Microbial cross-transmission during procedures can pose a significant risk to patient safety [5]. Anesthesiologists are more likely to transmit during perioperative treatment due to their proximity to potentially infectious equipment and patients, particularly during tracheal intubation [4]. Infection control is an important area of anesthesia.
Many methods exist to provide infection control during anesthesia. These include deep extubation in suitable individuals and analgesic drugs to enable pain-free extubation [4]. Rapid induction and intubation are encouraged, using a clear plastic cover that protects the screen and handle of a video-laryngoscope to limit the spread of microorganisms in aerosol caused by coughing [4]. Tracheal intubation should ideally only be performed when muscle relaxants are fully active to minimize coughing, and a full dosage of the drug should be administered at once [4]. Laryngeal mask airways can also enable a considerably smoother emergence in many individuals and may be employed in suitable situations [4]. After extubating a patient in the operating room, anesthesiologists should employ closed circuits and take every precaution to prevent coughing [4]. Preparing anesthetic and resuscitation medications, gadgets, and surgical tools in advance will decrease the number of people entering the operating room and decrease the chance of transmission [4].
Hand-mediated transmission is the leading contributor to healthcare-associated infections [1]. However, despite repeated recommendations, healthcare professionals often disregard proper hand hygiene while caring for patients [1]. One way to significantly reduce the transmission of possible pathogens and the occurrence of preventable healthcare-associated illnesses is to practice effective hand disinfection before and after direct patient contact [1]. If no water station is available, personnel should still apply an antibacterial hand rub between patients or activities, even if there is no visible soiling [1]. Disinfecting the hands is a simple but effective component of infection control within healthcare, including anesthesia. However, it is important to know that antimicrobial hand sanitizers are ineffective in preventing the spread of certain bacteria, such as Clostridium difficile [1].
The operating room environment, including the instruments utilized in the anesthesia work environment, can expose providers to potential infectious surfaces [4]. Therefore, until proven otherwise, healthcare staff should consider every patient infectious. This is especially true for anesthesiologists who often interact closely with patients and are thus exposed to airway aerosols and secretions. As part of standard anesthetic practice, safeguards against transmitting infectious agents between patient and anesthesiologist or between patients should be taken to prevent these exposures [1]. In teaching hospitals, an experienced medical professional should preferably be the one to intubate patients outside the operating room during an emergency [4]. All medical professionals engaged in the process must wear protective equipment, exercise personal hygiene, and change gloves following direct contact with the patient [4]. Hospital officials should ensure that sinks, soap, and antibacterial hand rubs are positioned in a manner that encourages frequent usage [3]. Before initiating hand decontamination, watches and jewelry must be removed at the beginning of each clinical session [1]. Abrasions and lacerations must be covered with water-resistant dressing [1]. Following the induction of anesthesia and stabilization of the patient, the anesthesia provider should disinfect all surfaces with alcohol- and quaternary ammonium compound-containing disinfection wipes [3]. Furthermore, all disposable materials must be discarded and placed in clearly labeled hazardous waste bags after surgery [4]. Proper infection control is necessary for minimizing the chance of adverse effects during anesthesia and surgery.
References
1. Association of Anaesthetists of Great Britain and Ireland (2008). Infection control in anaesthesia. Anaesthesia, 63(9), 1027–1036. https://doi.org/10.1111/j.1365-2044.2008.05657.x
2. Dexter, F., Parra, M. C., Brown, J. R., & Loftus, R. W. (2020). Perioperative COVID-19 Defense: An Evidence-Based Approach for Optimization of Infection Control and Operating Room Management. Anesthesia and analgesia, 131(1), 37–42. https://doi.org/10.1213/ANE.0000000000004829
3. Gould, D. J., Moralejo, D., Drey, N., Chudleigh, J. H., & Taljaard, M. (2017). Interventions to improve hand hygiene compliance in patient care. The Cochrane database of systematic reviews, 9(9), CD005186. https://doi.org/10.1002/14651858.CD005186.pub4
4. Li, W., Huang, J., Guo, X., Zhao, J., & Mandell, M. S. (2021). Anesthesia Management and Perioperative Infection Control in Patients With the Novel Coronavirus. Journal of cardiothoracic and vascular anesthesia, 35(5), 1503–1508. https://doi.org/10.1053/j.jvca.2020.03.035
5. Munoz-Price, L. S., Bowdle, A., Johnston, B. L., Bearman, G., Camins, B. C., Dellinger, E. P., Geisz-Everson, M. A., Holzmann-Pazgal, G., Murthy, R., Pegues, D., Prielipp, R. C., Rubin, Z. A., Schaffzin, J., Yokoe, D., & Birnbach, D. J. (2019). Infection prevention in the operating room anesthesia work area. Infection control and hospital epidemiology, 40(1), 1–17. https://doi.org/10.1017/ice.2018.303