This paper considers infection control issues relevant to prehospital care providers. Specifically it examines practices related to the routine cleaning of patient monitoring cables between patients and, the cleaning and disinfection of respiratory equipment, in particular laryngoscope blades, facemasks and self-inflating resuscitation bags. The infection control issues are identified and an analysis of the operational, human resource and management practices relevant to these issues are discussed. Recommendations for best practice are explored.
References
1.
Rural Ambulance Service, 2000, OH & S Bulletin (sic), Number 2, 2 May 2000, Department of Human Services (Victoria), Australia.
2.
Queensland Ambulance Service, 1997, Queensland Ambulance Service, Infection Control Guide (Revised), Department of Emergency Services (Queensland), Brisbane. Last Update January 2002.
3.
Queensland Ambulance Service, 2007, Queensland Ambulance Service, Clinical Practice Guidelines, Department of Emergency Services (Queensland), Brisbane.
4.
Queensland Ambulance Service, 1998, Queensland Ambulance Service, General Administration Manual, Department of Emergency Services (Queensland), Brisbane.
BowdenS, DruceJ and KellyH. Stability of Blood-borne Viruses in the Environment and the Risk of Infection., Victorian Infectious Diseases Bulletin, 1999 Nov;2(4).
7.
TjottaE, HungnesO, GrindeB. Survival of HIV-1 activity after disinfection, temperature and pH changes, or drying., J Med Virol.1991;35:223–7.
8.
Van BuerenJ, SimpsonRA, JacobsP, CooksonBD. Survival of human immunodeficiency virus in suspension and dried onto surfaces. J Clin Micro. 1994;32:571–4.
9.
BondWW, FaveroMS, PetersenNJ, GravelleCR, EbertJW, MaynardJE. Survival of hepatitis B virus after drying and storage for one week., Lancet. 1981;1:550–1.
10.
ChaufourX, DevaAK, VickeryK, ZouJ, KumaradevaP, WhiteGH,. Cossart YE. Evaluation of disinfection and sterilization of reusable angioscopes with the duck hepatitis B model. J Vasc Surg. 1999;30:277–82.
11.
SuCS, BowdenDS, FongLP, TaylorHR. Current tonometer disinfection may be inadequate for hepatitis B virus., Arch Ophthalmol.1994;112:1406–7.
GolderM, ChanCL, O'SheaS, CorbettK, ChrystieIL, FrenchG. Potential risk of cross infection during peripheral venous access by contamination of tourniquets, Lancet.2000 Jan;355(9197):44.
14.
ChriscoJA, DeVaneG. A descriptive study of blood in the mouth following routine oral endotracheal intubation. J Am Assoc Nurse Anesth. 1992;60:379–383.
15.
Centers for Diseases Control and Prevention (CDC).Guidelines for the prevention of nosocomial pneumonia. Am J Infect Control.1994;22:247–292.
16.
DreyfussD, DjedainiKK, WeberP, BrunP, LanoreJJ, RahmaniJ, BoussougantY, CosteFProspective study of nosocomial pneumonia and of patient and circuit colonization during mechanical ventilation with circuit changes every 48 hours versus no change. Am Rev Respir Dis. 1991;143:738–743.
17.
National Health and Medical Research Council (NHMRC).Infection Control in the Health Care Setting: Guidelines for the Prevention of Transmission of Infectious Diseases, (Draft for Public Consultation 22 July 2000), AusInfo, Canberra.
18.
MillerDM, YoukhanaI, KarunaratneWU, PearceA. Presence of protein deposits on ‘cleaned’ re-usable anaesthetic equipment, Anaesthesia. Nov;56(11):1069–1072.
19.
PhillipsRA, MonaghanWP. Incidence of visible and occult blood on laryngoscope blades and handles. Journal of the American Association of Nurse Anesthetist. 1997;65:241–246.
20.
EslerMD, BainesLC, WilkinsonDJ, LangfordRM. Decontamination of laryngoscopes: a survey of national practice. Anaesthesia. 1999 Jun;54(6):587–92.
21.
MorellRC and CrewsDA. A survey of laryngoscope contamination at a University and Community Hospital, Anesthesiology. 1994;80:960.
22.
SpringmanSR and MarxJA. The effectiveness of a new laryngoscope blade sheath as a barrier to laryngoscope blade bacterial contamination in the laboratory, Department of Anaesthesiology and Infection Control, University of Wisconsin Medical School, 2000. Madison, USA.
23.
RobertsRB. Cleaning the laryngoscope blade. Can Anaesth Soc J, 1973;20:241–244.
24.
SkiltonR. Decontamination procedures for medical equipment, Update in Anaesthesia. 1997; Issue 7: Article 5, 1.
