Vital Times 2017 - 63

Then what happens? When you complete an
evaluation of a CME lecture, there is a list of barriers
to implementing the ideas in the lecture you are asked
to pick one. Here's one that is not there: the barrier is
that no one wants to be "that guy." When this blog is
published, I become one side of "that guy." You know, the
anesthesiologist who goes on and on about SSIs and our
role in prevention. I never wanted to be "that guy." But
do you want to be the one who ignores our role in SSI
prevention and knowingly injects bacteria into patients?
Or the anesthesiologist who sees his patient return to the
OR two weeks later for a hardware removal for infection?

Suggested Reading
1. Kurtz SM, Lau E, Watson H, Schmier JK, Parvizi J.
Economic burden of periprosthetic joint infection in
the United States. J Arthroplasty. 2012; 27:61-5
2. Cloth hats are better at stopping hair and scalp fomites
than bouffant caps, J. Am College of Surgeons Vol. 225,
No. 5, November 2017.

How hard is it to "scrub the hub" every time you inject?
Frankly, it can be difficult (and sometimes dangerous)
depending on how many drugs you are injecting at one
time. For example, we use induction agents, muscle
relaxants, and narcotics in quick succession. But if you
scrub the hub at the start of the case, cap the stopcock
with a sterile device, wash your hands before putting on
gloves, inject using a syringe whose tip is either brand
new or covered with a disinfecting device, keep the dirty
airway items and gloves off the anesthesia work area, I
feel like you cared and helped me avoid an SSI.
So, I have started scrubbing the hub, washing my hands a
lot, and cleaning my workstation and anesthesia machine
and the Pyxis before my patients enter the OR (even if
the anesthesia techs already did this once...). I dispose
of my airway stuff before I turn back to my workstation.
Did I prevent an SSI? I know I helped prevent one. And
guess what - the surgeons notice. And they appreciate
the effort. Anytime you can get a surgeon to notice what
you do and recognize the value of what you do, consider
that a win.
Now you have to pick which "that guy or gal" you want to
be. The anesthesiologist who worries about SSIs or the
one who doesn't. Please worry because you may be my
anesthesiologist for my total knee someday. Now go wash
your hands...

Annual	Publication	2017	|	 	63



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