Recommendations
➤ To reduce risk of contamination in the OR, providers should consider wearing
double gloves during airway management and should remove the outer
gloves immediately after airway manipulation. As soon as possible, providers
should remove the inner gloves and perform HH.
➤ The authors recommend that facilities locate alcohol-based hand rub
(ABHR) dispensers at the entrances to ORs and near anesthesia providers
inside the OR in order to promote frequent HH. Several studies have
demonstrated that wearable ABHR dispensers with audible reminders
increase the frequency of HH as well as the potential to decrease the
incidence of hospital-acquired infection (HAI). Several studies have
demonstrated that wearable ABHR dispensers with audible reminders
increase the frequency of HH as well as the potential to decrease the
incidence of HAI. While the specific wearable devices used in these
studies are not currently available, the authors recommend that facilities
consider suitable wearable ABHR dispensers with automatic reminders
when commercially available. ABHR dispensers should be located in
accordance with applicable national and local fire safety standards and
codes. Additionally, the authors recommend that the facility delegate the
filling of the ABHR dispensers to designated personnel and regularly ensure
compliance with this practice.
➤ Changing gloves with HH between doffing and donning is the preferred
method of disinfection. Current data are inadequate for the authors to
either support or discourage the procedure of using ABHR on gloved hands
or to determine whether application of foam or gel affects glove integrity.
However, application of ABHR to gloved hands might be better than to not
perform any HH when doffing and donning are not feasible.
Environmental Disinfection
➤ The authors recommend that facilities ensure that standard direct
laryngoscope or video-laryngoscope reusable handles and blades undergo
high-level disinfection (at the minimum) or sterilization prior to use, or
that reusable laryngoscopes are replaced with single-use standard direct
laryngoscopes or video-laryngoscopes. Clean blades and handles should be
stored in packaging appropriate for semicritical items designated for "high-
level" disinfection.
➤ Current data are inadequate for the authors to make recommendations
regarding the use of disposable covers to prevent contamination of
anesthesia machines.
