WO2011060132A2 - Stethoscope disinfecting apparatus - Google Patents

Abstract

The disclosure provides apparatus and assemblies for disinfecting a stethoscope chestpiece. In some embodiments, an apparatus includes an applicator that dispenses a disinfecting fluid when contacted with a stethoscope chestpiece and a motion generator to move the applicator relative to the chestpiece. In some embodiments, an apparatus comprises a chestpiece receiver operably coupled to a means for dispensing a fluid disinfectant. In some embodiments, the assembly includes an absorbent material comprising a plurality of contact regions and a disinfecting fluid and a means for replacing one of the plurality of contact regions with another of the plurality of contact regions. Methods of use are also provided.

Description

STETHOSCOPE DISINFECTING APPARATUS

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Patent Application Nos. 61/261,203, 61/261,220 and 61/261,255, all filed November 13, 2009, which are incorporated herein by reference in their entirety.

BACKGROUND

The use of a stethoscope by health care providers is routine. As typically applied, the chestpiece of the stethoscope is normally placed in direct contact with the skin of the patient at various locations over the patient's body. In applying the stethoscope in this manner and in particular in situations where the stethoscope chestpiece may be exposed to bodily fluids of the patient, the transmission of infection from patient to patient is a distinct possibility.

While some stethoscopes are structured for disposal after each use, a great number of stethoscope instruments are non-disposable and are intended for continued and repeated use. This latter category of stethoscopes are typically carried by the health care provider on a substantially continuous basis and used repeatedly for examination of multiple patients. In order to avoid the transmission of infection from patient to patient when using this latter category of instruments, attempts have been made to facilitate at least a minimal cleaning and/or disinfecting of the chestpiece of the stethoscope. However, because of time demands and other situations which frequently occur, a health care provider may only perform a minimal disinfecting of the instrument on an occasional basis. Such cursory disinfecting procedures may involve a physical wiping of the head and diaphragm portions of the stethoscope with some type of disinfecting or cleaning material wipe. Although, these cursory disinfecting procedures may be effective, they are burdensome, time consuming, highly variable from one operator to the next, and require the ready availability of these wipes.

The transfer of pathogenic bacteria from one patient to another is a major cause of healthcare associated infections. This transfer may be facilitated by healthcare workers who do not adequately clean and disinfect their hands and/or patient care equipment after patient contact. There is a need to provide a simple device that allows health care providers to rapidly disinfect their stethoscope before and after examining a patient.

SUMMARY

The present disclosure is related to apparatus and assemblies for disinfecting the patient contact surfaces of a stethoscope. In particular, this disclosure is related to apparatus and methods for disinfecting a stethoscope chestpiece, for example.

In one aspect, the present disclosure provides a first apparatus for disinfecting a stethoscope chestpiece. The first apparatus can comprise a fluid disinfectant reservoir with fluid disinfectant therein. The first apparatus further can comprise an applicator including a contact surface. The contact surface can be dimensioned to receive a stethoscope chestpiece. The applicator can be in fluid communication with the reservoir. The first apparatus further can comprise a motion generator operably coupled to the applicator. The first apparatus further can comprise a dispensing means for delivering the fluid disinfectant to the applicator. The motion generator can be configured to move the applicator relative to the chestpiece.

In any of the above embodiments, the first apparatus further can comprise a biasing means. The biasing means can urge the applicator to a predetermined position.

In any of the above embodiments of the first apparatus, the contact surface can be non-abrasive. In any of the above embodiments of the first apparatus, the dispensing means can comprise the motion generator. In any of the above embodiments, the first apparatus can be configured to move the applicator relative to the chestpiece when force is applied against the applicator. In any of the above embodiments, the first apparatus can be configured to dispense the fluid disinfectant to the applicator when force is applied against the applicator

In any of the above embodiments, the first apparatus can be configured to dispense the fluid disinfectant to the applicator prior to moving the applicator relative to the chestpiece. In some embodiments, the first apparatus can be configured to dispense the fluid disinfectant to the applicator while moving the applicator relative to the chestpiece.

In any of the above embodiments, the first apparatus can be configured to move the applicator in an oscillating motion or a rotational motion relative to the chestpiece. In any of the above embodiments, the first apparatus further can comprise a housing configured to receive a stethoscope chestpiece. In these embodiments, the applicator can be disposed in the housing.

In any of the above embodiments of the first apparatus, the fluid disinfectant can comprise a foaming agent.

In another aspect, the present disclosure provides a second apparatus for disinfecting a stethoscope chestpiece. The second apparatus can comprise a fluid disinfectant reservoir with fluid disinfectant therein. The second apparatus further can comprise an applicator dimensioned to receive a stethoscope chestpiece. The applicator can be in fluid communication with the reservoir. The second apparatus further can comprise a dispensing means for delivering the fluid disinfectant to the applicator. The second apparatus can be configured to deliver the fluid disinfectant to the applicator when force is applied against the applicator. In some embodiments of the second apparatus, the fluid disinfectant can comprise a foaming agent.

In yet another aspect, the present disclosure provides a method of disinfecting a stethoscope chestpiece. The method can comprise providing a first or second apparatus according to any of the above embodiments. The method further can comprise contacting the chestpiece with the applicator and applying force against the applicator. Applying force against the applicator can dispense a fluid disinfectant to the applicator. The force can be applied substantially orthogonal to the applicator. In some

embodiments, the method further can comprise moving the chestpiece relative to the applicator while the chestpiece is contacting the applicator.

In yet another aspect, the present disclosure provides a third apparatus for disinfecting a stethoscope chestpiece. The third apparatus can comprise a reservoir containing fluid disinfectant. The third apparatus further can comprise a liquid dispenser in fluidic connection with the reservoir. The third apparatus further can comprise a receiver with a longitudinal axis. The receiver can comprise a first opening proximate the liquid dispenser and a larger second opening opposite the first opening. The third apparatus further can comprise an actuator. The second opening can be adapted to receive a stethoscope chestpiece. The actuator can be operably coupled to the liquid dispenser.

In any of the above embodiments of the third apparatus, a portion of the receiver can be flexible. In any of the above embodiments of the third apparatus, adapted to receive a stethoscope chestpiece can comprise adapted to provide circumferential contact between the receiver and the perimeter region of the stethoscope chestpiece.

In any of the above embodiments, the third apparatus further can comprise a sensor. The sensor can be operably coupled to the actuator. In some embodiments of the third apparatus, the sensor can be adapted to delay the operation of the actuator for a predetermined period of time.

In any of the above embodiments of the third apparatus, the sensor can be adapted to detect the movement of the receiver.

In any of the above embodiments of the third apparatus, the receiver can comprise a conical-shaped receiver. In any of the above embodiments of the third apparatus, dispenser can comprise an atomizer. In any of the above embodiments, the third apparatus further can comprise a housing. In any of the above embodiments, the third apparatus further can comprise a reset device adapted to move the receiver to a predetermined position.

In yet another aspect, the present disclosure provides a method of disinfecting a stethoscope chestpiece. The method can comprise providing the apparatus of any one of above embodiments of the third apparatus. The method further can comprise contacting the chestpiece with the receiver such that a portion of the chestpiece to be disinfected is facing the first opening. The method further can comprise actuating the liquid dispenser. In some embodiments, actuating the liquid dispenser can comprise moving the receiver. In some embodiments, moving the receiver can comprise urging the chestpiece against the receiver.

In yet another aspect, the present disclosure provides an assembly for disinfecting a patient-contact surface of a medical device. The assembly can comprise a first absorbent material comprising a plurality of contact regions. Each contact region can comprise a disinfecting fluid in an amount sufficient to permit transfer of at least a portion of the disinfecting fluid to a stethoscope that is contacted with a contact region. The assembly further can comprise a housing. The housing can include an entrance portion, an exit portion, and a path of travel for the patient-contact surface of a medical device. The entrance portion can be dimensioned to receive the patient-contact surface of a medical device. The path of travel can extend between the entrance portion and the exit portion. At least one of the plurality of contact regions can be disposed along at least a portion of the path of travel. The assembly further can comprise a means for exchanging the at least one contact region in the path of travel with another of the plurality of contact regions.

In yet another aspect, the present disclosure provides an assembly for disinfecting a patient-contact surface of a medical device. The assembly can comprise a first dry absorbent material comprising a plurality of contact regions. The assembly further can comprise a housing. The housing can include an entrance portion and an exit portion. The entrance portion can be dimensioned to receive a patient-contact surface of a medical device. The housing further can comprise a path of travel for a patient-contact surface of a medical device extending between the entrance portion and the exit portion. At least one of the plurality of contact regions can be disposed along at least a portion of the path of travel. The assembly further can comprise an applicator comprising a disinfecting fluid. The assembly further can comprise an actuator. The actuator is disposed proximate the entrance portion. The assembly further can comprise means for advancing and replacing the at least one contact region in the path of travel with another of the plurality of contact regions. When activated, the actuator can cause the applicator to dispense the disinfecting fluid into the first dry absorbent material. The disinfecting fluid dispensed into the first dry absorbent material can comprise an amount sufficient to permit transfer of at least a portion of the disinfecting fluid to a stethoscope that is contacted with a contact region.

In any of the above assembly embodiments, the medical device can comprise a stethoscope chestpiece, an ultrasound probe, or a thermometer.

In any of the above assembly embodiments, the means for advancing and replacing can comprise a material dispenser. The material dispenser can be configured to contain the plurality of contact regions.

In any of the above assembly embodiments, the disinfecting fluid can comprise a detectable indicator. In any of the above embodiments, the detectable indicator can be visually detectable.

In any of the above assembly embodiments, the travel path further comprises a second absorbent material. The second absorbent material can be a dry absorbent material. In some embodiments, the assembly can comprise a second entrance portion, a second exit portion, and a second travel path. The second absorbent material can be disposed in the second travel path.

In any of the above assembly embodiments, the plurality of contact regions can comprise a roll. In any of the above assembly embodiments, two or more of the plurality of contact regions can be separated by a liquid diffusion barrier. In any of the above assembly embodiments, the means for advancing and replacing can comprise a wind-up roll.

In some assembly embodiments, the at least one absorbent material can comprise a capture portion configured to releasably couple to the head portion of the stethoscope.

In any of the above embodiments, the assembly further can comprise an event monitor. In any of the above embodiments, the assembly further can comprise a stethoscope recorder.

In any of the above assembly embodiments, the first and/or second absorbent material can be selected from the group consisting of a polymeric nonwoven, a paper, or a foam.

In yet another aspect, the present disclosure provides a process a method of disinfecting the head portion of a stethoscope. The method can comprise providing a stethoscope with a head portion and an assembly according to any one of the above assembly embodiments. The method further can comprise positioning the head portion of the stethoscope in the entrance portion of the assembly and moving the head portion along the travel path with contact between the head portion and the absorbent material comprising disinfecting fluid.

In any of the above embodiments, the method further can comprise contacting the head portion with the second absorbent material.

In any of the above apparatus or assembly embodiments, the disinfecting fluid can comprise a foaming agent. The words "preferred" and "preferably" refer to embodiments of the invention that may afford certain benefits, under certain

circumstances. However, other embodiments may also be preferred, under the same or other circumstances. Furthermore, the recitation of one or more preferred embodiments does not imply that other embodiments are not useful, and is not intended to exclude other embodiments from the scope of the invention. As used herein, "a," "an," "the," "at least one," and "one or more" are used interchangeably. Thus, for example, a reservoir containing "a" disinfectant can be interpreted to mean that the reservoir can contain "one or more" disinfectants.

The term "and/or" means one or all of the listed elements or a combination of any two or more of the listed elements.

Also herein, the recitations of numerical ranges by endpoints include all numbers subsumed within that range (e.g., 1 to 5 includes 1, 1.5, 2, 2.75, 3, 3.80, 4, 5, etc.).

The above summary of the present invention is not intended to describe each disclosed embodiment or every implementation of the present invention. The description that follows more particularly exemplifies illustrative embodiments. In several places throughout the application, guidance is provided through lists of examples, which examples can be used in various combinations. In each instance, the recited list serves only as a representative group and should not be interpreted as an exclusive list.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention will be further explained with reference to the drawing figures listed below, where like structure is referenced by like numerals throughout the several views.

Figure 1 is a side view of one embodiment of a stethoscope disinfecting apparatus according to the present disclosure.

Figure 2 is a side view of a rotational motion generator feature of the stethoscope disinfecting apparatus of Figure 1.

Figure 3 a is a top perspective view of the applicator feature of the stethoscope disinfecting apparatus of Figure 1.

