Chloramine 3. Instructions for use Chloramine B general provisions Chloramine B product

(Approved by the head of the Main Sanitary and Epidemiological Directorate of the USSR Ministry of Health V.E. Kovshilo 10.21.75 No. 1359-75)

General information

Chloramines include a number of organic compounds having the general chemical formula RS02NH2 (R means radical), in which one or both hydrogen atoms located at nitrogen are replaced by chlorine.

A distinction is made between chloramine B, if the starting product is benzene, and chloramine T, if toluene is used for this.

Domestic chloramine used for disinfection purposes is called chloramine B * belongs to the group of monochloramines and has the formula: C6H5S02N(Na)Cl-3H20.

It is a sodium salt of chloramine benzene sulfonic acid and has the appearance of a white fine-crystalline powder (sometimes yellowish). Typically contains 26% active chlorine, retaining this amount of chlorine for a long time if properly stored (loss of active chlorine during the year does not exceed 0.1%).

Chloramine B is highly soluble in water at room temperature. Its solutions retain active chlorine for 15 days and can be prepared for future use. They do not spoil or discolor fabrics.

Chloramine has high activity against gram-negative and gram-positive microorganisms, starting from 0.2%. Since active chlorine binds with organic substances, the concentration of solutions under practical conditions is increased to 0.5-1-2-3-5%. Hot solutions of chloramine (50-60°C) have a higher disinfecting effect.

The bactericidal and virucidal properties of chloramine solutions are increased by the addition of ammonium compounds (ammonia, ammonium sulfate or ammonium chloride), which act as activators.

Activated chloramine solutions quickly lose active chlorine, so they are used immediately after preparation.

Chloramine is stored in a dark glass container with a well-fitted stopper or, even better, with a ground-in stopper, in a wooden container or in a tin container coated on the inside with asphalt varnish, as well as in polyethylene bags.

When storing chloramine, do not allow it to be directly exposed to light and moisture.

Chloramine and solutions prepared from it are checked from time to time for the content of active chlorine in them; This establishes the loss of active chlorine and the correct preparation and storage of solutions.

Preparation of chloramine solutions

Working solutions of chloramine are prepared by stirring it until completely dissolved in water, preferably heated to 50-60°C.

To prepare chloramine solutions, the following quantities of the drug are required:

Activated solutions of chloramine are prepared by first diluting a weighed amount of chloramine in cold or hot (50-60°C) water until completely dissolved, followed by adding an activator (ammonium chloride, sulfate, nitrate) in an amount equal to the amount of active chlorine in the solution, and 8 times less ammonia is added.

Activated chloramine solutions are used immediately after preparation.

To prepare 1 or 10 liters of activated solution you need:

Application of chloramine solutions

Solutions of chloramine in various concentrations are used for disinfection of intestinal and droplet infections of bacterial and viral etiology, tuberculosis, and fungal diseases.

For these infections, chloramine solutions are used to wipe or irrigate surfaces and soak objects to be disinfected, and also, in some cases, to fill secretions.

Disinfection regimes for various objects for the listed infections are presented in Table. 1-5.

Modes for disinfecting objects with chloramine in foci of intestinal and droplet infections of bacterial etiology

table 2

Regimes for disinfecting objects with chloramine in foci of microsporia, trichophytosis and favus

Table 3

Regimes for disinfecting objects with chloramine in areas of viral hepatitis and enteroviral infections

Precautions when working with chloramine

When working with chloramine, and especially its activated solutions, it is necessary to protect the respiratory system with a RU-60 respirator.

The work is performed in a robe, rubber gloves, and an apron.

The instructions for the use of chloramine for disinfection purposes dated December 24, 1947 shall be considered invalid from the moment of approval of these guidelines.

Regimes for disinfecting objects with activated chloramine solutions in foci of tuberculosis

Note. According to instructions for current and final disinfection for tuberculosis No. 744-68, the use of non-activated chloramine solutions in foci of tuberculosis is not recommended.

