Decontamination of ambulance and equipment, a problem for worker safety and national security

Purpose: To analyze the cleaning and decontamination procedures of ambulance, equipment and clothes both in the routine and in a CBRNe event (epidemics, HazMats) and provide solutions to agencies to ensure patient health and operator safety at work. Background: In Italy, the cleaning of the ambulance, equipment and clothes is carried out by the operators themselves without standard or certified procedures, there isn’t evidence of effective sterilization equal to the HACCP or laboratory tests. The sterilization of equipment is a utopia. Many ambulances 118 (new 112) do not have a station/garage, almost all don’t have rooms for the sterilization systems of equipment such as autoclaves, containers for biological liquid waste, or where to wash the ambulances after each patient or washing machines. The working clothes are washed at home by the operators, in the same washing machines where they wash the family clothes. The schooling of the operators is medium-low (medium-high school), with few graduate figures (doctors and nurses), none of these figures has a specific competence in the cleaning of ambulances or equipment, in decontamination and in CBRNe. The National health system is fragmented in the Regions, privatization further fragments the system, controls are not very effective or absent. Method and materials:Study and analysis of ""case studies"", law and risks for workers and for rescued / transported people (patients) Finding: There are no standardized procedures at national level for the cleaning / sterilization / decontamination of ambulances, equipment and clothing used both in routine and in a CBRNe event. Conclusions: These lacks and the absence of s standardization and procedures is a serious risk for both the health of the rescued people and the workers. Our solutions can give a solid starting point if accepted quickly by the bodies and by the State.