Figure 3b is a top view of one embodiment of an applicator according to the present disclosure.

Figure 3 c is a top view of another embodiment of an applicator according to the present disclosure.

Figures 4a-4c are side views of one embodiment of a stethoscope disinfecting apparatus as the apparatus is used in a method of disinfecting a stethoscope according to the present disclosure. Figure 5 is a side view of one embodiment of an oscillating motion generator according to the present disclosure.

Figure 6 is a front perspective view of a stethoscope comprising a chestpiece.

Figure 7 is a side view of the chestpiece of Figure 6.

Figure 8a is a side view, partially in section, of an alternative embodiment of a stethoscope disinfecting apparatus with a stethoscope chestpiece contacting a receiver according to the present disclosure.

Figure 8b is a side view, partially in section, of the stethoscope disinfecting apparatus of Figure 8a with the receiver actuating a liquid dispenser according to the present disclosure.

Figure 8c is a side view, partially in section, of one embodiment of a stethoscope disinfecting apparatus with a large stethoscope chestpiece contacting a receiver which actuates a liquid dispenser according to the present disclosure.

Figure 9 is a cross-sectional view of one embodiment of a stethoscope chestpiece receiver according to the present disclosure.

Figures 10a- 10b are top views of the liquid dispenser apparatus of Figures 8a-c, showing one embodiment of the actuation of a liquid dispenser.

Figure 1 la is a front perspective view of the housing of one embodiment of a stethoscope disinfecting assembly according to the present disclosure.

Figure 1 lb is a rear perspective view of the housing of Figure 11a, showing a pivotable mounting plate.

Figure 12a is a front view of one embodiment of a stethoscope disinfecting apparatus with front panels defining a straight path of travel according to the present disclosure.

Figure 12b is a front view of one embodiment of a stethoscope disinfecting apparatus with front panels defining a tortuous path of travel according to the present disclosure.

Figure 12c is a front view of one embodiment of a stethoscope disinfecting apparatus without front panels.

Figure 12d is a front view of a stethoscope disinfecting apparatus with a plurality of paths of travel according to the present disclosure

Figure 13 is a front perspective view of the applicator subassembly of Figure

13a. Figure 14 is a rear perspective view of the interior of one embodiment of a housing according to the present disclosure, showing one embodiment of an absorbent material dispenser subassembly.

Figure 15 is a front perspective view of the housing of Figure 14, showing the absorbent material dispenser subassembly.

Figure 16a is a front perspective view of one embodiment of a housing according to the present disclosure, showing one embodiment of an actuator subassembly.

Figure 16b is a rear perspective view of the interior of the housing of Figure 16a, showing the actuator subassembly in a first position.

Figure 16c is a rear perspective view of the interior of the housing of Figure 16a, showing the actuator subassembly in a second position.

Figure 17 is a front perspective exploded view of one embodiment of a stethoscope disinfecting apparatus according to the present disclosure.

Figure 18a is a front perspective view of one embodiment of an absorbent material comprising a plurality of contact regions.

Figure 18b is a front perspective view of another embodiment of an absorbent material comprising a plurality of contact regions.

Figure 18c is a front perspective view of one embodiment of an absorbent material comprising a plurality of contact regions, each region comprising a stethoscope capture portion.

Figure 18d is a front perspective view of another embodiment of an absorbent material comprising a plurality of contact regions, each region comprising a stethoscope capture portion.

DETAILED DESCRIPTION

Before any embodiments of the invention are explained in detail, it is to be understood that the invention is not limited in its application to the details of construction and the arrangement of components set forth in the following description or illustrated in the accompanying drawings. The invention is capable of other embodiments and of being practiced or of being carried out in various ways. Also, it is to be understood that the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting. The use of "including," "comprising," "containing," or "having" and variations thereof herein is meant to encompass the items listed thereafter and equivalents thereof as well as additional items. Unless specified or limited otherwise, the terms "supported," and "coupled" and variations thereof are used broadly and encompass both direct and indirect supports and couplings. It is to be understood that other embodiments may be utilized and structural or logical changes may be made without departing from the scope of the present disclosure. Furthermore, terms such as "front," "rear," "top," "bottom," and the like are only used to describe elements as they relate to one another, but are in no way meant to recite specific orientations of the apparatus, to indicate or imply necessary or required orientations of the apparatus, or to specify how the invention described herein will be used, mounted, displayed, or positioned in use.

The present disclosure is generally related to apparatus, assemblies, and methods for disinfecting patient contact surfaces of a medical device such as a stethoscope chestpiece, an ultrasound probe, or a thermometer, for example. In particular, the present disclosure relates to the disinfection of the chestpiece of a stethoscope.

The inventive apparatus provides the ability to disinfect the patient contact surface of a chestpiece using only one hand. Furthermore, the apparatus is adapted to minimize or eliminate exposure of the operator to the liquid and/or vapor forms of the fluid disinfectant used to disinfect the chestpiece.

Definitions:

Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Methods and materials similar or equivalent to those described herein can be used in the practice of the present invention, and exemplified suitable methods and materials are described below. For example, methods may be described which comprise more than two steps. In such methods, not all steps may be required to achieve a defined goal and the invention envisions the use of isolated steps to achieve these discrete goals. The disclosures of all publications, patent applications, patents and other references are incorporated herein by reference in their entirety. In addition, the materials, methods, and examples are illustrative only and not intended to be limiting. Stethoscope Disinfecting Apparatus

Stethoscopes are routinely used by health care professionals in the assessment of a patient's heart, lungs, or blood pressure, for example. FIG. 6 shows a top perspective view of a typical mechanical stethoscope 690. The typical stethoscope 690 comprises two earpieces 691, which are inserted into the operator's ears during use; tubing 692, which conveys sounds to the earpieces; and a chestpiece 694, which is typically placed in contact with the patient's clothing or skin over the area of the body to be assessed by the operator. Electronic stethoscopes are similar having the same basic features.

The outer perimeter of the chestpiece 694 typically has a circular or, less commonly, an ellipsoid shape. Other shapes may be suitable for use with the assemblies of the present disclosure. FIG. 7 shows a side view of the chestpiece of the stethoscope of FIG. 6. A diaphragm 795 is located on one side of the chestpiece 794. A bell 796 is typically located on the side of the chestpiece 794 opposite the diaphragm 795. The bell 796 is generally applied to the skin with light pressure in order to hear low- frequency sounds. The diaphragm 795 is generally applied to the skin with firm pressure in order to hear high-frequency sounds. FIG. 7 further shows that the bell 796 of the chestpiece 794 further comprises a rim 798. As can be seen in FIG. 7, the diaphragm 795 and the rim 798 form the outer surfaces of the opposite sides of the chestpiece 794. These outer surfaces (i.e., the diaphragm 795 and the rim 798) comprise the major surfaces of the stethoscope that come into direct contact with a patient's skin and/or clothing. Desirably, it is primarily these patient contact surfaces that should be disinfected between patients when the stethoscope is used sequentially on multiple patients. Although not every stethoscope comprises a bell, such stethoscopes without a bell are nonetheless suitable for use with the assemblies described herein.

FIG. 1 shows one embodiment of a stethoscope disinfecting apparatus 100 according to the present disclosure. The apparatus 100 comprises a reservoir 110, which comprises a fluid disinfectant. The reservoir 110 is any suitable container (e.g., a bottle or polymer bag) for holding the fluid disinfectant. The reservoir 110 should be made of stable materials (e.g., plastic, glass) that are not substantially degraded by the fluid disinfectant and, preferably, are capable of holding the fluid disinfectant for extended periods of time without substantial evaporative moisture loss. In the illustrated embodiment, the reservoir 110 further comprises a reservoir cap 112, which may be optionally detachably attached (e.g., as a screwcap) to the reservoir 110.

The apparatus 100 further comprises an applicator 120. The applicator 120 is in fluid communication with the reservoir 110. In some embodiments, the applicator 120 is in selective fluid communication with the reservoir 110, wherein the selective fluid communication is controlled by a pump, or a valve, for example.

The applicator 120 comprises a contact surface 122. The contact surface 122 is the surface of the apparatus 100 that contacts a stethoscope chestpiece. Accordingly, the contact surface 122 should be made from materials that are non-abrasive and that are compatible with preserving the function and, preferably, the appearance of a stethoscope chestpiece. The contact surface 122 may be fabricated from a variety of materials including, for example, a material selected from the group consisting of a bristle, a woven material, a nonwoven material, a paper, a foam, and a combination of any two or more of the foregoing. In some embodiments, the contact surface 122 comprises a porous material. Advantageously, the porous material can provide rapid distribution of a fluid disinfectant throughout the contact surface 122 and, thus, facilitate the transfer of a portion of the fluid disinfectant to the entire contact surface of the stethoscope chestpiece.

The applicator 120 is dimensioned to receive a stethoscope chestpiece. A variety of stethoscope types are available, with a range of different- sized chestpieces.

For example, certain electronic stethoscopes comprise chestpieces that are

approximately 5.6 cm in diameter. In contrast, certain stethoscopes used to assess infants comprise chestpieces that are approximately 2.25 cm in diameter. Although it is not necessary, it is preferred that the applicator 120 is dimensioned to receive a range of different-sized stethoscope chestpieces, up to at least about 5.6 cm in diameter, or larger.

Optionally, the applicator 120 can further comprise a pad 124. The pad 124 can function to assist the applicator in conforming to the surface of the stethoscope chestpiece. In these embodiments, the pad 124 can be made from a variety of pliable materials including, for example, open-cell foam, closed-cell foam, paper, rubber, and the like. In some embodiments, the pad 124 may advantageously also function to disperse the fluid disinfectant and deliver it to the contact surface 122. In this embodiment, the pad 124 can be made from a relatively porous material such as open- cell foam, for example. Preferably, the pad 124 is made from a material that is not substantially degraded by the fluid disinfectant.

The applicator 120 further can comprise a base 126, which provides structural support for the pad 124 and/or the contact surface 122. The base 126, for example can be a molded plastic part or any other suitable rigid or semi-rigid material that is not substantially degraded by the fluid disinfectant.

In some embodiments, the contact surface 122 and, optionally, the pad 124 may be detachably attached to the base 126. The attachment means can include any suitable attachment means known in the art such as an adhesive, hook and loop structures, a clamp, or a staple, for example. In these embodiments, the contact surface 122 and, optionally, the pad 124, may be detached, discarded and replaced after a single use, to reduce or eliminate the possibility of cross-contamination.

The apparatus 100 further comprises a dispensing means. In the illustrated embodiment, the dispensing means comprises a manual pump (not shown) that is actuated by urging the applicator 120 toward the reservoir 110. This motion creates pressure within the reservoir 110, which pumps the fluid disinfectant from the reservoir 110 to the applicator 120. A person of ordinary skill in the relevant art will recognize that the manual pump may be substituted with a variety of automated pumping means that are known in the art. A gravity-fed means, controlled by an actuatable valve, for example, could also serve as an alternative dispensing means for an apparatus 100 according to the present disclosure.

In the illustrated embodiment, the applicator 120 is shown in a first position. As described below, the applicator 120 can be urged toward the reservoir and, thus, be moved into a plurality of other possible positions. Therefore, it may be desirable to return the applicator 120 to the original position (i.e., the first position shown in FIG.

1). Thus, in some embodiments, the apparatus 100 further comprises a biasing means 170. The biasing means 170 comprises a structure that is adapted to urge the applicator 120 to a predetermined position first position. In this embodiment, the biasing means 170 comprises a spring.

In the illustrated embodiment, the biasing means 170 contacts the reservoir 110 and the base 126. The biasing means 170 is tensioned to urge the base 126 away from the reservoir 110. The biasing means 170 can provide the force necessary to return the applicator 120 to the position shown in FIG. 1 after the applicator 120 has been urged toward the reservoir 110, as described below. The biasing means 170 can be adapted for a predetermined tensioning force. Advantageously, this tensioning force will regulate the minimum amount of force needed to urge the applicator 120 toward the reservoir 110. This minimum force can cause the pad 124, if present, and contact surface 122 to conform to a chestpiece in contact with the applicator, thereby providing more uniform contact with the irregular surfaces of a stethoscope chestpiece (not shown). Advantageously, this conforming interaction between the contact surface 122 and the chestpiece 190 can reduce the amount of fluid disinfectant needed to wet the entire surface of the chestpiece (not shown).