Table 5. Regimes for disinfecting objects with activated chloramine solutions for anthrax

Note. To disinfect surfaces during anthrax, 10-20% solutions of bleach are recommended.

WWW . DEZSREDSTVA . RU reference and information Internet catalog p. 21

INSTRUCTION No. 04/09

on the use of disinfectant

"Chloramine B 99.9"

(“Jiaxing Grand Corporation”, China)

in medical and preventive institutions, infectious foci, in public utility and trade enterprises, in transport, in children's institutions, education, culture, recreation, sports, penitentiary and social security

INSTRUCTION No. 04/09

on the use of disinfectant "Chloramine B 99.9"

(Jiaxing Grand Corporation, China)

in medical and preventive institutions, infectious foci, in public utility and trade enterprises, in transport, in children's institutions, education, culture, recreation, sports, penitentiary and social security

The instructions were developed: at the Testing Laboratory Center of the State Unitary Enterprise "Moscow City Disinfection Center" (SUE MGCD), the Testing Laboratory Center of the Federal State Institution "RNIITO named after. R.R. Vreden Rosmedtekhnologii"; FSUE "SSC Applied Microbiology" (FSUE "SSC PMB").

Authors: N.P. Sergeyuk., Yu.G. Suchkov, M.P. Munitsyna, M.A. Tarabrina, K.A. Shestakov, A.N. Kochetov (State Unitary Enterprise MGCD), A.G. Afinogenova, A.V. Semenov, M.A. Bichurina, N.P. Ovchinnikov (FSI "RNIITO named after R.R. Vreden Rosmedtekhnologii"); V.N. Gerasimov, M.V. Khramov (FGUN "SSC PMB").

1. General information.

1.1. Means "Chloramine B 99.9" is a crystalline powder of white or slightly yellowish color with the smell of chlorine, containing as the active substance the sodium salt of benzenesulfonic acid chloramide (99.9%, but not less than 99.5%). The content of active chlorine in the product is not less than 25.0%. Solubility in water is not less than 20 g / 100 ml.

It is used in the form of activated, non-activated solutions and powder.

The shelf life of the product in unopened manufacturer's packaging is 6 years; The shelf life of non-activated solutions is 15 days (if stored in a cool, dark place in a closed container). Activated solutions of the product are used immediately after preparation.

1.2 Remedy "Chloramine B 99.9" has an antimicrobial effect against bacteria (including mycobacterium tuberculosis), viruses, fungi of the genus Candida, dermatophytes, pathogens of particularly dangerous infections - anthrax, plague, cholera, tularemia.

1.3.Remedy "Chloramine B 99.9" According to the parameters of acute toxicity according to GOST 12.1.007-76, it belongs to the 3rd class of moderately hazardous substances when administered into the stomach, to the 4th class of low-hazardous substances when applied to the skin and according to the degree of volatility, moderately toxic when administered parenterally, has a local irritating effect on the skin and pronounced - on the mucous membranes of the eyes; has a sensitizing effect.

Working solutions in the form of vapors do not cause irritation to the respiratory system, with a single exposure they do not have a local irritating effect on the skin, with repeated exposures they cause dryness and flaking of the skin, and if they come into contact with the eyes they cause mild irritation.

When used by irrigation, working solutions, as well as activated solutions, cause severe irritation to the respiratory system and eyes.

The maximum permissible concentration of chlorine in the air of the working area is 1 mg/m3.

1.4. Means "Chloramine B 99.9" intended for:

Disinfection of indoor surfaces, hard furniture, sanitary equipment, rubber mats, shoes made of plastic and rubber, linen, dishes, toys, patient care items, medical products, medical waste, including dressings (cotton-gauze bandages, tampons etc.), underwear and disposable medical products; cleaning material, secretions from infections of bacterial (including tuberculosis) and viral etiology, candidiasis and dermatophytosis, especially dangerous infections (anthrax, plague, cholera, tularemia) during final, ongoing and preventive disinfection in infectious foci, medical institutions, in clinical, microbiological, virological laboratories, children's institutions, sanitary transport,

Carrying out general cleaning in medical, preventive and children's institutions;

Preventive disinfection at communal facilities (hotels, hostels, hairdressers, public toilets), cultural, recreational, sports institutions (sports and cultural-health complexes, swimming pools, cinemas, offices, etc.), sanitary checkpoints, social security institutions and penitentiary institutions; catering and trade enterprises,

Applications by the population in everyday life.

