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Archive March 2019 XX, No. 3

Anesthesia Alert: Anesthesia's Infection Control Challenges

It's time for your providers to clean up their acts - and their workstations.

L. Munoz-Price

L. Munoz-Price, MD


T. Andrew Bowdle

T. Andrew Bowdle, MD, PhD, FASE


Pamela Bevelhymer, RN, BSN, CNOR
A HIDDEN THREAT The anesthesia computer mouse and the anesthesia cart are among the most contaminated surfaces in the OR.

We've always known about the hidden bacterial threat in your OR's anesthesia work area, the microbes lingering on the anesthesia machine and the pathogens on the laryngoscope handle that didn't get a full cleaning between cases. Then there's the anesthesia provider's hands — be they bare or overdue for a fresh pair of gloves — as they intubate the patient, and prepare and deliver IV medications. And yet we're still struggling to prevent the infections that originate from that challenging environment. Here are 3 takeaways from The Society for Healthcare Epidemiology of America's (SHEA) new guidance ( on infection prevention in the anesthesia work area.

Hand hygiene

We recommend anesthesia providers follow the World Health Organization's (WHO) My 5 Moments for Hand Hygiene ( cleaning their hands before touching a patient, before clean/aseptic procedures, after body fluid exposure/risk, after touching a patient and after touching patient surroundings. Following the WHO protocols to the full extent may be difficult — or maybe even impossible — but we want providers to wash their hands more often.

One simple switch can help: Add a hand gel dispenser to the anesthesia work area. A surprising number of anesthesia providers don't have access to hand sanitizer in their immediate workspace. Fire codes come up from time to time as an excuse, but you can adhere to fire codes and still have a dispenser in the anesthesia work area.

We also recommend providers double-glove during airway management and discard the outer gloves immediately after airway manipulation. As soon as possible, they should remove their inner gloves and wash their hands.

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