In some embodiments, the apparatus 100 further comprises a motion generator

130. The motion generator 130 is configured to move the applicator 122 relative to a stethoscope chestpiece (not shown).

FIG. 2 shows the motion generator 230 of FIG. 1. In this embodiment, the motion generator 230 comprises a threaded helix 232 that is rotatably engaged with the reservoir cap (not shown). In this embodiment, the motion generator 230

advantageously serves an additional function. That is, the motion generator 230 further comprises a liquid conduit 234, which forms a fluid communication linkage between the reservoir (not shown) and the contact surface (not shown).

FIG. 3a shows a top perspective view of one embodiment of an applicator 320 according to the present disclosure. The applicator 320a comprises a contact surface

322, which may comprise a non-abrasive, textured surface, such as the soft bristles shown on the upper surface of the applicator 322 in FIG. 3a. Optionally, the contact surface 322 may comprise an opening 328 through which a stream or a spray 350 of fluid disinfectant may be dispensed onto the surface of a stethoscope chestpiece.

FIG. 3b shows a top view of another embodiment of an applicator 320b according to the present disclosure. In this embodiment, the contact surface 322 is coextensive with the base 326. The base 326 comprises a plurality of orifices 325 through which fluid disinfectant is distributed to the contact surface 322. In this embodiment, the contact surface 322 is made from a material (e.g., a synthetic nonwoven material) that is sufficiently porous to permit the fluid disinfectant to pass through the contact surface 322 to a stethoscope chestpiece.

FIG 3c shows a top view of another embodiment of an applicator 320c according to the present disclosure. This embodiment comprises an opening 328 that extends through the contact surface 322 to the base 326. The base 326 comprises an orifice 325, which delivers fluid disinfectant from the liquid conduit (not shown).

In any of the above embodiments, the apparatus may further comprise a housing (not shown). The housing could form an enclosure (e.g., a cup-shaped housing) around the applicator and can be configured to receive the chestpiece of a stethoscope.

Advantageously, the housing could capture any excess fluid disinfectant dispensed by the applicator. Alternatively, the housing could comprise a structure to mount the apparatus on a surface, such as a wall, a cabinet, a cart, and the like.

The present disclosure provides methods for disinfecting a stethoscope (e.g., a stethoscope chestpiece). FIGs. 4a through 4c show side views of one embodiment of a method for disinfecting a stethoscope chestpiece according to the present disclosure. Briefly, the method comprises i) providing a stethoscope disinfecting apparatus including a applicator according to the present disclosure, ii) contacting the stethoscope chestpiece with the applicator, and iii) applying force to the applicator thereby dispensing fluid disinfectant to the applicator.

FIG. 4a show a side view of one step in a method for disinfecting a stethoscope chestpiece 490. In this step, a stethoscope chestpiece 490 is contacted with an apparatus 400. The apparatus 400 comprises a reservoir 410 containing fluid disinfectant. The apparatus 400 further comprises a motion generator 430, including a threaded helix and a liquid conduit as described above, that is rotatably coupled to a similarly-threaded structure in the reservoir cap 415. The apparatus further comprises an applicator 420 with a contact surface 422. As shown in FIG. 4a, the chestpiece 490 is contacted with the contact surface 422 (i.e., the stethoscope contact surface) of the apparatus 400.

FIG. 4b shows a side view of another step in a method for disinfecting a stethoscope chestpiece 490. In this step, manual force is applied to the chestpiece 490 in the direction of arrow 492 (i.e., in a direction that is substantially orthogonal to the stethoscope contact surface of the applicator 420) to urge the chestpiece 490 against the applicator 420. As the chestpiece 490 is urged against the applicator 420, the motion generator 430 rotates as it threads itself into the reservoir cap 415. The rotational motion of the motion generator 430 causes the applicator 420 to likewise rotate while the chestpiece 490 is held in a fixed position relative to the applicator 420. Thus, as the applicator 420 is depressed, the motion generator 430 causes the applicator 420 to move relative to the chestpiece 490. In addition to causing rotation of the applicator 420, the insertion of the motion generator 430 into the reservoir 410 provide a motive force (e.g., by pressurizing the reservoir 410) to pump fluid disinfectant (e.g., in the form of a stream or a spray 450) from the reservoir 410 to the applicator 420, where it can be transferred to the chestpiece 490.

Advantageously, the rotational motion of the applicator can provide a mild scrubbing action, thereby permitting the removal of loosely-attached debris (e.g., dust, hair, skin) from the chestpiece. This may enhance the removal of microorganisms from the chestpiece.

FIG. 4c shows a side view of another step in a method for disinfecting a stethoscope chestpiece 490. In this step, the manual pressure is released from the chestpiece 490, allowing the motion generator 430 to reverse the threading action and cause the apparatus to return in the direction of arrow 494 to the original configuration shown in FIG 4a. This movement can cause the applicator to rotate in the reverse direction (e.g., counterclockwise, as shown by the arrows) and can be facilitated by a biasing means, as shown in FIG. 1. Advantageously, this additional rotational motion can provide additional cleaning and disinfection of the chestpiece 490.

In another embodiment (not shown) the apparatus may not include a motion generator. In this embodiment, the downward pressure on the applicator may simply result in the dispensing of the fluid disinfectant to the applicator, where it can be transferred to the chestpiece. Thus, in this embodiment, the apparatus does not provide a motive force to move the applicator relative to the chestpiece. However, in this embodiment, the operator may manually move the chestpiece relative to the applicator in a wiping motion. In this embodiment, the applicator can be returned to its original position by a biasing means, as described above.

FIG. 5 shows a side view of another embodiment of a motion generator according to the present disclosure. In this embodiment, a fluid conduit 534 constructed from a relatively flexible material (e.g., plastic or rubber tubing) includes a serrated structure 536 attached (e.g., adhesively attached) thereto. Attached to the reservoir cap 515 is a stationary pin 538. The serrated structure 536 and the stationary pin 538 are in operable contact such that, as the applicator 520 is urged toward the reservoir cap 515, the serrated structure 536 contacts the stationary pin 538, thereby causing the liquid conduit 534 to deflect in an oscillating manner as shown by the arrow. The oscillating movement of the liquid conduit 534 causes a likewise oscillating movement of the applicator 520, thereby moving the applicator 520 relative to a stationary chestpiece (not shown) in contact with the applicator 520.

Although the illustrated embodiments show the contact surface of the applicator generally facing in an upward direction, it is contemplated that, in some embodiments, the applicator could be oriented at any angle, including at an angle wherein the applicator is facing downward. These alternative orientations may present certain advantages, such as a fluid connection whereby the fluid disinfectant is supplied from the reservoir to the applicator by the force of gravity which, advantageously, can keep a pumping mechanism primed, for example.

FIG. 8a shows a side view, partially in section, of one embodiment of an alternative stethoscope disinfecting apparatus 800 according to the present disclosure. The apparatus comprises a back plate 812, which can comprise holes (not shown) or coupling devices (e.g., screws, clamps, adhesive strips, or the like, not shown) to attach the back plate 812 to a surface (e.g., a vertical surface such as a wall, a cabinet, or a cart, for example; a horizontal surface such as a countertop, a desk, a table, a shelf, or a cart; or an angled surface). Although the illustrated embodiment depicts the back plate 812 as substantially planar, it is contemplated that the back plate 812 could

alternatively be configured to attach to a curvilinear or an irregularly-shaped surface.

The back plate 812 can be fabricated from a variety of rigid or semi-rigid materials, such as plastic, wood, or metal, for example.

Attached to the back plate 812 is a housing 810, which is shown in cross-section in FIG. 8a. The housing 810 forms a protective shield to limit the access of dust and other contaminants, for example, to the other parts of the apparatus 800. In addition, the housing may contain and/or minimize the broad release of liquid or vapor forms of a liquid disinfectant as it is applied to a patient contact surface of a medical device such as a stethoscope, thereby reducing or eliminating exposure to the liquids or vapors. The housing 810 can be formed from plastic or sheet metal, for example, using processes that are well known in the art and can be coupled to the back plate 812 by an adhesive, a screw, or a rivet, for example. In some embodiments, the housing 810, can be hingedly coupled to the back plate 812, thereby permitting easy access to the other parts of the apparatus 800 for maintenance and repair. Attached to the back plate 812 is a reservoir support 814. The reservoir support 814 can be formed as a unitary part with the back plate 812. The support 814 should be sufficiently rigid to remain substantially unflexed while bearing the weight of the reservoir 840 containing a fluid disinfectant and when force is applied to the reservoir 840 during actuation of the dispenser 842, as described below.

Attached to the back plate 812 are fixed guides 824. Fixed guides 824 are slideably engaged with mobile guides 822. Mobile guides 822 are coupled to the chestpiece receiver 820, which is shown in cross-section in FIG 8a. The fixed guides 824 and mobile guides 822 can be fabricated from metal or plastic, for example, and can slideably engage in a manner similar to the guide rails that function to guide a drawer into a cabinet. At least one of the mobile guides 822 can further comprise a stop structure (not shown) that functions to prevent disengagement of the mobile guides 822 from the fixed guides 824. Alternatively, the housing 810 can serve as a stop structure to prevent disengagement of the mobile guides 822 from the fixed guides 824.

The chestpiece receiver 820 can be configured to receive a stethoscope chestpiece 890. Stethoscope chestpieces are provided in various sizes and the outer perimeter of the chestpiece typically forms a circular shape. The shape of the receiver 820 can be configured to be complementary to any particular shape of a stethoscope chestpiece 890. The receiver 820 can also be dimensioned to receive any particular size of chestpiece 890.

A preferred embodiment of the present disclosure comprises a receiver 820 that forms a frustoconical shape, as shown in cross-section in FIG 8a and in greater detail in FIG. 9. Referring to FIG. 9, FIG. 9 shows a cross-sectional view of one embodiment of a receiver 920 according to the present disclosure. The receiver 920 is coupled to mobile guides 922, as described above. In this embodiment, the receiver 920 comprises a frustoconical shape. The receiver 920 has a longitudinal axis (line A). The first opening 920a of the receiver 920 is smaller than the second opening 920b of the receiver.

Referring back to FIG 8, it can be seen that the first opening of the receiver 820 is proximate the dispenser 842 and the larger second opening of the receiver 820 is distal to the dispenser 842. The larger opening of the receiver 820 is adapted to receive a stethoscope chestpiece 890. The frustoconical shape of the receiver 820 is particularly adaptable to receive a large variety of stethoscope chestpieces 890. Furthermore, the conical shape of the receiver 820 allows the formation of a

substantially continuous seal between the circular perimeter of a typical chestpiece 890 and the receiver 820. Furthermore, the conical shape permits the operator to tilt an oval-shaped chestpiece (not shown) or an ellipsoid-shaped chestpiece (not shown) as it contacts the conical receiver 820 to form a substantially continuous seal with those chestpieces, too. Thus, a conical-shaped receiver is uniquely adapted to receive a variety of different-shaped chestpieces and form a substantially continuous seal around the perimeter of the chestpieces.

The continuous seal is desirable because it further serves to minimize or prevent the release of liquid or vapor forms of the liquid disinfectant from the disinfecting apparatus, as discussed above. A continuous seal potentially minimizes and perhaps completely prevents overspray from the dispenser from contacting the operator's hands.

Furthermore, the conical-shaped receiver 820 of the illustrated embodiment is also uniquely adapted to receive a variety of different-sized chestpieces 890 and, advantageously, form a substantially continuous seal around the perimeter of the chestpiece 890. FIG. 8a shows the receiver 890 contacting a relatively small chestpiece 890 (e.g., from a stethoscope designed to be used on infants). In contrast, FIG. 8c shows the receiver 890 in contact with a relatively large chestpiece 890 (e.g., from an electronic stethoscope designed to be used on adults).

The receiver can be fabricated from a variety of materials such as plastic or metal, for example. In certain preferred embodiments, the receiver is fabricated from a material that is somewhat flexible, permitting the receiver to conform to the shape of the chestpiece. However, the receiver should be reinforced and/or rigid enough to substantially retain its shape as force is applied to a chestpiece that is in contact with the receiver. In some embodiments, the receiver can be fabricated from a relatively rigid material and can further comprise a layer of relatively pliable material (e.g., silicone rubber) on the surface of the receiver that receives the chestpiece.

Referring back to FIGS. 8a-c, the apparatus 800 further comprises a reservoir 840 containing fluid disinfectant. The reservoir is operably coupled to a dispenser 842, such that the dispenser 842 is in fluid communication with the reservoir 840. As shown in FIG 8a, the reservoir 840 and the dispenser 842 are disposed on the reservoir support 814. The dispenser 842 may comprise a simple mechanical pump. In some

embodiments, the dispenser 842 may comprise an automated pump (not shown). The dispenser further comprises an opening 844 to dispense the fluid disinfectant. The opening 844 may comprise a simple opening, a nozzle, or an atomizer, for example, and may dispense the fluid disinfectant as a stream, droplets, or a fine mist, for example.