2. Preparation of working solutions

2.1. Means "Chloramine B 99.9" used in the form of non-activated and activated solutions with ammonium salts or ammonia.

2.2. Working solutions of the product are prepared in enamel, glass or polyethylene containers by stirring the powder in water until completely dissolved in accordance with the calculations given in tables 1 and 2.

Table 1

Preparation of non-activated solutions of the product "Chloramine B 99.9"

Note: to dissolve the product faster, use heated water

up to 50-60 0 C.

To impart cleaning properties to working solutions of the product "Chloramine B 99.9" You can add synthetic detergents approved for use in medical institutions in an amount of 0.5% (5 g/l of solution or 50 g/10 l of solution).

2.3. Activated solutions of the product are prepared by adding an activator (one of the ammonium salts - ammonium chloride, sulfate, ammonium nitrate or ammonia) to its working solutions. The ratio of the amount of ammonium salt and the amount of active chlorine in the working solution is 1: 2, and the ratio of ammonia and the amount of active chlorine is 1: 8. Activated solutions are used immediately after preparation. When preparing activated solutions of the product "Chloramine B 99.9" use the calculations given in table. 2.

table 2

Preparation of activated solutions of the product "Chloramine B 99.9"

3. Using ChloramineB99.9"

3.1. Solutions of the product are used to disinfect indoor surfaces (floors, walls, doors, hard furniture, etc.), sanitary equipment (bathtubs, sinks, etc.), rubber mats, cleaning materials, linen, tableware, laboratory utensils, and tableware. for secretions, toys, patient care items, medical products made of corrosion-resistant metals, glass, plastics, rubber, secretions (sputum, feces, etc.), sanitary transport.

It is allowed to use solutions of the product "Chloramine B 99.9" with the addition of synthetic detergents approved for use in medical institutions in an amount of 0.5% (5 g/l solution or 50 g/10 l solution).

Disinfection of objects is carried out by wiping, irrigation, immersion, soaking and falling asleep. Modes for disinfecting objects with solutions of the product "Chloramine B 99.9" are given in table. 3-12.

3.2. Indoor surfaces (floors, walls, etc.), sanitary equipment (baths, sinks, etc.), ambulance vehicles are wiped with a rag soaked in a solution of the product or irrigated with a hydraulic remote control, Automax, or Quasar-type sprayer. The consumption rate of the product solution when wiping is 150 ml/m2 of surface, when using a solution with detergent - 100 ml/m2, when irrigation - 300 ml/m2 (hydropult, automax), - 150 ml/m2 (spray type "Quasar"). After disinfection is completed, sanitary equipment is washed with water and the room is ventilated.

3.3. The laundry is soaked in a container with a solution of the product at a consumption rate of 5 l/kg of dry laundry. Cover the container tightly with a lid. After disinfection is completed, the linen is washed and rinsed.

3.4. The cleaning material is soaked in a solution of the product, after disinfection is completed, rinsed and dried.

3.5. Tableware freed from food residues, laboratory dishes, and dishes containing secretions are completely immersed in the product solution. The solution consumption rate is 2 liters per 1 set of tableware. The container is closed with a lid. After disinfection, the dishes are washed with water until the smell of chlorine disappears.

3.6. Disinfection of patient care items and toys is carried out by irrigation, wiping or immersion in a solution of the product. After disinfection is completed, they are washed with water until the smell of chlorine disappears.

3.7. Rubber mats are disinfected by wiping with a rag soaked in a solution of the product, or by immersing in a solution of the product. Shoes made of plastic and rubber are immersed in the product solution, preventing them from floating. After disinfection is completed, they are washed with running water and dried.

