➤ To reduce the bioburden of organisms and the risk of transmitting these
organisms to patients, the facility should clean and disinfect high-touch
surfaces on the anesthesia machine and anesthesia work area between
OR uses with an EPA-approved hospital disinfectant that is compatible with
the equipment and surfaces based on the manufacturers' instruction for
use. Because of challenges in consistent cleaning and disinfection between
cases of the anesthesia machine and anesthesia work area, the authors
suggest prioritizing high-touch surfaces. In addition, the authors suggest
evaluating strategies aimed at improving the ability to clean these surfaces
(eg, disposable covers, re-engineering of work surfaces).
➤ Anesthesia providers should use only disinfected ports for intravenous
access. Ports may be disinfected either by scrubbing the port with a
sterile alcohol-based disinfectant before each use immediately prior to
each use or using sterile isopropyl alcohol containing caps that cover
ports continuously. Prior to use, isopropyl alcohol-containing caps should
cover the port for the minimum time recommended by the manufacturer.
Ports should be properly disinfected prior to each individual drug
injection or at the beginning of a rapid succession of injections, such as
during induction of anesthesia.
The authors recommend that providers consider using isopropyl alcohol
containing caps, which, when in place for the recommended period, make
ports immediately available for use at all times. Stopcocks should have
closed injection ports installed to convert them into "closed ports," or
they should be covered with sterile caps.
➤ Anesthesia providers should wipe medication vials' rubber stoppers and
necks of ampules with 70% alcohol prior to vial access and medication
withdrawal.
➤ All central venous catheters (CVCs) and axillary and femoral arterial
lines should be placed with full maximal sterile barrier precautions. Full
maximal sterile barrier precautions include wearing mask, cap, sterile
gown, and sterile gloves and using a large sterile drape during insertion.
Peripheral arterial lines (eg, radial, brachial, or dorsalis pedis arterial
lines) should be placed with a minimum of a cap, mask, sterile gloves, and
a small sterile fenestrated drape.
➤ To reduce the risk of bacterial contamination of the syringe and syringe
contents, the authors recommend that anesthesia providers cap
needleless syringes that will be used to administer multiple doses of
a drug to the same patient after each administered dose. Needleless
syringes should be capped with a sterile cap that completely covers the
Luer connector on the syringe.
Recommendations