Attached to the reservoir 840 are actuator guides 848. The reservoir 840 may be made of any suitable material (e.g., glass, plastic) to contain the fluid disinfectant. Actuator guides 848 may be formed of the same material as the reservoir 940, or may be attached by an adhesive or welded, for example, to the reservoir 840. The actuator guides 848 comprise an incline that slopes away from the receiver 820 in an orientation generally away from the dispenser 842.

Attached to the upper mobile guide 822 is an actuator 828. The actuator 828 is adapted to slidably engage the actuator guide 948 as described below. The actuator 828 can comprise, for example, a wheel structure.

The apparatus 800 of FIG 8a is shown in a first position, whereby the mobile guides 822 are substantially extended away from the fixed guides 824.

FIG. 8b shows a side view, partially in section, of the stethoscope disinfecting apparatus 800 of FIG 8a. Fig. 8b shows the apparatus 800 in a second position, wherein the chestpiece 890 contacting the receiver 820 has been urged in the direction of the solid arrow, causing the mobile guides 822 to substantially overlap the fixed guides 824. This motion of the mobile guides 822 has caused the actuator 828 to contact and slideably engage the actuator guide 848. Because the mobile guides 822 are slideably coupled to the fixed guides 824, the engagement of the actuator 828 with the actuator guide 848 forces the reservoir 840 downward (in the direction of the hollow arrow) as the actuator 828 traverses the incline of the actuator guide 848. The downward motion of the reservoir 840 compresses the dispenser 842, thereby dispensing a stream or a spray 860 of fluid disinfectant onto the chestpiece 890.

FIGS. lOa-lOb show top views of the moving parts of the apparatus of FIG. 8a- c. FIG. 10a shows the receiver 1020 in a position corresponding to the receiver 800 position in FIG. 8a. Chestpiece 1090 contacts receiver 1020, which is a conical-shaped receiver 1020 shown in cross-section in this illustration. The receiver 1020 is attached to mobile guides 1022, which are slideably engaged with and substantially extended away from fixed guides 1024. Attached to the mobile guides 1022 are actuators 1028. The actuators 1028 are slideably engaged with actuator guides 1048, as described above. Actuator guides 1048 are attached to the reservoir 1040.

FIG. 10b shows that, as the chestpiece 1090 is urged against the receiver 1020, the mobile guides 1022 move into a position that substantially overlaps the fixed guides 1024. Simultaneous with that lateral movement of the mobile guides 1022, the actuators 1028 laterally traverse the actuator guides 1048, causing downward pressure on the reservoir 1040, resulting in the release of a stream or a spray 1060 of fluid disinfectant from the dispenser (not shown).

It is contemplated within the invention that other types of mechanisms can be used to coordinate the action of contacting a chestpiece with a chestpiece receiver and the dispensation of a stream or a spray of fluid disinfectant onto the chestpiece. For example, a sensor (e.g., an optical sensor or a pressure sensor) could be positioned to detect a chestpiece coming in contact with the receiver. The sensor could actuate a mechanism (e.g., a pump motor) to dispense the fluid disinfectant. The sensor can be adapted to delay the operation of the actuator for a predetermined amount of time (e.g.,

1 second, 2 seconds, 3 seconds, 4 seconds, 5 seconds, 10 seconds, or longer).

Advantageously, this predetermined delay period can permit the operator to properly position the chestpiece in the receiver before actuating the dispenser.

In any of the above embodiments, the apparatus may comprise a sensor adapted to detect movement of the receiver. Advantageously, the sensor may actuate the dispenser when the sensor detects that the receiver has reached a predetermined position (e.g., a predetermined position, relative to the dispenser).

In any of the above embodiments, the apparatus may further comprise a reset device (not shown). The reset device may serve to return the receiver to a

predetermined (e.g., "starting") position. The reset device may comprise, for example a biasing spring to urge the receiver to the predetermined position.

It is further contemplated that, while maintaining the orientation of the receiver to the fluid disinfectant dispensing means, the apparatus could be configured to deliver the disinfectant stream or spray in a generally horizontal direction (as shown and described in the illustrated embodiments), in a generally vertical direction (either upward or downward), or in another angular position (e.g., at a 45 degree angle or a 60 degree angle). In certain preferred embodiments, the fluid disinfectant is supplied from the reservoir to the applicator by the force of gravity which, advantageously, can keep a pumping mechanism primed, for example.

Stethoscope Disinfecting Assembly

The present disclosure further provides an assembly for disinfecting

stethoscopes. FIG. 11a shows one embodiment of a stethoscope disinfecting assembly 1100 according to the present disclosure. The assembly 1100 comprises a housing 1111. The housing 1111 includes a generally linear path of travel 1115 illustrated by the arrow. The path of travel 1115 is the portion of the housing 1111 that is contacted with a chestpiece of a stethoscope (not shown) as it passes through the housing 1111 and as is disinfected by the assembly 1100.

The housing 1111 may be fabricated from a semi-rigid or rigid material (e.g., plastic, metal) using processes that are well known in the art (injection molding, for example). When fabricated from metal, it may be desirable to apply a polymer film or the like along the path of travel 1115 of the housing 1111 in order to form a

nonabrasive contact surface for a stethoscope chestpiece.

The housing 1111 further comprises a dispensing slot 1116, an optional receiving slot 1117, and an optional fill level window 1118. The fill level window 1118 may simply comprise a slot, an opening, or a plurality of openings in the housing 1111. Alternatively, the fill level window 1118 may comprise a substantially translucent or transparent material that permits the operator to observe the amount of remaining disinfecting solution in a reservoir (described below) located in the interior of the housing 1111. The dispensing slot 1116 and receiving slot 1117, respectively, are used to deliver absorbent material 1122 to and remove absorbent material 1122 from the path of travel 1115.

The housing 1111 may further comprise optional front panels 1112. The front panels 1112 can serve to guide the chestpiece along the path of travel 1115.

Additionally, the front panels 1112 may function to urge the chestpiece against the absorbent material 1122 as the chestpiece is moved along the path of travel 1115. The front panels may be fabricated from rigid (e.g., metal, plastic), semi-rigid (e.g., plastic), or flexible (e.g., plastic, rubber) materials and can be coupled to the housing 1111 by any suitable means known in the art (e.g., screws, bolts, rivets, adhesives). Optionally, the front panels 1112 can be coupled to the housing 1111 via a spring-loaded hinge (not shown), for example, to bias the front panels 1112 toward the housing 1111, thereby urging a chestpiece passing between the front panels 1112 and the housing 1111 against the absorbent material 1122 as the chestpiece is passed along the path of travel 1115. Other tensioning mechanisms known in the art may be suitable to bias the front panels 1112 toward the housing 1111.

Also shown in FIG.11a are actuator levers 1114. The actuator levers 1114 function to actuate the applicator subassembly (described below) when the chestpiece contacts the levers 1114 as it passes along the path of travel 1115, as described below.

During use, a stethoscope chestpiece is passed along the path of travel 1115 of the assembly 1100 such that a patient contact surface of the stethoscope is contacted with the absorbent material 1122 and an effective amount of disinfecting solution is transferred from the absorbent material 1122 to the chestpiece to reduce the number of microorganisms on the chestpiece.

In some embodiments, the absorbent material 1122 is preloaded with the disinfecting solution. With this embodiment the housing is designed to prevent "dry out" of the preloaded absorbent material 1122. As used herein the term "absorbent material" refers to a cloth or fabric like material capable of at least temporarily holding the disinfectant solution but releasing sufficient quantity onto the chestpiece as it is contacted. The absorbent material may be a nonwoven such as a carded web, spunlaced web, spunbond, spunbond/meltblow, and the like, a woven or knitted fabric, or a foam. It also may be a paper. The absorbent material preferably has sufficient tensile strength particularly when wet to prevent tearing as the device is dragged across it and as the absorbent is indexed forward. Thus, optionally the absorbent material may comprise a scrim embedded into the absorbent and/or bonded to the absorbent sheet. The absorbent material may or may not have a barrier film backing on one side. The absorbent material may be fabricated of natural or synthetic fibers or a combination thereof. Particularly preferred materials include cellulose, rayon, polyester, polyolefin and nylons as biodegradable fabrics such as biodegradable aliphatic polyesters such as polylactic acid, polyglycolic/lactic acid, polyglycolic acid, polyhydroxybutyrate, as well as polyesters form diols and diacids.

In some embodiments, the movement of the chestpiece along the path of travel 1115 actuates an applicator, which dispenses a disinfecting solution into and/or onto the absorbent material 1122, as described below. For example, a stethoscope chestpiece can be contacted with the housing 1111 of the assembly 1100 of FIG. 11a proximate the fill level window 1118. As the chestpiece is gently urged against the housing 1111 , it is manually moved along the path of travel 1115 in the direction of the arrow in FIG. 11a. As the chestpiece moves, it contacts and passes between actuator levers 1114, causing an applicator (not shown) to dispense a disinfecting solution onto the absorbent material 1122. As the chestpiece moves further along the path of travel 1115, it contacts the absorbent material 1122, where an effective amount of disinfecting solution is transferred to a patient contact surface of the chestpiece. Preferably the surface of the chestpiece is completely wetted by the disinfecting solution. As the chestpiece moves further, it exits (i.e., breaks contact with) the housing 1111 of the assembly 1100. In some embodiments, not shown, the absorbent material extends to the end of the housing, where the chestpiece would break contact with the housing. An optional second absorbent material may be present to remove excess disinfectant and dry the chestpiece, as described herein.

FIG. 1 lb shows a rear perspective view of the assembly 1100 of FIG. 11a. The housing 1111 is pivotably attached via pivot pin 1119 to a mounting plate 1113. The mounting plate 1113 can be fabricated preferably from a rigid or semi-rigid material (e.g., metal or plastic). Holes 1155 allow for the assembly 1100 to be attached to a vertical surface (e.g., a wall, a door, a cart, or a cabinet), a horizontal surface (e.g., a countertop, a shelf, a cart), or an angled surface. Although the illustrated embodiment shows a substantially planar mounting plate 1113, it will be appreciated by a person of ordinary skill in the appropriate art that the shape of the mounting plate 1113 can be adapted to be mountable on curvilinear or irregularly-shaped surfaces.

FIG. 1 lb shows the housing 1111 pivoted away from the mounting plate 1113. In the illustrated position, the interior of the housing is accessible to the operator to replenish and/or to perform routine maintenance (e.g., cleaning, repair) procedures on the housing, the actuator subassembly (described below), the applicator subassembly (described below), or the dispenser subassembly (described below). Also shown in FIG. 1 lb are the fill level window 1118, the dispensing slot 1116, and the receiving slot 1117.

An assembly of the present disclosure can feature a variety of configurations for the path of travel of the stethoscope chestpiece. FIG. 12a shows an assembly 1200a with one configuration of a path of travel 1215. In this embodiment, the housing 1211 comprises front panels 1212, which serve to guide the stethoscope chestpiece along a substantially linear path of travel 1215 over the absorbent material 1222.

FIG. 12b shows an assembly 1200b with an alternative configuration of a path of travel 1215. In this embodiment, the housing 1211 comprises irregularly- shaped front panels 1212, together which serve to guide the stethoscope chestpiece along a twisting, non- linear (i.e., "tortuous") path of travel 1215 over the absorbent material 1222. Advantageously, this configuration results in more contact between the chestpiece and the absorbent material 1222. The increased contact can result in a prolonged scrubbing interaction (i.e., physical cleaning) between the chestpiece and the absorbent material, as well as a prolonged contact to allow the transfer of at least a portion of the disinfecting liquid to from the absorbent material 1222 to the chestpiece. Furthermore, the tortuous path changes direction which allows wiping the chest piece in more than one direction which may improve removal of debris and microbial and/or viral contamination.

FIG. 12c shows an assembly 1200c with another alternative configuration of a path of travel 1215. In this embodiment, the housing 1211 does not include front panels to guide the stethoscope chestpiece along a substantially directed path of travel 1215 over the absorbent material 1222. Instead, the operator may utilize one of a plurality of potential paths of travel 1215, some of which are illustrated in FIG. 12c. Advantageously, this embodiment can permit the operator to maximize the contact between the chestpiece and the available surface area of the absorbent material 1222.