3.8. Disinfection of medical devices is carried out in plastic or enamel (without damaging the enamel) containers, closed with lids.

Medical products, immediately after their use, are completely immersed in a container with a solution of the product, filling the channels and cavities of the products with the help of auxiliary means (electric pumps, syringes, pipettes), while removing air bubbles. Detachable products are processed in disassembled form. Products with locking parts are immersed open, having previously made several working movements with them in the solution for better penetration of the solution into hard-to-reach areas of the products. The thickness of the layer of product solution above the products must be at least 1 cm.

After disinfection, metal and glass products are washed under running water for 3 minutes, and rubber and plastic products - for at least 5 minutes.

3.9. The sputum collected in a container is poured with a solution of the product (at a ratio of 1 part sputum: 2 parts solution) and mixed thoroughly.

3.10. Liquid secretions and feces infected with bacteria of especially dangerous infections are disinfected by adding (dissolving) powder of the product in a ratio of 10:1 (volume/weight), thoroughly mixing and subsequent exposure for 120 minutes. When liquid secretions and feces are infected with anthrax spores, they are filled with a 10.0% activated solution of the drug in a 1:1 ratio (volume/weight), mixed thoroughly and left for 120 minutes.

3.11. Disinfection (neutralization) of medical waste of classes B and C of medical institutions, including infectious diseases departments, dermatovenerological, TB and mycological hospitals, as well as laboratories working with microorganisms of pathogenicity groups 1-4 (including especially dangerous infections), is carried out taking into account the requirements of Sanitary rules and regulations SanPiN 2.1.728-99 “Rules for the collection, storage and disposal of waste from medical institutions.”

Used dressings, napkins, cotton swabs, single-use underwear are immersed in a separate container with product solutions. Upon completion of disinfection, the waste is disposed of.

Disinfection of single-use medical devices is carried out in plastic or enameled (without damaging the enamel) containers, closed with lids. When disinfecting, products are completely immersed in the product solution. Detachable products are immersed in the solution in disassembled form. Products with locking parts are immersed open, having previously made several working movements with them in the solution for better penetration of the solution into hard-to-reach areas of the products. During soaking (disinfection soaking), the channels and cavities must be filled (without air pockets) with a solution. The thickness of the mortar layer above the products must be at least 1 cm.

After disinfection is completed, the products are removed from the container with the solution and disposed of.

Containers for the collection and disposal of medical waste are treated by wiping according to the appropriate infection regimes.

3.12. Disinfection regimes for various objects in outbreaks of cholera and tularemia are given in Table 10.

3.13. Disinfection regimes for various objects in plague foci are given in Table 11.

3.14. Disinfection regimes for various objects in anthrax outbreaks are given in Table 12.

3.15. When carrying out general cleaning in medical-prophylactic and children's institutions, they are guided by the regimes presented in table. 13.

3.16. Sanitary transport for transporting infectious patients is processed in the regimes recommended for the corresponding infections, and for infections of unknown etiology - in the regimes recommended for viral infections (Table 5). Regular preventive treatment of sanitary transport is carried out according to the regimes presented in Table 3.

3.17. In hotels, hostels, clubs and other public places, various objects are disinfected according to the regimes indicated in Table 3.

3.18. In bathhouses, hairdressing salons, swimming pools, sports complexes, sanitary inspection rooms, when carrying out preventive disinfection, the treatment of objects is carried out according to the regimes recommended for dermatophytosis (Table 9).

3.19. In everyday life, the product is used in accordance with the household label.

Table 3

Modes for disinfecting objects with non-activated solutions of the product
"Chloramine B 99.9" for bacterial (except tuberculosis) infections

Target: disinfection

Equipment:

Workwear

A weighed portion of dry chloramine powder is 10 g, 20, 30.

Water capacity with markings up to 1l

Container for disinfectant solution

Wooden spatula.

Action algorithm:

1. Put on overalls.

2.Pour a small amount of water into a labeled container.

