Decontamination of Anaesthetic Equipment and Ventilators

Abstract

For some years there has been concern over the role of anaesthetic and ventilatory equipment in the transmission of infection. It is known that those pieces of anaesthetic apparatus which come in direct contact with the skin and mucous membranes of the patient (face mask, airway, endotracheal tube, catheter mounts, suction catheters) are all liable to become contaminated with microorganisms (Stark, Green and Pask, 1962). Jenkins and Edgar (1964) found all the corrugated tubing in one hospital to be contaminated with Pseudomonas pyocyanea, and showed experimentally that a small proportion of these organisms could be caught up in the inspiratory gas. They showed further that coughing into anaesthetic apparatus caused heavy contamination of masks and Y-pieces, and that soda-lime in a Waters' canister was ineffective as a bacterial filter. However, as a result of experimental work, Stark, Green and Pask (1962) concluded that it was unlikely that infection would be transmitted from patient to patient via anaesthetic machines, but did state that if a patient was known to be infected with virulent organisms, then readily sterilizable apparatus should be used. Virtually every organism has been isolated from anaesthetic equipment, and transmission of infection from such apparatus to patient has been confirmed in a number of instances (

Epidemiology and Prevention of Pseudomonas Aeruginosa Chest Infection in an Intensive Care Unit

“…autoclaving, ethylene oxide, detergent wash or disposable; chemical disinfection is not advised. 17 Cape (disposable heated paper) or Williams (autoclavable siliconized glass beads) bacterial filters can be placed on both the inspiratory and expiratory circuits of ventilators so as to isolate the patient bacteriologically. [18][19] We have found that simultaneously there were epidemic, endemic and endogenous types of Ps.…”

“…Pseudomonad vaccines are reducing the mortality rate in infected burned patients,22 and may have their place in the future management of patients in intensive care units. However, there is still a need for effective decontamination of equipment, as recommended by Lumley,17 together with the use of bacterial filters where possible, in order to prevent cross-infection. and Dr. D. G. Fleck, Consultant Microbiologist, St. George's Hospital, London SW17 for assistance.…”

History of Infection Control in Anaesthesia

“…In evaluating the comparative cost of disposable and re-usable items, many factors are often forgotten. To the costs of storage, delivery and collection of re-usable items must be added those of cleaning and sterilising 37 .…”

Adverse Effects of Buffered Glutaraldehyde on the Heidbrink Expiratory Valve

“…The use and efficiency of buffered glutaraldehyde (Cidex) as a chemical disinfectant for anaesthetic equipment have been described by Haselhuhn, Broson and Borick (1967), Meeks, Pembleton and Hench (1967) and Stark (1972). Residual air, wetness and the need for rinsing and packaging after disinfection are among the disadvantages of chemical disinfection described by Lumley (1976). Apart from absorption by rubber and plastics (Varpela, Otterstrom and Hackman, 1971), Cidex was reported to be noncorrosive to metals and harmless to anaesthetic equipment.…”