Fig. 12d shows an assembly 1200d with a plurality of paths of travel 1215a and 1215b, respectively. In this embodiment, the assembly 1200d comprises actuator levers 1214 along a first path of travel 1215a. The actuator levers 1214 actuate an applicator (not shown) to dispense a disinfecting liquid to a first absorbent material 1222a. Thus, as a stethoscope chestpiece moves along the first path of travel 1215a, a portion of the disinfecting liquid is transferred to the chestpiece. In contrast, the second path of travel 1215b comprises a dry second absorbent material 1222b. When the chestpiece is moved along the second path of travel 1215b, the dry second absorbent material 1222b functions to absorb excess fluid transferred to the chestpiece from the first absorbent material 1222a. Alternatively, travel path 1215b and dry second absorbent 1222b could be directly in line with path 1215a and first disinfectant impregnated absorbent in order to disinfect and dry the device in a single step. Stethoscope disinfecting assemblies of the present disclosure comprise an absorbent material with a plurality of contact regions. Preferably, each contact region is used once and then replaced with another contact region, thus eliminating the possibility of cross-contamination. The absorbent material can comprise a variety of suitable materials including, for example, a polymeric nonwoven, a paper, or a foam.

In some embodiments, the absorbent material may comprise a roll of absorbent material 1822, as shown in FIG 18a. The roll of absorbent material may comprise a plurality of individual contact regions 1828 distributed along the length of the roll.

The plurality of individual contact regions in a roll may be provided with a barrier to inhibit fluid communication with one another. FIG. 18b shows a roll of absorbent material 1822 with a plurality of contact regions 1828. Each contact region 1828 is separated from the adjacent contact regions 1828 by a liquid diffusion barrier 1829. The liquid diffusion barrier 1829 can be, for example a hydrophobic polymer or a wax that is applied to the absorbent material 1822 such that it infuses the material 1822 and forms a liquid-resistant (e.g., water-resistant) diffusion barrier.

Advantageously, the liquid diffusion barrier 1829 can prevent excessive diffusion of the disinfecting solution, thereby controlling the effective quantity of disinfecting solution in each contact region 1828. Furthermore, the liquid diffusion barrier 1829 can also advantageously function to reduce or prevent longitudinal cross-contamination within the absorbent material 1822.

FIG. 18c shows a front perspective view of another embodiment of an absorbent material 1822 comprising a plurality of contact regions 1828i-iii. Optionally, the absorbent material may comprise perforations 1839 for separating the contact regions 1828. In this embodiment, each contact region 1828i-iii comprises a capture element 1870, configured to releasably engage a stethoscope chestpiece as it travels along the absorbent material 1822 in the direction designated by the arrow. The capture element 1870 may be fabricated from a string, for example, which may be attached to the absorbent material by any suitable means known in the art such as stitching, stapling, or adhesive bonding, for example.

When positioned in a housing, such as the one illustrated in FIG. 11a, the first contact region 1828i of FIG 18c would pass through the dispensing slot 1116 (for example, from an unwind spindle, as described herein) and lie along the path of travel 1115, with the capture element 1829 positioned near the bottom end of the path of travel 1115. As the stethoscope chestpiece is moved along the path of travel 1115, the chestpiece would releasably engage with the capture element 1870, thereby pulling the second contact region 1828ii out of the housing 1111 and into position along the path of travel 1115. The chestpiece could then be disengaged from the capture element 1829. After use, the first contact region 1828i then could be separated from the rest of the absorbent material 1822 by tearing off the first contact region at the perforation 1839. Alternatively the chestpiece could remain engaged with the capture element 1870 and used to separate the first contact region 1828i from the rest of the absorbent material. The absorbent material region 1828i could then be disengaged from the chestpiece after the region has already been separated from the rest of the absorbent material.

FIG. 18d shows a front perspective view of another embodiment of an absorbent material 1822 comprising a plurality of contact regions 1828 comprising a capture element 1870. In this embodiment, the capture element 1870 is created by forming a slit in the absorbent material. The absorbent material 1822 can be positioned in a housing, as described for the embodiment of FIG. 18c.

In another embodiment (not shown) the absorbent material may have coated on the surface a strip of material having a relatively high coefficient of friction which serves as capture element. In this embodiment the capture element may have raised features that help capture the device as it is passed through causing the absorbent to index. In this embodiment the capture strip also may function as the barrier strip discussed above. Suitable materials for the high coefficient of friction strip include thermoplastics such as polyurethanes, block copolymers such as Kraton polymers, metallocene polyolefins, polyisobutylene and other elastomers. These may be applied as a hot melt coating or from a solvent or water borne dispersion.

In some embodiments, the contact regions of the absorbent material may be provided as individual sheets, folded and stacked in a Z-fold configuration, a configuration that is well known for certain facial tissues and paper towels. In this configuration, the friction between individual contact regions can entrain a plurality of adjacent contact regions, causing several adjacent regions to move when force is applied to one contact region. Accordingly, this factional force provides a means for advancing and replacing one contact region with another contact region. Stethoscope disinfecting assemblies of the present disclosure include a means for exchanging at least one contact region in the path of travel with another of a plurality of contact regions. As described above, in some embodiments, the plurality of contact regions are distributed longitudinally along a role of absorbent material. FIG. 14 shows a rear perspective view of one embodiment of a housing 1411 of a stethoscope disinfecting assembly 1400 according to the present disclosure.

In addition to the housing 1411, FIG. 14 shows one embodiment of a means for exchanging a contact region in a path of travel with another of a plurality of contact regions. The contact regions are located on a roll of absorbent material 1422, as described above. The unused absorbent material 1422 is disposed on an unwind spindle 1423 that is rotatably coupled to the housing 1411. The absorbent material 1422 is threaded through a slot (dispensing slot 116, FIG. 1) in the front of the housing 1411 along the path of travel (1115, FIG. 11) and back through another slot (receiving slot 1117, FIG. 11) into the interior of the housing 1411, where it is rolled onto a rewind spindle 1424. In the illustrated embodiment of FIG. 14, knobs 1426 can be used manually to advance the absorbent material 1422 in either direction. Typically, in use, the knob 1426 attached to the rewind spindle 1424 would be turned to advance the unused absorbent material 1422 from the roll on the unwind spindle 1423 to the path of travel (not shown) and wind up the used absorbent material onto the rewind spindle 1424. It will be recognized that, although the unwind spindle 1423 is shown to be in a position that is superior to the rewind spindle 1424 in FIG. 14, the orientation of the spindles could be reversed in some embodiments. It is contemplated that the manual advancement mechanism shown in the illustrated embodiment could be replaced with a variety automated (e.g., motor-driven) advancement means that are known in the art. Alternatively the action of the chestpiece passing through the levers 1114 could advance the absorbent material via mechanical mechanism, linkage, and/or

transmission elements (not electric motor driven).

Also shown in FIG. 14 are the fill level window 1418, the manifold slot 1437 (described below), and the shelf 1439 on which the fluid reservoir (described below) rests.

The medical device disinfecting assembly also may have a fill level window to indicate the amount of absorbent roll that remains. This window may be on the front or side of the housing. The absorbent roll may be colored or patterned and may have a different color or pattern near the end of the roll to indicate to the user that it is time to change the roll of absorbent material. The absorbent roll may be terminated in an occlusive film which serves to be wound around the contaminated roll prior to removal in order to protect the housing and the clinician from exposure to the contaminated roll.

FIG. 15 shows a front perspective view of the stethoscope disinfecting assembly of FIG. 14, showing several parts that comprise the means for advancing and replacing a contact region of an absorbent material. The assembly 1500 includes a housing 1511 with a fill level window 1518. Also, shown are the dispenser slot 1516, through which the absorbent material 1522 is passed from the unwind spindle (1423, FIG. 14), and the receiver slot 1517, through which the absorbent material 1522 is passed from the front of the housing 1511 to the rewind spindle (1424, FIG. 14). Knobs 1526 are turned to rotate the spindles to advance the absorbent material to move a new contact region of the absorbent material into position in the path of travel 1515.

In some embodiments, stethoscope disinfecting assemblies of the present disclosure comprise an applicator comprising a fluid disinfectant and an actuator that causes the applicator to dispense the fluid disinfectant onto and/or into an absorbent material. The amount of fluid disinfectant dispensed by the applicator onto and/or into the absorbent material comprises an amount sufficient to permit transfer of at least a portion of the fluid disinfectant from the absorbent material to a stethoscope that is contacted with the absorbent material. FIG. 16a shows a front perspective view of one embodiment of an assembly 1600 of this embodiment. The assembly 1600 includes actuator levers 1614 in a first (i.e., "off) position. The actuator levers 1614 are pivotably engaged with the housing 1611. When a stethoscope chestpiece is gently contacted to the housing and moved along the path of travel 1615, the chestpiece contacts actuator levers 1614, causing them to move as shown by the arrows to a second (i.e., "on") position. As the actuator levers 1614 deflect to the second position, they actuate the applicator, as described below, to dispense fluid disinfectant.

FIG. 16b shows a rear perspective view featuring the applicator subassembly located in the housing 1611 of the assembly 1600 of FIG. 16a. The applicator subassembly is shown in a first position, which coincides with the first position of the actuator levers 1614 of FIG. 16a. The subassembly comprises gear segments 1642 with gears that are operably engaged for synchronous movement of the gear segments 1642. The gear segments 1642 are operably coupled to pivot knobs 1641 such that, when the pivot knobs 1641 rotate about their respective longitudinal axes, the gear segments 1642 similarly rotate about the longitudinal axis of the pivot knob 1641 to which it is coupled. In some embodiments, the pivot knob 1641 and corresponding gear segment 1642 are fabricated as a unitary piece, from plastic, for example, by an injection molding process, for example. Each gear segment 1642 further comprises a tensioning stop 1646.

The subassembly further comprises a tensioned biasing spring 1645 coupled to each pivot knob 1641. One end of the biasing spring 1645 is supported against the tensioning mount 1646 of each respective gear segment 1642, while the other end of the biasing spring 1645 is supported against a spring stop 1647 adjacent each respective gear stop 1643. The spring stops 1647 may be fabricated as part of the housing 1611, for example. Alternatively, the spring stops 1647 may be fabricated as a separate part, which is coupled to the housing by a screw or bolt, for example. The spring stop 1647 should be fabricated from a material (e.g., rigid plastic, metal) that is rigid enough to substantially resist bending or breaking from the force of the biasing spring 1645. In the first position, as shown in FIG. 16b, the tension from the biasing spring 1645 urges the gear segments 1642 against a gear stop 1643. Rotatably attached to the gear segments 1642 are rollers 1644. The rollers 1644 can be fabricated from a non- abrasive rigid or semi-rigid material such as plastic or rubber, for example. The rollers 1644 can be attached to the gear segments 1642 via a screw or a bolt, for example or held in place using a snap fit onto a post molded as part of the gear segments 1642.

Also shown as a silhouette in FIG. 16b is the reservoir 1632. The reservoir 1632 holds a fluid disinfectant and is fabricated from a material (e.g., plastic) that is substantially resistant to evaporative loss of and/or degradation by the fluid

disinfectant. A flexible conduit 1634 is in fluid communication with the reservoir

1632. The conduit 634 may be fabricated from plastic or rubber tubing, for example, and may be connected to the reservoir 1632 by a variety of means that are well known in the art. The conduit 1634 should be substantially resistant to chemical degradation by the fluid disinfectant composition. Optionally, the reservoir 1632 may further comprise a one-way valve (not shown) that is actuated to open and permit passage of the fluid disinfectant when negative pressure is created in or applied to the conduit 1634. It can be seen that, in this first position of the subassembly, the rollers 1644 are contacting, but not substantially deforming, the flexible conduit 1634. FIG. 16c shows a rear perspective view featuring the applicator subassembly located in the housing 1611 of the assembly 1600 of FIG.1 6a. The applicator subassembly is shown in a second position, which coincides with the deflected ("on") position of the actuator levers 1614 of FIG. 16a. It can be seen that, when the actuator levers (1614, FIG. 16a) are deflected to the second position, causing the moving parts of the applicator subassembly to move to the second position, the rollers 1644 are pivoted against the flexible conduit 1634, substantially deforming the conduit 1634. This movement can create a peristaltic motion in the flexible conduit 1634, thereby drawing fluid disinfectant from the reservoir 1632 and into the conduit 1634. The fluid disinfectant can flow from the conduit 1634 into the connector 1635, where it can further flow into the manifold 1636. The fluid disinfectant can then flow from the manifold 1636 onto and/or into the absorbent material (not shown). The fluid could be moved from the reservoir through the conduit via peristaltic action. This would require the conduit to be pinched substantially between the two rollers 1644. However, it was primarily envisioned that there would be a one way valve between the reservoir and the conduit that would allow fluid to move only from the reservoir to the conduit. There would be another valve at the bottom of the conduit that opens only when a certain cracking pressure has been achieved within the conduit. When the rollers contact the conduit they don't necessarily squeeze the fluid through the conduit in a peristaltic manner, but squeeze the conduit and build up pressure within the conduit sufficient to open the valve at the bottom of the conduit and allow the fluid to flow into the manifold 1636. The pressure to squeeze fluid through the conduit in a peristaltic fashion may present more resistance to the movement of the actuator levers and the motion of the chestpiece through the device than the pumping action described above.