3.Pour the required amount of dry chloramine powder into the container.

4.Add water to 1 liter, stir and close the lid.

5. Mark the date and time of preparation of the solution on the tag and sign.

Note: A 0.5% chloramine solution is used to disinfect tableware. A 1% chloramine solution is used to treat objects that have not been in contact with the patient’s blood and mucous membranes, and for routine cleaning of premises. A 3% chloramine solution is used to disinfect instruments and care items that come into contact with the patient’s blood and mucous membranes. A 5% chloramine solution is used for general cleaning of premises, disinfection of objects and instruments in contact with tuberculosis infection.

Strictly follow safety precautions when working with disinfectants. If the solution gets on your skin or mucous membranes, rinse them quickly and generously with running water (use the freshly prepared solution once).

ALGORITHM FOR STERILIZATION OF MEDICAL DEVICES IN A DRY-HEAT CABINET

Target: destruction of vegetative forms of microorganisms and their spores.

Conditions:

Sterilization of glass, metal, fine porcelain products.

Sterilization by open method, on trays.

All sterilized utensils and instruments must be pre-disinfected and subjected to pre-sterilization treatment.

Requirements: Do not wrap materials to be sterilized in cotton, silk or synthetic fabrics: they will burn or char.

Action algorithm:

1. Treat the inside of the dry-heat cabinet by wiping it twice with a rag soaked in a disinfectant solution.

2. Place the tools on the grid in the trays.

3. To control the sterilization performed, place test indicators at 5 control points (2 indicators on the back wall, 2 on the front and 1 in the center). Turn on the dry-heat oven, at 180 degrees, sterilization lasts 60 minutes, this time is made up of 25 minutes. materials needed for heating, and 35 min. - the period of death of microorganisms and their spores at the specified temperature.

4. Turn off the dry-heat oven, open the doors only after With lowering the temperature to 45-50 degrees. A nurse in a clean surgical gown, a mask, and sterile gloves pulls out sterile instruments in trays.

Note: make a note in the sterilization control log.

LAYING STERILIZATION BOXES

Target: laying for sterilization in an autoclave and maintaining sterility during storage for a regulated time.

Equipment:

Disinfectant solution: 1% chloramine solution (or other regulated solution)

Rags marked “for beaks” - 2 pieces

Containers for disinfection of rags and gloves

Gloves, mask

A large linen (calico) napkin for lining the inner surface of the bix

Dressing material, medical products

Sterilization boxes of different capacities and shapes with tags.

Action algorithm:

1. Wash your hands and dry them.

2. Check the serviceability of the bix.

3. Disinfect the bix twice with an interval of 15 minutes from the inside and outside.

4. Line the inside of the bix with a linen napkin so that it hangs down 2/3 of the height of the bix.

5. Place materials or products loosely so that ventilation between them is maintained.

6. Place the sterilization indicator on three levels depending on the temperature conditions for a given type of product.

7. Cover the entire laid material with a napkin hanging from the edges of the bix.

8. Close the lid of the box with a lock.

9. Attach a tag to the handle indicating the name of the department and office, the type of material being sterilized.

10. Open the windows in the containers and place them in the autoclave.

Note: delivery of bix to the central processing center is carried out in a tight, clean bag, delivery from the central processing center is also carried out in a dense, clean bag.

AZOPYRAM TEST

Target: carry out comprehensive quality control of pre-sterilization cleaning of medical instruments.

Equipment:

Azopyram stock solution

3% hydrogen peroxide solution

Glass with blood smears

Tray with cotton swabs, instruments subject to quality control

Pre-sterilization cleaning control log.

Conditions:

Use a freshly prepared 1% azopyram solution for 1-2 hours.

Action algorithm:

1.Check the activity of the working solution by dropping a few drops onto a glass with a blood smear; if the color of the reagent changes, then the reagent is “working”.

2.Apply 1 - 2 drops of 1% azopyram working solution with a pipette onto the product.

A blue-violet color indicates the presence of blood.

