{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T11:06:12Z","timestamp":1789383972270,"version":"build-2803163510"},"reference-count":19,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"unspecified","delay-in-days":256,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Prehosp. Disaster med."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1049023X26109066_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1049023X26109066_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this exploratory study, 90 clinically used SUDs \u2013 endotracheal tubes (ETT), laryngeal mask airway (LMA), intravenous administration sets (IVS), syringes (SYR), indwelling urinary catheters (IDC), and nasogastric tubes (NGT) \u2013 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1049023X26109066_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      All three cleaning agents achieved statistically significant reductions in bacterial load (P &lt; 0.05) with no difference between methods. The PCR testing detected\n                      <jats:italic>Hemophilus influenzae<\/jats:italic>\n                      (H. influenzae) and\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      (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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1049023X26109066_as4\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1049023x26109066","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T10:32:41Z","timestamp":1789381961000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Contingency Methods for Cleaning Single-Use Medical Equipment in Crisis, Disaster, or War"],"prefix":"10.1017","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8952-9073","authenticated-orcid":false,"given":"Karl","family":"Chevalley","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01tm6cn81","id-type":"ROR","asserted-by":"publisher"}],"name":"Sahlgrenska Academy"},{"id":[{"id":"https:\/\/ror.org\/01tm6cn81","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Gothenburg Centre for Disaster Medicine"},{"name":"V\u00e4stra G\u00f6taland Region"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Knut","family":"Taxbro","sequence":"additional","affiliation":[{"name":"V\u00e4stra G\u00f6taland Region"},{"name":"Linkoping University Department of Biomedical and Clinical Sciences"},{"name":"Ryhov County Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Mernelius","sequence":"additional","affiliation":[{"name":"Linkoping University Department of Biomedical and Clinical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Sigfridsson","sequence":"additional","affiliation":[{"name":"Linkoping University Department of Biomedical and Clinical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00f6ran","family":"Sandstr\u00f6m","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01tm6cn81","id-type":"ROR","asserted-by":"publisher"}],"name":"Sahlgrenska Academy"},{"name":"Swedish Defence University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"S1049023X26109066_ref7","doi-asserted-by":"publisher","DOI":"10.1017\/dmp.2022.265"},{"key":"S1049023X26109066_ref12","volume-title":"Medical Regulations for the Swedish Armed Forces, Part 1: General Principles (SjvR FM 1)","year":"2000"},{"key":"S1049023X26109066_ref19","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.12.1.147"},{"key":"S1049023X26109066_ref6","unstructured":"6. National Board of Health and Welfare. War surgery treatment principles as a basis for calculating supply consumption in war according to BERMED. Stockholm, Sweden; 1994."},{"key":"S1049023X26109066_ref2","volume-title":"Strengthened Supply Preparedness for Health and Medical Care","author":"Kullgren","year":"2021"},{"key":"S1049023X26109066_ref1","volume-title":"Sweden During the Pandemic: Healthcare and Public Health, Volume 2","year":"2021"},{"key":"S1049023X26109066_ref8","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2024.0901"},{"key":"S1049023X26109066_ref3","first-page":"106","article-title":"Army Medicine\u2019s Critical Role in Large-Scale Combat Operations Enable the Force","volume":"102","author":"Marsh","year":"2022","journal-title":"Military Review."},{"key":"S1049023X26109066_ref13","doi-asserted-by":"publisher","DOI":"10.1002\/aorn.12639"},{"key":"S1049023X26109066_ref10","volume-title":"Conditions for reprocessing and reusing single-use medical devices in Sweden","year":"2020"},{"key":"S1049023X26109066_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2015.12.029"},{"key":"S1049023X26109066_ref17","first-page":"103","article-title":"Decontamination of anesthetic equipment","volume":"4","author":"Sabir","year":"2004","journal-title":"Continuing Education in Anesthesia, Critical Care and Pain."},{"key":"S1049023X26109066_ref4","volume-title":"Emergency stockpiling \u2013 an overview of stockpiling as a tool for increased security of supply in Sweden","author":"Ann-Sofie Stenerus","year":"2019"},{"key":"S1049023X26109066_ref5","doi-asserted-by":"publisher","DOI":"10.1186\/s13049-024-01299-7"},{"key":"S1049023X26109066_ref14","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5049.120152"},{"key":"S1049023X26109066_ref9","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2022-009550"},{"key":"S1049023X26109066_ref11","unstructured":"11. National Board of Health and Welfare. Basis for determining which healthcare products should be included in healthcare supply preparedness. Stockholm, Sweden; 2024."},{"key":"S1049023X26109066_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2019.01.018"},{"key":"S1049023X26109066_ref16","author":"Rutala","year":"2008"}],"container-title":["Prehospital and Disaster Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1049023X26109066","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T10:32:45Z","timestamp":1789381965000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1049023X26109066\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"alternative-id":["S1049023X26109066"],"URL":"https:\/\/doi.org\/10.1017\/s1049023x26109066","relation":{},"ISSN":["1049-023X","1945-1938"],"issn-type":[{"value":"1049-023X","type":"print"},{"value":"1945-1938","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of World Association for Disaster and Emergency Medicine","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e21"}}