Alternatively, the fluid disinfectant reservoir can be equipped with a pump which when depressed expels the disinfectant onto the absorbent either as a liquid stream or as a spray. Preferably, in this embodiment the pump is depressed and liquid is expelled onto the absorbent through the motion of pulling or pushing the medical device through the disinfectant housing.

FIG. 13 shows a front perspective view of the fluid transporting components of the applicator subassembly of FIG. 16c. The reservoir 1332 functions to contain the fluid disinfectant. The conduit 1334 is in fluid communication with the reservoir 1332. A connector 1335 provides fluidic connection between the conduit 1334 and the manifold 1336. The manifold 1336 comprises a plurality of openings out of which fluid disinfectant can pass. It will be appreciated that the manifold 1336 and connector 1335 can be fabricated as a unitary part of molded plastic or metal, for example, which can be coupled to the flexible conduit 1334. In use, the manifold 1336 is positioned in a slot (see slot 1537, FIG. 15) such that the manifold contacts the absorbent material

(see absorbent material 1522, FIG. 15). As the fluid disinfectant passes through the openings in the manifold 1336, it is transferred to the absorbent material.

The illustrated embodiment described herein relates to an applicator mechanism that employs manual energy to actuate a system to deliver fluid disinfectant to the absorbent material. It will be appreciated by a person of ordinary skill in the relevant art that motorized valves and pumps, actuated by sensors positioned along the path of travel of the stethoscope chestpiece could be used alternatively to provide fluid disinfectant to the absorbent material.

In any of the above embodiments, the housing may further comprise a compliant material (e.g. rubber, foam, or the like) disposed along the path of travel behind the absorbent material. The compliant material would permit the absorbent material to conform to the stethoscope chestpiece as it moves along the path of travel. Preferably, the compliant material is substantially nonabsorbent. Advantageously, this can result in more efficient transfer of the fluid disinfectant from the absorbent material to the chestpiece.

Although the illustrated embodiments show that the fluid disinfectant is dispensed to the absorbent material from the rear-facing side of the absorbent material, it is contemplated that the manifold may be alternatively positioned to dispense the fluid disinfectant to the front- facing side of the absorbent material (e.g., from the top edge of the contact region or from one of the lateral edges of the contact region of the absorbent material).

FIG. 17 shows an exploded front perspective view of one embodiment of a stethoscope disinfecting assembly 1700 according to the present disclosure. In addition to the features shown and described above, FIG 17 also shows a sensorl750 located in the housing near the terminus of the path of travel 1715. The sensor 1750 can be a pressure transducer or an optical sensor known in the art. The sensor 1750 can be configured as an event sensor, to detect the passage of a stethoscope chestpiece through the stethoscope disinfecting assembly 1700. The sensor 1750 may further communicate that event to a processor (not shown). The sensor 1750 could also be located near the start of the path of travel (or anywhere between the start and terminus).

Pre-loaded Absorbent Materials

In one embodiment, stethoscope disinfecting assemblies of the present disclosure include an absorbent material that comprises a fluid disinfectant. More specifically, in this embodiment, the assembly does not include an applicator comprising a fluid disinfectant because the absorbent material provided with the assembly comprises a fluid disinfectant.

As with other embodiments described herein, the absorbent material of this embodiment comprises a plurality of contact surfaces and the assembly includes a means for advancing a replacing one of a plurality of contact surfaces with another of the plurality of contact surfaces.

The absorbent materials may be impregnated or saturated (e.g., partially saturated, fully saturated, or supersaturated) with any of the fluid disinfectants described herein. The absorbent materials may be provided in a container (e.g., a foil pouch) configured to resist moisture loss by evaporation. The fluid disinfectant may further comprise a suitable humectant (e.g., glycerol or propylene glycol; at a concentration of about 10% w/v or less) to resist evaporative moisture loss. In some embodiments, the contact regions of the absorbent material may be provided as a continuous roll, as described herein.

Pre-loaded absorbent materials may be configured as a roll or in stacked sheets in any of the configurations described above (see, for example, FIGS. 18a-18d) and the contact regions can be advanced and replaced in the stethoscope disinfecting assembly as described above.

Monitoring Systems

Stethoscope disinfecting assemblies of the present disclosure may further comprise a proximity sensor such as an RFID sensor, for example. The proximity sensor, in concert with a processor, could function as a stethoscope recorder system.

The system could be used to record how often a particular stethoscope was disinfected. The system further may comprise an IR or ultrasound sensor to detect the identification of a particular stethoscope that is disinfected. The stethoscope recorder, in conjunction with the event sensor, described herein, and a processor, may comprise a system for detecting and recording the use of the stethoscope disinfecting assembly with a specifically-identified stethoscope. Such monitoring systems could be used, for example, as a part of an infection prevention compliance program.

Fluid Disinfectants:

Stethoscope disinfecting apparatuses of the present disclosure include a fluid disinfectant. Suitable fluid disinfectants are described in U.S. Patent Application Publication Nos. 2005/0089539; 2006/0052452; 2006/0051385 and 2006/0051384, each of which is incorporated herein by reference in its entirety. Suitable disinfecting solutions may include, for example, C2-C4 alkyl alcohols and in particular ethanol, 2 propanol, and 1-propanol, iodine and its complexed forms such as povidone/iodine, chlorhexidine salts such as chlorhexidine digluconate (CHG); modified phenols such as triclosan, parachlorometaxylenol (PCMX), hexachlorophene, and triclocarban;

surfactants comprising one or two long chain hydrophobes (C8-C22) and a quaternary ammonium group such as benzalkonium chloride, cetylpyridinium chloride, didecyldimethylammonium bromide and the like, C8-C12 alkyl carboxylic acid monoesters of glycerin, propylene glycol and/or sucrose, C8-C12 alkyl monoethers of glycerin, propylene glycol and/or sucrose, quaternary silanes comprising one or two long chain hydrophobes (C8-C22) and a quaternary ammonium group such as

3(trimethoxysilyl)propyl dimethyloctadecylammonium chloride, hydrogen peroxide as well as complexes and compounds that liberate hydrogen peroxide such as hydrogen peroxide complexes with polyvinylpyrrolidone and perborates that generate hydrogen peroxide, peracetic acid, hexamethylene biguanide, polyhexamethylene biguanide, ozone, chlorine oxide, polymers comprising a quaternary amine, silver, silver salts such as silver chloride, silver oxide and silver sulfadiazine; and natural oils that have antimicrobial activity such as tea tree oil, cinnamon oil and the like; as well as combinations thereof.

In any of the embodiments, the fluid disinfectant optionally can comprise a foaming agent. Advantageously, the foaming agent can increase the volume of the fluid disinfectant applied to the absorbent material, thereby providing better transfer of the fluid disinfectant from the absorbent material to the stethoscope chestpiece. In contrast to liquids, which may drip off of a surface relatively quickly, foam typically is retained on a surface for a longer period of time. Advantageously, in these

embodiments, the longer retention of the fluid disinfectant can promote significantly greater disinfection of the stethoscope chestpiece.

Suitable foaming agents do not deteriorate the performance of the stethoscope.

Preferably, the foaming agent will not negatively affect the feel or the appearance of the stethoscope. Suitable foaming agents include, for example, a fluoro chemical surfactant (e.g., the fluorochemical surfactant described in paragraphs 0030 and 0076- 0078 of U.S. Patent Application Publication No. US2005/0129626, which is incorporated herein by reference in its entirety), a nonionic surfactant (e.g., the nonionic surfactant described in paragraphs 0090-0091 of U.S. Patent Application Publication No. US2005/0129626), and a silicone copolyol in combination with a builder polymer (e.g., the silicone copolyol described in paragraphs 0029-0031 and the builder polymer described in paragraphs 0032-0038 of U.S. Patent Application

Publication No. US2006/0281663, which is incorporated herein by reference in its entirety).

In some embodiments, the fluid disinfectant may further comprise a detectable indicator (e.g., a fluorescent indicator or a visually-detectable (e.g., colored) indicator). Advantageously, the indicator can be detected to confirm the fluid disinfectant was dispensed into/onto the absorbent material, for example. Preferably, the indicator may be an indicator that substantially adheres to the absorbent material and does not transfer to the stethoscope.

Stethoscope disinfecting assemblies of the present disclosure can be used to provide effective disinfecting processes to reduce the number of a wide variety of microorganisms. For example, they can be used in processes to reduce the number of microorganisms (e.g., Gram positive bacteria, Gram negative bacteria, fungi, protozoa, mycoplasma, yeast, viruses, and even lipid-enveloped viruses) on a patient contact surface of a stethoscope chestpiece. Particularly relevant microorganisms include Staphylococcus spp., Streptococcus spp., Pseudomonas spp., Enterococcus spp., and Esherichia spp., bacteria, as well as herpes virus, Aspergillus spp., Fusarium spp., and

Candida spp. Particularly virulent organisms include Staphylococcus aureus (including resistant strains such as Methicillin Resistant Staphylococcus Aureus (MRSA), Staphylococcus epidermidis, Streptococcus pneumoniae, Enterococcus faecalis, Vancomycin Resistant Enterococcus (VRE), Pseudomonas auerginosa, Escherichia coli, Aspergillus niger, Aspergillus fumigatus, Aspergillus clavatus, Fusarium solani, Fusarium oxysporum, Fusarium chlamydosporum, Candida albicans, Candida glabrata, and Candida krusei.

EMBODIMENTS

Embodiment 1 is an apparatus for disinfecting a stethoscope chestpiece, comprising:

a fluid disinfectant reservoir with fluid disinfectant therein; an applicator comprising a contact surface;

wherein the contact surface is dimensioned to receive a stethoscope chestpiece;

wherein the applicator is in fluid communication with the reservoir;

a motion generator operably coupled to the applicator; and a dispensing means for delivering the fluid disinfectant to the applicator; wherein the motion generator is configured to move the applicator relative to the chestpiece.

Embodiment 2 is the apparatus of embodiment 1 , further comprising a biasing means, wherein the biasing means is adapted to urge the applicator to a predetermined position.

Embodiment 3 is the apparatus of embodiment 1 or embodiment 2, wherein the contact surface is non-abrasive.

Embodiment 4 is the apparatus of any one of the preceding embodiments, wherein the dispensing means comprises the motion generator.

Embodiment 5 is the apparatus of any one of the preceding embodiments, wherein the apparatus is configured to move the applicator relative to the chestpiece when force is applied against the applicator.

Embodiment 6 is the apparatus of any one of the preceding embodiments, wherein the apparatus is configured to dispense the fluid disinfectant to the applicator when force is applied against the applicator Embodiment 7 is the apparatus of embodiment 5 or embodiment 6, wherein the apparatus is configured for the force to be applied substantially orthogonal to the stethoscope contact surface of the applicator.

Embodiment 8 is the apparatus of any one of the preceding embodiments, wherein the apparatus is configured to dispense the fluid disinfectant to the applicator prior to moving the applicator relative to the chestpiece.

Embodiment 9 is the apparatus of any one of embodiments 1 through 7, wherein the apparatus is configured to dispense the fluid disinfectant to the applicator while moving the applicator relative to the chestpiece.

Embodiment 10 is the apparatus of any one of the preceding embodiments, wherein configured to move the applicator relative to the chestpiece comprises configured to move the applicator in a direction that is substantially orthogonal to a direction of the force applied to the chestpiece.

Embodiment 11 is the apparatus of embodiment 10, wherein configured to move the applicator relative to the chestpiece comprises configured to move the applicator in an oscillating motion.

Embodiment 12 is the apparatus of embodiment 10, wherein configured to move the applicator relative to the chestpiece comprises configured to move the applicator in a rotational motion.

Embodiment 13 is the apparatus of any one of the preceding embodiments, wherein fluid communication comprises selective fluid communication.

Embodiment 14 is the apparatus of any one of the preceding embodiments, wherein the reservoir is positioned such that the fluid disinfectant cannot be transferred to the applicator by gravity flow alone, wherein the dispensing means comprises a pump.

Embodiment 15 is the apparatus of any one of the preceding embodiments, wherein the apparatus further comprises a housing configured to receive a stethoscope chestpiece, wherein the applicator is disposed in the housing.