5. If the sample is positive, the entire batch of products must be re-cleaned, starting from the first stage of decontamination.

6. Record the test results in the log book.

Note:

ALGORITHMS FOR QUALITY CONTROL OF PRE-STERILIZATION TREATMENT

PHENOLPHTHALEIN TEST

Target: quality control of washing medical products from the cleaning solution.

Equipment:

Reagent: 1% alcohol solution of phenolphthalein

Reagent pipette

Tray with cotton swabs

Tools subject to quality control.

Action algorithm:

1.Apply 1-2 drops of a 1% alcohol solution of phenolphthalein to the product.

2.Hold the instrument over the cotton wool, observing the color of the flowing reagent.

4. If the test is negative, the color of the reagent does not change.

5. If the test is positive, the color of the reagent changes from pink to crimson. In this case, the products must be washed again under running water.

Note: 1% of the total number of products is subject to quality control of pre-sterilization cleaning.

ALGORITHM FOR GENERAL CLEANING OF THE ROOM

Target: destruction of pathogenic and conditionally pathogenic microorganisms.

Requirement:

General cleaning is carried out once a week according to the schedule.

Cleaning should be carried out from the least contaminated areas to the most contaminated, as well as from high-lying areas to lower ones.

Conditions:

General cleaning should be carried out in the absence of patients.

Action algorithm:

1. Put on a change of sanitary clothing for general cleaning.

2. Prepare a disinfectant solution according to the instructions included with the disinfectant used.

3. To carry out general cleaning, use cleaning equipment with markings.

4.Take out the trash.

5.Fold up bedding, move beds, bedside tables to the center of the room.

6. Sweep cobwebs from the ceiling.

7.Use a rag generously moistened with a disinfectant solution to irrigate it in a certain sequence: walls, glass, window sill, heating system pipes, furniture, floor.

8. Treat the sink with a cleaning agent using a special rag, which must be disinfected or boiled after use.

9.After 1 hour, use a clean rag to wash off the treated surfaces with a soap and soda solution (25 g of detergent per 10 liters of water, 25 g of soda ash).

10. Dry the treated surfaces with a dry cloth.

11. Turn on the bactericidal irradiator for 30 minutes, leave the room.

12.Remove gloves, wash your hands.

13.Ventilate the room for 10 minutes.

Note: After general cleaning, empty the containers of dirty water, prepare a disinfectant solution, and immerse the rags for disinfection for 1 hour. Dry the rags and store them dry in a place specially designated for storing cleaning equipment. Treat the mop with a rag soaked in a disinfectant solution by wiping.

DISINFECTION OF MEDICAL INSTRUMENTS

Stage – disinfection

Target: ensuring infectious safety.

Equipment:

Two containers with appropriate markings and a disinfectant solution for washing instruments from blood and other biological fluids

Waste medical products

Cotton-gauze swabs or brushes for washing instruments.

Conditions: disinfect products immediately after use

1. Put on overalls: gown, mask, gloves.

2. Prepare a disinfectant solution in two containers.

In the first container:

Rinse by filling the internal channels of medical devices.

In the second container:

Fill the internal channels of medical devices by completely immersing them in the solution;

Cover the container with a lid for 1 hour;

After 1 hour, rinse the medical products several times under running water and place them in a tray.

3.Pour out the used disinfectant. solution into the sewer.

4.Remove your gloves and throw them into the KBU.

I APPROVED
Head of the Main Sanitary and Epidemiological Directorate of the USSR Ministry of Health
V. E. KOVSHILO
October 21, 1975

METHODOLOGICAL INSTRUCTIONS
ON THE USE OF CHLORAMINE FOR DISINFECTION PURPOSES

I. General information

1. Chloramines include a number of organic compounds having the general chemical formula RSO2NH2 (R means radical), in which one or both hydrogen atoms located at nitrogen are replaced by chlorine. They are distinguished if the starting product is benzene, and chloramine T if toluene is used for this.

