The following text was automatically extracted from the image on this page using optical character recognition software:
[xi-, 6r~ P928 81/ - ,It
Vol. 47, No. 28
Texas Preventable Disease July 18, 1987
contents:
* inS Recommendations for Decontaminating
Z Manikins Used in Cardiopulmonary
Frank Bryant, Jr, MD, FAAFP Robert Bernstein, MD, FACP Resuscitation Training
Chairman Commissioner Recent FDA Drug Approval
Texas Board of Health
Bureau of Epidemiology, 1100 West 49th Street, Austin, Texas 78756-3180 (512-458-7207)
RECOMMENDATIONS FOR DECONTAMINATING
MANIKINS USED IN CARDIOPULMONARY
RESUSCITATION TRAINING*
These recommendations were established by members of the Multidisciplinary ad hoc Committee for
Evaluation of Sanitary Practices in Cardiopulmonary Resuscitation Training representing the
following organizations: American Heart Association: Subcommittee on Emergency Cardiac Care;
American Red Cross: First Aid and CPR Programs; Centers for Disease Control: Center for
Infectious Diseases, Laboratory Program Office.
In past years, we have received numerous inquiries concerning the possible role of
cardiopulmonary resuscitation (CPR) training manikins in transmitting viral hepatitis type B.
Recently, inquiries have been received about the potential for transmission of not only
hepatitis B but also acquired immunodeficiency syndrome (AIDS), herpes viruses, and various
upper and lower respiratory infections (influenza, infectious mononucleosis, tuberculosis, etc).
The use of CPR manikins has increased rapidly because of expanded training programs
sponsored by medical and emergency organizations. To date, it is estimated that over 40 million
people have had direct contact with manikins during training courses. In the US, a number of
companies distribute multiple model lines of manikins for training programs in hospitals, police
and fire departments, service organizations, lay groups, and schools as part of health, first aid,
and physical education courses. Since practicing with a manikin is an integral part of CPR
training, the care andmaintenance of the manikin is of utmost importance. Instructors and
training agencies rely heavily on manufacturers' recommendations for manikin use and
maintenance, and these recommendations should be examined carefully before purchasing
manikins.
To our knowledge, the use of CPR training manikins has never been documented as being
responsible for an outbreak or even an isolated case of bacterial, fungal, or viral disease. It is
our opinion, however, that manikin surfaces may present a risk of disease transmission under
certain circumstances and that these surfaces should be cleaned and disinfected consistently to
minimize this risk. Although the major portion of the following discussion was written in 1978
* pertaining only to sanitary practices that should be followed to prevent transmission of hepatitis
type B, the current revision by the ad hoc Committee for Evaluation of Sanitary Practices in
Cardiopulmonary Resuscitation Training is applicable to lessening the risks of transmitting a
wide variety of infectious diseases.
There are several important infection control considerations in CPR training. First, the act of
* mouth-to-mouth or mouth-to-nose artificial respiration obviously requires close physical contact
in which a potential rescuer must ignore his or her concerns for personal protection or aesthetic
apprehensions to save the life of a victim. Accordingly, in training sessions, students are urged
to overcome such hesitations, and they may practice on manikins contaminated by the hands
and oral fluids of previous students. This situation becomes especially obvious during the
practice of two-rescuer CPR in which the manikin cannot be adequately cleaned between uses
by the two students. Also, the practice of removing upper airway obstruction involves sweeping
the back of the manikin throat with a finger, and in this situation, contamination from previous
students may be smeared on the manikin face. In practice, there is usually no pause at this
point to decontaminate the face before beginning mouth-to-mouth breathing. Additionally, the
* Reprinted with permission from: Infection Control 1984;5(8):399-401
Texas Department of Health