settings
Abstract
BACKGROUND: Shortages of disposable medical equipment can critically impair health care delivery during disasters or armed conflict. Although reprocessing single-use medical devices (SUDs) may represent the only feasible option under such conditions, evidence supporting simple, field-adapted cleaning methods is limited. METHODS: In this exploratory study, 90 clinically used SUDs - endotracheal tubes (ETT), laryngeal mask airway (LMA), intravenous administration sets (IVS), syringes (SYR), indwelling urinary catheters (IDC), and nasogastric tubes (NGT) - were collected after surgery in a regional hospital. Devices were randomly allocated to cleaning with peracetic acid (PAA), 70% ethanol, or dishwashing detergent. Each item was brushed, immersed for ten minutes, and then air-dried. Microbiological sampling included pre-cleaning and post-cleaning cultures, and airway devices underwent Polymerase Chain Reaction (PCR) testing for 28 respiratory pathogens. Functional integrity was assessed after cleaning. RESULTS: All three cleaning agents achieved statistically significant reductions in bacterial load (P < 0.05) with no difference between methods. The PCR testing detected Hemophilus influenzae (H. influenzae) and Staphylococcus aureus (S. aureus) among other pathogens in 47% of airway devices before cleaning; all post-cleaning samples were negative. No structural or functional damage was observed. CONCLUSION: Basic cleaning procedures with commonly available agents substantially reduced microbial contamination without impairing device function. These methods cannot replace validated sterilization but may serve as the only viable option when medical supply is critically constrained, such as in disasters or in armed conflict. Preparedness planning should encompass strategic stockpiling, surge production capacity, and resilient supply chains, together with rationing and substitution strategies, and - only as a last resort - protocols for cleaning and reusing single-use medical equipment.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.