2. Domestic chloramine used for disinfection purposes is called chloramine B, belongs to the group of monochloramines and has the formula: C6H5SO2N(Na)Cl x 3 H2O. It is a sodium salt of benzene sulfonic acid chloramide and has the appearance of a white fine-crystalline powder (sometimes yellowish). Typically contains 26% active chlorine, retaining this amount of chlorine for a long time if properly stored (loss of active chlorine during the year does not exceed 0.1%).

3. Chloramine B is highly soluble in water at room temperature. Its solutions retain active chlorine for 15 days and can be prepared for future use. They do not spoil or discolor fabrics.

4. Chloramine has high activity against gram-negative and gram-positive microorganisms, starting from 0.2%. Since active chlorine binds with organic substances, the concentration of solutions under practical conditions is increased to 0.5-1-2-3-5%. Hot solutions of chloramine (50-60°) have a higher disinfecting effect.

5. The bactericidal and virucidal properties of chloramine solutions are increased by the addition of ammonium compounds (ammonia, ammonium sulfate or ammonium chloride), which act as activators. Activated chloramine solutions quickly lose active chlorine, so they are used immediately after preparation.

6. Store chloramine in a dark glass container with a well-fitted stopper or, even better, with a ground stopper, in a wooden container or in a tin container coated on the inside with asphalt varnish, as well as in polyethylene bags. When storing chloramine, avoid direct exposure to light and moisture.

7. Chloramine and solutions prepared from it are checked from time to time for the content of active chlorine in them; This establishes the loss of active chlorine and the correct preparation and storage of solutions.

II. Preparation of chloramine solutions

8. Working solutions of chloramine are prepared by stirring it until completely dissolved in water, preferably heated to 50-60°.

9. To prepare chloramine solutions, the following quantities of the drug are required:

10. Activated solutions of chloramine are prepared by first diluting a weighed amount of chloramine in cold or hot (50-60°) water until completely dissolved, followed by adding an activator (ammonium chloride, sulfate, ammonium nitrate) in an amount equal to the amount of active chlorine in the solution, and 8 times less ammonia is added. Activated chloramine solutions are used immediately after preparation.

11. To prepare 1 or 10 liters of activated solution you need:

III. Application of chloramine solutions

12. Solutions of chloramine in various concentrations are used for disinfection of intestinal and droplet infections of bacterial and viral etiology, tuberculosis, and fungal diseases.

14. For these infections, chloramine solutions are used to wipe or irrigate surfaces and soak objects to be disinfected, and also, in some cases, to fill secretions.

Disinfection regimes for various objects for the listed infections are presented in Table. 1-5.

Table 1

REGIMES FOR DISINFECTION WITH CHLORAMINE OBJECTS IN FOCI OF INTESTINAL AND DROPLET INFECTIONS OF BACTERIAL ETIOLOGY

table 2

REGIMES FOR DISINFECTION OF OBJECTS IN FOIMS OF MICROSPORIA, TRICHOPHYTIA AND FAVUS

Table 3

REGIMES FOR DISINFECTION OF OBJECTS IN FOIMS OF VIRAL HEPATITIS AND ENTEROVIRAL INFECTIONS

Table 4

REGIMES FOR DISINFECTION OF OBJECTS WITH ACTIVATE SOLUTIONS OF CHLORAMINE IN FOCI OF TUBERCULOSIS

Note: According to the instructions for carrying out current and final disinfection for tuberculosis N 744-68, the use of non-activated chloramine solutions in foci of tuberculosis is not recommended.

Table 5

MODES FOR DISINFECTION OF OBJECTS WITH ACTIVATE SOLUTIONS OF CHLORAMINE FOR ANTHRAX

IV. Precautions when working with chloramine

When working with chloramine, and especially its activated solutions, it is necessary to protect the respiratory system with a RU-60 respirator. The work is performed in a robe, rubber gloves, and an apron.

The instructions for the use of chloramine for disinfection purposes dated December 24, 1947, from the moment these guidelines were approved, shall be considered no longer in force.