Abstract:Background: Many studies have shown that contaminated medical equipments act like a vector for crossinfection. Infection control programmes are effective in decreasing hospital-acquired infection rate, however, the implementation of such programmes is hindered by poor compliance of health care workers.Methods: Random selection of health care workers, at our institution, was given questionnaires and were asked to give their stethoscopes to be sampled.Results: 151 health care workers were involved in this study. Physicians were 79/151 and their stethoscopes were found to be the most contaminated (68.3%). The total number of contaminated stethoscopes was 72/151 (47.7%). Coagulasenegative staphylococcus was isolated from 66 diaphragms from 72 (92%).Conclusion: Nosocomial infections carry a higher level of morbidity and mortality. This study showed that there is lack of good compliance with routinely disinfecting the health care workers stethoscopes. We recommend that the significance of disinfecting diaphragms of stethoscopes should be clarified to the health care workers.

Over the last few years the role of ultrasound has steadily increased and has now an established role in anesthesia and critical care. The various applications of this technology in this field include ultrasound-guided insertion of central lines (internal jugular, subclavian, axillary, femoral) and peripheral venous catheters, arterial line insertion, regional blocks etc. The simple reason of using this technology is “You believe what you see”. In this text we will mainly focus on central line, peripheral venous placement and arterial blood flow patterns under ultrasound guidance.In our institution at KFMC, internal jugular vein cannulation is preferred to cannulation of the subclavian vein because of the higher incidence of pneumothorax and subclavian artery puncture associated with the later. The incidence of carotid artery puncture is higher in children younger than five years than in older children during this procedure. The use of ultrasonography has been shown to increase the success rate and decrease the incidence of complications associated with IJV cannulation in adults.We will go through a stepwise approach in identifying and confirming the required blood vessels for ultrasound-guided cannulation using B-mode (2D), color flow doppler and Pulse Wave Doppler

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