ter job of drawing up drugs. It's eminently clear that there's a lot at
stake here. We need to design new systems, have new training and
come up with some new approaches. It may not be possible to reduce
that 6.3% rate to zero, but there are some things we can do immediate-
ly to begin to bring the numbers down. We can:
• Make sure to routinely use alcohol or some other disinfectant on
vials and injection ports.
• Transition to pre-filled syringes. Some drugs we'll always have to
draw up ourselves — opiates, for example — but pre-filled syringes
can take one step out of the potential microbial contamination
process (see "The Case for Pre-Packaged Medications" at
osmag.net/vCwCR3);
• Be sure to double-glove. Studies (including by me) show a
decreased rate of site contamination when anesthesia providers are
able to remove contaminated outer gloves before moving on to subse-
quent tasks.
• Be cautious while approaching injection ports and think about
what we're approaching them with.
Infection Prevention
IP
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In the long run, I'd also like to see us take a closer look at how
anesthesia machines are designed. Right now they have a lot of
dials and buttons, as well as convoluted, complex surfaces that
provide myriad places for microbes to hide and fester. Imagine
taking all that away and instead having a simple touch-screen —
one that would be easy to clean and much less likely to act as a
reservoir for organisms.
— Chuck Biddle, CRNA, PhD
INTELLIGENT DESIGN
Touch-Screen Anesthesia Machines?