Embodiment 16 is the apparatus of any one of the preceding embodiments, wherein the applicator comprises a contact surface comprising a material selected from the group consisting of a bristle, a woven material, a nonwoven material, a paper, a foam, and a combination of any two or more of the foregoing. Embodiment 17 is the apparatus of any one of the preceding embodiments, further comprising a plurality of applicator openings.

Embodiment 18 is the apparatus of any one of the preceding embodiments, wherein the fluid disinfectant comprises a foaming agent.

Embodiment 19 is an apparatus for disinfecting a stethoscope chestpiece, comprising:

a fluid disinfectant reservoir with fluid disinfectant therein; a applicator dimensioned to receive a stethoscope chestpiece, wherein the applicator is in fluid communication with the reservoir; and

a dispensing means for delivering the fluid disinfectant to the applicator; wherein the apparatus is configured to deliver the fluid disinfectant to the applicator is when force is applied against the applicator.

Embodiment 20 is the apparatus of embodiment 19, wherein the apparatus is configured for the force to be applied substantially orthogonal to the stethoscope contact surface of the applicator.

Embodiment 21 is the apparatus of embodiment 19 or 20, wherein fluid communication comprises selective fluid communication.

Embodiment 22 is the apparatus of any one of embodiments 19 through 21, wherein the reservoir is positioned such that the fluid disinfectant cannot be transferred to the applicator by gravity flow alone, wherein the dispensing means comprises a pump.

Embodiment 23 is the apparatus of any one of embodiments 19 through 22, wherein the apparatus further comprises a housing configured to receive a stethoscope chestpiece, wherein the applicator is disposed in the housing.

Embodiment 24 is the apparatus of any one of embodiments 19 through 23, wherein the applicator comprises a contact surface comprising a material selected from the group consisting of a bristle, a woven material, a nonwoven material, a paper, a foam, and a combination of any two or more of the foregoing.

Embodiment 25 is the apparatus of any one of embodiments 19 through 24, further comprising a fluid diffuser element.

Embodiment 26 is the apparatus of any one of embodiments 19 through 25, wherein the fluid disinfectant comprises a foaming agent. Embodiment 27 is the apparatus of any one of the preceding embodiments, wherein the dispensing means comprises a fluid connection whereby the fluid disinfectant is supplied from the reservoir to the applicator by the force of gravity.

Embodiment 28 is a method of disinfecting a stethoscope chestpiece, comprising:

providing the apparatus of any one of embodiments 1-27; contacting the chestpiece with the applicator; and

applying a force against the applicator, wherein applying force dispenses a fluid disinfectant to the applicator;

wherein the force is applied substantially orthogonal to the applicator.

Embodiment 29 is the method of embodiment 28, further comprising moving the chestpiece relative to the applicator while the chestpiece is contacting the applicator.

Embodiment 30 is an apparatus for disinfecting a stethoscope chestpiece, comprising:

a reservoir containing fluid disinfectant;

a liquid dispenser in fluidic connection with the reservoir; a receiver with a longitudinal axis, comprising

a first opening proximate the liquid dispenser;

a larger second opening opposite the first opening; and an actuator;

wherein the second opening is adapted to receive a stethoscope chestpiece;

wherein the actuator is operably coupled to the liquid dispenser.

Embodiment 31 is the apparatus of embodiment 30, wherein a portion of the receiver is flexible.

Embodiment 32 is the apparatus of embodiment 30 or embodiment 31, wherein adapted to receive a stethoscope chestpiece comprises adapted to provide

circumferential contact between the receiver and the perimeter region of the

stethoscope chestpiece.

Embodiment 33 is the apparatus of any one of embodiments 30 through 32, further comprising a sensor, wherein the sensor is operably coupled to the actuator. Embodiment 34 is the apparatus of embodiment 33, wherein the sensor is adapted to delay the operation of the actuator for a predetermined period of time.

Embodiment 35 is the apparatus of embodiment 30, wherein the receiver is configured to move in a direction oriented with its longitudinal axis.

Embodiment 36 is the apparatus of embodiment 35, further comprising a sensor.

Embodiment 37 is the apparatus of embodiment 36, wherein the sensor is adapted to detect movement of the receiver.

Embodiment 38 is the apparatus of embodiment 36, wherein the receiver further comprises the actuator.

Embodiment 39 is the apparatus of any one of embodiments 30 through 38, wherein the receiver comprises a conical-shaped receiver.

Embodiment 40 is the apparatus of any one of embodiments 30 through 39, wherein the liquid dispenser comprises an atomizer.

Embodiment 41 is the apparatus of any one of embodiments 30 through 40, further comprising a housing.

Embodiment 42 is the apparatus of any one of embodiments 35 through 41, further comprising a reset device adapted to move the receiver to a predetermined position.

Embodiment 43 is the apparatus of any one of embodiments 30 through 42, wherein, a liquid dispenser in fluidic connection with a reservoir comprises a fluid connection whereby the fluid disinfectant is supplied from the reservoir to the dispenser by the force of gravity.

Embodiment 44 is a method of disinfecting a stethoscope chestpiece, comprising:

providing the apparatus of any one of embodiments 30-43; contacting the chestpiece with the receiver such that a portion of the chestpiece to be disinfected is facing the first opening; and

actuating the liquid dispenser.

Embodiment 45 is the method of embodiment 44, wherein actuating the liquid dispenser comprises moving the receiver.

Embodiment 46 is the method of embodiment 45, wherein moving the receiver comprises urging the chestpiece against the receiver. Embodiment 47 is an assembly for disinfecting a patient-contact surface of a medical device, comprising:

a first absorbent material comprising a plurality of contact regions, wherein each contact region comprises a fluid disinfectant in an amount sufficient to permit transfer of at least a portion of the fluid disinfectant to a the patient contact surface of a reusable medical device that is contacted with a contact region;

a housing, including;

an entrance portion and an exit portion, wherein the entrance portion is dimensioned to receive at least the patient contact surface of a medical device;

a path of travel for a medical device contact surface extending between the entrance portion and the exit portion, wherein at least one of the plurality of contact regions is disposed along at least a portion of the path of travel; and ;

means for advancing and replacing the at least one contact region in the path of travel with another of the plurality of contact regions.

Embodiment 48 is the assembly for disinfecting a patient-contact surface of a medical device, comprising:

a first dry absorbent material comprising a plurality of contact regions; a housing, including;

an entrance portion and an exit portion, wherein the entrance portion is dimensioned to receive a patient-contact surface of a medical device;

a path of travel for a patient-contact surface of a medical device extending between the entrance portion and the exit portion, wherein at least one of the plurality of contact regions is disposed along at least a portion of the path of travel;

an applicator comprising a fluid disinfectant;

an actuator, wherein the actuator is disposed proximate the entrance portion; and

means for advancing and replacing the at least one contact region in the path of travel with another of the plurality of contact regions;

wherein, when activated, the actuator causes the applicator to dispense the fluid disinfectant into the first dry absorbent material, wherein the fluid disinfectant dispensed into the first dry absorbent material comprises an amount sufficient to permit transfer of at least a portion of the fluid disinfectant to a patient-contact surface of a medical device that is contacted with a contact region.

Embodiment 49 is the assembly of embodiment 47 or embodiment 48, wherein the medical device is selected from the group consisting of a stethoscope chestpiece, an ultrasound probe, and a thermometer.

Embodiment 50 is the assembly of any one of embodiments 47 through 49, wherein the means for advancing and replacing comprises a material dispenser, wherein the dispenser is configured to contain the plurality of contact regions.

Embodiment 51 is the assembly of any one of embodiments 47 through 50, wherein the fluid disinfectant comprises a detectable indicator.

Embodiment 52 is the assembly of embodiment 51, wherein the detectable indicator is visually detectable.

Embodiment 53 is the assembly of any one of embodiments 47 through 52, wherein the fluid disinfectant comprises a foaming agent.

Embodiment 54 is the assembly of any one of embodiments 47 through 53, wherein the travel path further comprises a second absorbent material, wherein the second absorbent material is a dry absorbent material.

Embodiment 55 is the assembly of any one of embodiments 47 through 54, wherein assembly comprises a second entrance portion, a second exit portion, and a second travel path, wherein the second absorbent material is disposed in the second travel path.

Embodiment 56 is the assembly of any one of embodiments 47 through 55, wherein the plurality of contact regions comprises a roll.

Embodiment 57 is the assembly of embodiment 56, wherein two or more of the plurality of contact regions are separated by a liquid diffusion barrier.

Embodiment 58 is the assembly of embodiment 56 or embodiment 57, wherein the means for advancing and replacing further comprises a wind-up roll.

Embodiment 59 is the assembly of any one of embodiments 47 through 57, wherein at least one absorbent material comprises a capture portion configured to releasably couple to the chestpiece of the stethoscope.

Embodiment 60 is the assembly of any one of embodiments 47 through 55, wherein the plurality of contact regions comprises a Z-fold configuration. Embodiment 61 is the assembly of any one of embodiments 47 through 60, further comprising an event monitor.

Embodiment 62 is the assembly of any one of embodiments 47 through 61 , further comprising a stethoscope recorder.

Embodiment 63 is the assembly of any one of embodiments 47 through 62, wherein the travel path is substantially direct.

Embodiment 64 is the assembly of any one of embodiments 47 though 63, wherein at least a portion of the travel path is tortuous.

Embodiment 65 is the assembly of any one of embodiments 47 through 64, wherein the first and/or second absorbent material is selected from the group consisting of a polymeric nonwoven, a paper, or a foam.

Embodiment 66 is a method of disinfecting the chestpiece of a stethoscope, comprising:

providing a stethoscope with a chestpiece and the assembly of any one of embodiments 47 through 65;

positioning the chestpiece of the stethoscope in the entrance portion of the assembly; and

moving the chestpiece along the travel path with contact between the chestpiece and the absorbent material comprising fluid disinfectant.

Embodiment 67 is the method of embodiment 66, wherein the assembly comprises the assembly of embodiment 48 or embodiment 49, further comprising the step of actuating the applicator.

Embodiment 68 is the method of embodiment 66, wherein the assembly comprises the assembly of any one of embodiments 55 through 65, further comprising the step of contacting the chestpiece with the second absorbent material.

Embodiment 69 is the applicator or the assembly of any one of the preceding embodiments, wherein the fluid disinfectant comprises a disinfecting agent selected from the group consisting of C2-C4 alkyl alcohols and in particular ethanol, 2 propanol, and 1-propanol, iodine and its complexed forms such as povidone/iodine, chlorhexidine salts such as chlorhexidine digluconate (CHG); modified phenols such as triclosan, parachlorometaxylenol (PCMX), hexachlorophene, and triclocarban; surfactants comprising one or two long chain hydrophobes (C8-C22) and a quaternary ammonium group such as benzalkonium chloride, cetylpyridinium chloride, didecyldimethylammonium bromide and the like, C8-C12 alkyl carboxylic acid monoesters of glycerin, propylene glycol and/or sucrose, C8-C12 alkyl monoethers of glycerin, propylene glycol and/or sucrose, quaternary silanes comprising one or two long chain hydrophobes (C8-C22) and a quaternary ammonium group such as

3(trimethoxysilyl)propyl dimethyloctadecylammonium chloride, hydrogen peroxide as well as complexes and compounds that liberate hydrogen peroxide such as hydrogen peroxide complexes with polyvinylpyrrolidone and perborates that generate hydrogen peroxide, peracetic acid, hexamethylene biguanide, polyhexamethylene biguanide, ozone, chlorine oxide, polymers comprising a quaternary amine, silver, silver salts such as silver chloride, silver oxide and silver sulfadiazine; and natural oils that have antimicrobial activity such as tea tree oil, cinnamon oil and the like; as well as combinations thereof.

The present invention has now been described with reference to several specific embodiments foreseen by the inventor for which enabling descriptions are available. Insubstantial modifications of the invention, including modifications not presently foreseen, may nonetheless constitute equivalents thereto. Thus, the scope of the present invention should not be limited by the details and structures described herein, but rather solely by the following claims, and equivalents thereto.

Claims

What is claimed is:

1. An apparatus for disinfecting a stethoscope chestpiece, comprising:

a fluid disinfectant reservoir with fluid disinfectant therein;

an applicator comprising a contact surface;

wherein the contact surface is dimensioned to receive a stethoscope chestpiece;

wherein the applicator is in fluid communication with the reservoir; a motion generator operably coupled to the applicator; and

a dispensing means for delivering the fluid disinfectant to the applicator;

wherein the motion generator is configured to move the applicator relative to the chestpiece.

