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Recommendations for Infection Control for the Practice of Anesthesiology

Recommendations for Infection Control for the Practice of Anesthesiology. Developed by the ASA Committee on Occupational Health Task Force on Infection Control (Third Edition) . R2 Chitsupha Parichatpricha R2 Prapairat Hemmaraj Aj Kattiya Manomayangkul.

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Recommendations for Infection Control for the Practice of Anesthesiology

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  1. Recommendations for Infection Control for the Practice of Anesthesiology Developed by the ASA Committee on Occupational Health Task Force on Infection Control (Third Edition) R2 ChitsuphaParichatpricha R2 PrapairatHemmaraj AjKattiyaManomayangkul

  2. Prevention of Healthcare-Associated Infection in Patients Prevention of Occupational Transmission of Infection to Anesthesiologists

  3. Preventionof Healthcare-Associated Infection in Patients • A. Hand Hygiene • B. Preventing Contamination of Medications • C. Prevention of Surgical Site Infection

  4. Prevention of Healthcare-Associated Infection in Patients • D. Prevention of Intravascular Catheter-Related Infection • E. Prevention of Infection Associated with NeuraxialProcedures

  5. PREVENTION OF HEALTHCARE-ASSOCIATED INFECTION IN PATIENTS

  6. A. Hand Hygiene

  7. Hand washing

  8. Methods: • Following 5 observers pose as nursing staff in an academic center • observed the Hand-hygeineof anesthesia providers • 4-week period throughout the perioperative period

  9. B. Preventing Contamination of Medications and Fluids Safe Injection Practices Aseptic technique Category IA

  10. 2. Syringes, needles and cannulaeCategory IA

  11. 3. Single-dose vials (SDVs) Category IA 4. Multi-dose vials (MDVs) Category IA

  12. 5. Fluid infusion and administration sets (i.e. intravenous bags, tubing, and connectors) Category IB

  13. Medication and Fluid Use in the Immediate Patient Treatment

  14. Alcohol-basedcleanser deployed by squeezing device Deviceworn by provider The Sprixx GJ device (Harbor MedicalInc., Santa Barbara, CA)

  15. C. Prevention of Surgical Site Infections Glucose control Nicotine use Hair removal Preoperative Considerations Transfusion Antiseptic shower Antimicrobial prophylaxis

  16. C. Prevention of Surgical Site Infections Operating Room Ventilation Normothermia Cleaning Intraoperative Considerations Surgical attire Asepsis and surgical technique

  17. C. Prevention of Surgical Site Infections Postoperative Considerations Postoperative Incision Care

  18. D. Prevention of Intravascular Catheter-Related Infections General Considerations 1. Hand hygiene 2. Aseptic technique 3. Catheter site care 4. Dressing regimens 5. Replacement of administration sets

  19. iii. Central Venous Catheters 1. Catheter selection 2. Insertion 3. Barrier precautions 4. Catheter replacement 5. Pressure transducers 6. Catheter site dressing

  20. E. Prevention of Infection Associated with Neuraxial Procedures

  21. epidural abscess 1 :145,000 • Meningitis 0.2 -1.3 : 10,000 • Post-duralpuncture meningitis manifests 6-36 hours after dural puncture • symptoms : fever, back pain/tenderness and radicular pain leading to weakness and paralysis

  22. Summary of Advisory Statements

  23. Prevention of Occupational Transmission of Infection to Anesthesiologists

  24. Prevention of Occupational Transmission of Infection to Anesthesiologists • Needlestick/Sharps Safety • Transmission-based Precautions • Bloodborne Pathogens (hepatitis B virus, hepatitis C virus, human immunodeficiency virus) • Tuberculosis (TB)

  25. Needle stick/Sharps Safety

  26. Needleless device needleless intravenous access systems

  27. Devices with safety protection features scalpels with safety-activated blade covers self-sheathing needles

  28. Devices with safety protection features Syringe with a Retractable Needle safety intravenous catheters

  29. 1-handed technique

  30. Sharp disposal container • Puncture-resistant, leak-proof containers  located closely ,sealed and replaced before completely filled

  31. Mode of transmission • Direct contact transmission • Blood , secretion, mucous membrane • Indirect contact transmission • Enviromental surface, clothing • Droplet transmission • Coughs, sneezes, talks, sings,intubation,suctioning • Airborne transmission • Droplet nuclei (<= 5 micron)

  32. Isolation precautions Isolation precautions Transmission-based precautions Standard precautions • Airborne precaution • Droplet precaution • Contact precaution

  33. Contact precautions

  34. Standard precautions and • Private • 3 feet between patients • Signage outside room • Gown and glove • Face and eye protection • Remove gloves and gown before exiting room. • Avoid self-contamination • Perform hand hygiene after removal of PPE. • Dedicated patient equipment • Clean equipment prior to its use with other patients. • Cleaning of room • Maintain transport and entire perioperative period. • Communicate

  35. Droplet precautions mumps pertussis Rubella=German measles diphtheria

  36. Single 3 feet. HCWssurgical mask, gloves, gown, and eye protection Patientstandard mask Respiratory hygiene/cough etiquette. Communicate precaution level

  37. movie

  38. Airborne precaution Measles Chicken pox

  39. Airborne infectious isolation room(AIIR) • N95 for HCW • Standard surgical mask for patient • Door closed all time • Postponed elective procedure • Signage and communication

  40. Airborne infection isolation room (AIIR) • Negative pressure • Door close all-time • 6-12 air exchanges per hour (ACH). • Air exhausted directly to the outside or recirculated through a HEPA filter.

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