disturbing, if not altogether surprising. In 6.3% of the cases, the filters
trapped potentially pathogenic microorganisms that would have
reached patients. On top of that, when they cultured the insides of the
syringe barrels, 16% were contaminated. Where did all the pathogenic
organisms come from? In all likelihood, from a breach in technique
that let them be transferred from such sources as the anesthesia
workstation, the anesthesia provider's hands, the room or the patient.
Complex task
But while the disturbing findings speak to a need for improved tech-
niques and heightened awareness, they also speak to the complexity
and difficulty that anesthesia providers face when trying to engage in
high-quality asepsis in the OR. The fact is, it's almost impossible to
inject a drug sterilely into a patient during anesthetic care — unless,
that is, it's the only job you have. But anesthesia providers have multi-
ple jobs. And they aren't gowned and gloved the way surgeons are,
and they're not operating in an area that has a dedicated laminar flow.
So, what's the answer? The study authors suggest that maybe we
should routinely use those same 0.2-micron filters for injections. But
the study participants rated ease of use with the filters as a 3.5 out of
10, with 0 being very easy and 10 being very difficult.
It's an easy leap to make, but I'm not sure it's the best answer. Using
filters would increase the resistance to injection, and as suggested by
the study, there are some drugs you can't inject through the filters —
propofol, for one — because they're too viscous. Also, while filters
might trap organisms that are larger than 0.2 microns, a lot of viruses
are much smaller than that.
New ways to draw up drugs
I think what this study really tells us is that we need to be doing a bet-
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