2. The apparatus of claim 1, further comprising a biasing means, wherein the biasing means is adapted to urge the applicator to a predetermined position.

3. The apparatus of claim 1 or claim 2, wherein the contact surface is non- abrasive.

4. The apparatus of any one of the preceding claims, wherein the dispensing means comprises the motion generator.

5. The apparatus of any one of the preceding claims, wherein the apparatus is configured to move the applicator relative to the chestpiece when force is applied against the applicator.

6. The apparatus of any one of the preceding claims, wherein the apparatus is configured to dispense the fluid disinfectant to the applicator when force is applied against the applicator

7. The apparatus of claim 5 or claim 6, wherein the apparatus is configured for the force to be applied substantially orthogonal to the stethoscope contact surface of the applicator.

8. The apparatus of any one of the preceding claims, wherein the apparatus is configured to dispense the fluid disinfectant to the applicator prior to moving the applicator relative to the chestpiece.

9. The apparatus of any one of claims 1 through 7, wherein the apparatus is configured to dispense the fluid disinfectant to the applicator while moving the applicator relative to the chestpiece.

10. The apparatus of any one of the preceding claims, wherein configured to move the applicator relative to the chestpiece comprises configured to move the applicator in a direction that is substantially orthogonal to a direction of the force applied to the chestpiece.

11. The apparatus of claim 10, wherein configured to move the applicator relative to the chestpiece comprises configured to move the applicator in an oscillating motion.

12. The apparatus of claim 10, wherein configured to move the applicator relative to the chestpiece comprises configured to move the applicator in a rotational motion.

13. The apparatus of any one of the preceding claims, wherein fluid communication comprises selective fluid communication.

14. The apparatus of any one of the preceding claims, wherein the reservoir is positioned such that the fluid disinfectant cannot be transferred to the applicator by gravity flow alone, wherein the dispensing means comprises a pump.

15. The apparatus of any one of the preceding claims, wherein the apparatus further comprises a housing configured to receive a stethoscope chestpiece, wherein the applicator is disposed in the housing.

16. The apparatus of any one of the preceding claims, wherein the applicator comprises a contact surface comprising a material selected from the group consisting of a bristle, a woven material, a nonwoven material, a paper, a foam, and a combination of any two or more of the foregoing.

17. The apparatus of any one of the preceding claims, further comprising a plurality of applicator openings.

18. The apparatus of any one of the preceding claims, wherein the fluid disinfectant comprises a foaming agent.

19. An apparatus for disinfecting a stethoscope chestpiece, comprising:

a fluid disinfectant reservoir with fluid disinfectant therein;

a applicator dimensioned to receive a stethoscope chestpiece, wherein the applicator is in fluid communication with the reservoir; and

a dispensing means for delivering the fluid disinfectant to the applicator;

wherein the apparatus is configured to deliver the fluid disinfectant to the applicator is when force is applied against the applicator.

20. The apparatus of claim 19, wherein the apparatus is configured for the force to be applied substantially orthogonal to the stethoscope contact surface of the applicator.

21. The apparatus of claim 19 or 20, wherein fluid communication comprises selective fluid communication.

22. The apparatus of any one of claims 19 through 21, wherein the reservoir is positioned such that the fluid disinfectant cannot be transferred to the applicator by gravity flow alone, wherein the dispensing means comprises a pump.

23. The apparatus of any one of claims 19 through 22, wherein the apparatus further comprises a housing configured to receive a stethoscope chestpiece, wherein the applicator is disposed in the housing.

24. The apparatus of any one of claims 19 through 23, wherein the applicator comprises a contact surface comprising a material selected from the group consisting of a bristle, a woven material, a nonwoven material, a paper, a foam, and a combination of any two or more of the foregoing.

25. The apparatus of any one of claims 19 through 24, further comprising a fluid diffuser element.

26. The apparatus of any one of claims 19 through 25, wherein the fluid disinfectant comprises a foaming agent.

27. The apparatus of any one of the preceding claims, wherein the dispensing means comprises a fluid connection whereby the fluid disinfectant is supplied from the reservoir to the applicator by the force of gravity.

28. A method of disinfecting a stethoscope chestpiece, comprising:

providing the apparatus of any one of claims 1-27;

contacting the chestpiece with the applicator; and

applying a force against the applicator, wherein applying force dispenses a fluid disinfectant to the applicator;

wherein the force is applied substantially orthogonal to the applicator.

29. The method of claim 28, further comprising moving the chestpiece relative to the applicator while the chestpiece is contacting the applicator.

30. An apparatus for disinfecting a stethoscope chestpiece, comprising:

a reservoir containing fluid disinfectant;

a liquid dispenser in fluidic connection with the reservoir;

a receiver with a longitudinal axis, comprising

a first opening proximate the liquid dispenser;

a larger second opening opposite the first opening; and

an actuator;

wherein the second opening is adapted to receive a stethoscope chestpiece; wherein the actuator is operably coupled to the liquid dispenser.

31. The apparatus of claim 30, wherein a portion of the receiver is flexible.

32. The apparatus of claim 30 or claim 31 , wherein adapted to receive a stethoscope chestpiece comprises adapted to provide circumferential contact between the receiver and the perimeter region of the stethoscope chestpiece.

33. The apparatus of any one of claims 30 through 32, further comprising a sensor, wherein the sensor is operably coupled to the actuator.

34. The apparatus of claim 33, wherein the sensor is adapted to delay the operation of the actuator for a predetermined period of time.

35. The apparatus of claim 30, wherein the receiver is configured to move in a direction oriented with its longitudinal axis.

36. The apparatus of claim 35, further comprising a sensor.

37. The apparatus of claim 36, wherein the sensor is adapted to detect movement of the receiver.

38. The apparatus of claim 36, wherein the receiver further comprises the actuator.

39. The apparatus of any one of claims 30 through 38, wherein the receiver comprises a conical-shaped receiver.

40. The apparatus of any one of claims 30 through 39, wherein the liquid dispenser comprises an atomizer.

41. The apparatus of any one of claims 30 through 40, further comprising housing.

42. The apparatus of any one of claims 35 through 41, further comprising a reset device adapted to move the receiver to a predetermined position.

43. The apparatus of any one of claims 30 through 42, wherein, a liquid dispenser in fluidic connection with a reservoir comprises a fluid connection whereby the fluid disinfectant is supplied from the reservoir to the dispenser by the force of gravity.

44. A method of disinfecting a stethoscope chestpiece, comprising:

providing the apparatus of any one of claims 30-43;

contacting the chestpiece with the receiver such that a portion of the chestpiece to be disinfected is facing the first opening; and

actuating the liquid dispenser.

45. The method of claim 44, wherein actuating the liquid dispenser comprises moving the receiver.

46. The method of claim 45, wherein moving the receiver comprises urging the chestpiece against the receiver.

47. An assembly for disinfecting a patient-contact surface of a medical device, comprising:

a first absorbent material comprising a plurality of contact regions, wherein each contact region comprises a f uid disinfectant in an amount sufficient to permit transfer of at least a portion of the fluid disinfectant to a the patient contact surface of a reusable medical device that is contacted with a contact region;

a housing, including;

an entrance portion and an exit portion, wherein the entrance portion is dimensioned to receive at least the patient contact surface of a medical device;

a path of travel for a medical device contact surface extending between the entrance portion and the exit portion, wherein at least one of the plurality of contact regions is disposed along at least a portion of the path of travel; and ;

means for advancing and replacing the at least one contact region in the path of travel with another of the plurality of contact regions.

48. An assembly for disinfecting a patient-contact surface of a medical device, comprising:

a first dry absorbent material comprising a plurality of contact regions; a housing, including;

an entrance portion and an exit portion, wherein the entrance portion is dimensioned to receive a patient-contact surface of a medical device;

a path of travel for a patient-contact surface of a medical device extending between the entrance portion and the exit portion, wherein at least one of the plurality of contact regions is disposed along at least a portion of the path of travel;

an applicator comprising a fluid disinfectant;

an actuator, wherein the actuator is disposed proximate the entrance portion; and

means for advancing and replacing the at least one contact region in the path of travel with another of the plurality of contact regions;

wherein, when activated, the actuator causes the applicator to dispense the fluid disinfectant into the first dry absorbent material, wherein the fluid disinfectant dispensed into the first dry absorbent material comprises an amount sufficient to permit transfer of at least a portion of the fluid disinfectant to a patient-contact surface of a medical device that is contacted with a contact region.

49. The assembly of claim 47 or claim 48, wherein the medical device is selected from the group consisting of a stethoscope chestpiece, an ultrasound probe, and a thermometer.

50. The assembly of any one of claims 47 through 49, wherein the means for advancing and replacing comprises a material dispenser, wherein the dispenser is configured to contain the plurality of contact regions.

51. The assembly of any one of claims 47 through 50, wherein the fluid disinfectant comprises a detectable indicator.

52. The assembly of claim 51 , wherein the detectable indicator is visually detectable.

53. The assembly of any one of claims 47 through 52, wherein the fluid disinfectant comprises a foaming agent.

54. The assembly of any one of claims 47 through 53, wherein the travel path further comprises a second absorbent material, wherein the second absorbent material is a dry absorbent material.

55. The assembly of any one of claims 47 through 54, wherein assembly comprises a second entrance portion, a second exit portion, and a second travel path, wherein the second absorbent material is disposed in the second travel path.

56. The assembly of any one of claims 47 through 55, wherein the plurality of contact regions comprises a roll.

57. The assembly of claim 56, wherein two or more of the plurality of contact regions are separated by a liquid diffusion barrier.

58. The assembly of claim 56 or claim 57, wherein the means for advancing and replacing further comprises a wind-up roll.

59. The assembly of any one of claims 47 through 57, wherein at least one absorbent material comprises a capture portion configured to releasably couple to the chestpiece of the stethoscope.

60. The assembly of any one of claims 47 through 55, wherein the plurality of contact regions comprises a Z-fold configuration.

61. The assembly of any one of claims 47 through 60, further comprising an event monitor.

62. The assembly of any one of claims 47 through 61, further comprising a stethoscope recorder.

63. The assembly of any one of claims 47 through 62, wherein the travel path is substantially direct.

64. The assembly of any one of claims 47 though 63, wherein at least a portion of the travel path is tortuous.

65. The assembly of any one of claims 47 through 64, wherein the first and/or second absorbent material is selected from the group consisting of a polymeric nonwoven, a paper, or a foam.

66. A method of disinfecting the chestpiece of a stethoscope, comprising:

providing a stethoscope with a chestpiece and the assembly of any one of claims

47 through 65;

positioning the chestpiece of the stethoscope in the entrance portion of the assembly; and

moving the chestpiece along the travel path with contact between the chestpiece and the absorbent material comprising fluid disinfectant.

67. The method of claim 66, wherein the assembly comprises the assembly of claim

48 or claim 49, further comprising the step of actuating the applicator.

68. The method of claim 66, wherein the assembly comprises the assembly of any one of claims 55 through 65, further comprising the step of contacting the chestpiece with the second absorbent material.

69. The applicator or the assembly of any one of the preceding claims, wherein the fluid disinfectant comprises a disinfecting agent selected from the group consisting of C2-C4 alkyl alcohols and in particular ethanol, 2 propanol, and 1-propanol, iodine and its complexed forms such as povidone/iodine, chlorhexidine salts such as chlorhexidine digluconate (CHG); modified phenols such as triclosan, parachlorometaxylenol (PCMX), hexachlorophene, and triclocarban; surfactants comprising one or two long chain hydrophobes (C8-C22) and a quaternary ammonium group such as benzalkonium chloride, cetylpyridinium chloride, didecyldimethylammonium bromide and the like, C8-C12 alkyl carboxylic acid monoesters of glycerin, propylene glycol and/or sucrose, C8-C12 alkyl monoethers of glycerin, propylene glycol and/or sucrose, quaternary silanes comprising one or two long chain hydrophobes (C8-C22) and a quaternary ammonium group such as 3(trimethoxysilyl)propyl dimethyloctadecylammonium chloride, hydrogen peroxide as well as complexes and compounds that liberate hydrogen peroxide such as hydrogen peroxide complexes with polyvinylpyrrolidone and perborates that generate hydrogen peroxide, peracetic acid, hexamethylene biguanide, polyhexamethylene biguanide, ozone, chlorine oxide, polymers comprising a quaternary amine, silver, silver salts such as silver chloride, silver oxide and silver sulfadiazine; and natural oils that have antimicrobial activity such as tea tree oil, cinnamon oil and the like; as well as combinations thereof.