Use of the ASRA Checklist significantly improved the trainees' medical management and nontechnical performance during a simulated episode of severe LAST. Partial use of the checklist correlated with lower overall performance.

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Our results support the concept of an infection prevention bundle in reducing AWE contamination. Anesthesia providers deliver care in a unique environment in which "clean" and "contaminated" tasks are performed rapidly and often in parallel. Linking hand hygiene to specific high-impact tasks such as administering medications, designating areas for contaminated equipment, and double gloving before airway management are simple steps that can be implemented rapidly and are compatible with timely patient care. Our study has improved awareness of infection prevention issues in our department, and has highlighted simple and achievable actions that have the potential to reduce health care-associated infections.