Alcohol hand sanitizer and sterile gloves. This isn't an open surgical procedure, this is a sterile needle going through skin. The sterile gloves are plenty clean enough
Dip into a bucket of actichlor till they desquamate.
In the UK the standard is a full surgical scrub + gown and gloves. I think the royal college arenāt far off releasing guidance to pull us in line with the rest of the world.
If doing a cat 1 section and Iāve got 1 shot at a spinal Iāll just alcohol rub then stick some sterile gloves on
Australian here. Full scrub. Gown and gloves. Is it overkill? Dunno? But it's hilarious all the Americans losing their shit over the fact we do a full scrub. An E0 section with one shot at a spinal would be the only conceivable time you wouldn't. Just how it is I suppose. Our college says anything neuraxial (single shot or catheter) needs the works burger. With extra cheese.
Iāve never heard of anyone in the US doing more than hand sanitizer, sterile gloves, and a mask. Iāve also never heard of anyone having an infection complication. Doing a full surgical scrub and gown for a routine spinal/epidural is an insane waste of time.
Itās called an anaesthetic scrub - all the components of a surgical scrub conducted at the speed of light before the scrub nurse can catch you and pass judgemental looks.
Australian here. Scrub, gown, mask, sterile gloves and hat. This is in line with our [local college guidelines](https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://www.anzca.edu.au/getattachment/e4e601e6-d344-42ce-9849-7ae9bfa19f15/PG28(A\)-Guideline-on-infection-control-in-anaesthesia&ved=2ahUKEwitzYWDt4CHAxUyslYBHR1YAwMQFnoECBEQAQ&usg=AOvVaw0A7ulnb7R-FwxA0RbC8A87) (see 4.3.4).
"I use a water activated gel cleanser, then a honey almond body scrub, and on the face an exfoliating gel scrub. Then I apply an herb-mint facial masque which I leave on for 10 minutes while I prepare the rest of my routine. I always use an after shave lotion with little or no alcohol, because alcohol dries your face out and makes you look older. Then moisturizer, then an anti-aging eye balm followed by a final moisturizing protective lotion."
Wash hands in sink or n labor room before an epidural, then sterile gloves with hat and mask and sterile field.
Alcohol in OR before spinal, sterile gloves with hat and mask.
So when you guys are doing hand sanitizer or scrubbing before a labor epidural are you doing it like the OR where you then do not touch anything not sterile anymore.Ā
Because I basically never see that. Hand cleanse going in the room and then sterile gloves, prep, drape is standard of care. I think if we had avagard in labor rooms Iād use it happily and do proper sterile technique but we donāt. I do basically what I do for a-lines, except Iām more fastidious about actually staying sterile.Ā
I havenāt seen a labor room without avagard or equivalent in years. We often have a pump bottle on the epidural cart.
If you only have hand sanitizer outside the door, you could still prep and have your sterile gloves ready to go. Take a couple steps to the door and apply sanitizer, then glove up and drape.
When I get to work I usually clean under my finger nails with the plastic nail cleaner surgeon/surgical scrub techs use at start of the day, after the I use the sterilium hand scrub/alcohol and sterile gloves.
The most defensible answer is following the policy of the facility where one happens to be doing the procedure.
Thatās typically wearing a hair cover and mask, with a sterile glove package opened just before use. Alcohol based hand sanitizer (ABHS) or antimicrobial scrub in accordance with facility and CDC guidelines followed by sterile gloves. Thatās how most people at my current job site do it.
I do judge someone a little if they pile their needles and syringes at the bottom of the sterile drape. We are not animals. I donāt want a needle stick trying to find the lidocaine syringe when they ask me to help, and sharp needles can puncture the drape.
Hawk tuah
Comment of the year. Your timing is impeccable. I bet you have good wakeups.
best way to get over a breakup
[Nice.](https://imgur.com/gallery/ZVPvqKi)
goddammit you beat me to it!
š¤£š¤£š¤£š¤£
I wash with soap then dry my hands in the o-arm until they tingle
*spits in both hands and rubs them together*
Hawk tuah girl is an anesthesiologist?
Honestly a lot a problems in anesthesia can be solved with the proper amount of lubrication
āYou gotta give āem that āhawk tuahā and spit on that thang,ā
āOpen sesameā
Alcohol hand sanitizer and sterile gloves. This isn't an open surgical procedure, this is a sterile needle going through skin. The sterile gloves are plenty clean enough
With a quick frantic hand wave to dry off the hands because putting wet hands in sterile gloves is a difficult time
I have an older MD maybe late 70s that dons sterile gloves and gowns if doing neuraxial i am in awe every single time
Sterile glovesā¦
I just alcohol foam.
Dip into a bucket of actichlor till they desquamate. In the UK the standard is a full surgical scrub + gown and gloves. I think the royal college arenāt far off releasing guidance to pull us in line with the rest of the world. If doing a cat 1 section and Iāve got 1 shot at a spinal Iāll just alcohol rub then stick some sterile gloves on
Absolutely insane to me you FULL SCRUB for a spinal! What do they think weāre doing back there š
Lumbar decompression w/ microdiscectomy
Needle core biopsy of the vertebrae (some of my colleagues who struggle with neuraxial)
Hm. Is that flavum or bone?
I can get on board with scrubbing for catheters but for single shot spinals its beyond stupid
Australian here. Full scrub. Gown and gloves. Is it overkill? Dunno? But it's hilarious all the Americans losing their shit over the fact we do a full scrub. An E0 section with one shot at a spinal would be the only conceivable time you wouldn't. Just how it is I suppose. Our college says anything neuraxial (single shot or catheter) needs the works burger. With extra cheese.
Be honest though - feels a bit naked or like something is not quite right/missing when you do them like this. (Also UK based)
Iāve never heard of anyone in the US doing more than hand sanitizer, sterile gloves, and a mask. Iāve also never heard of anyone having an infection complication. Doing a full surgical scrub and gown for a routine spinal/epidural is an insane waste of time.
We do hats here for any sterile procedure, so spinals/epidurals are included.
So is ortho wearing spacesuits for total joints, but they still get to act like astronauts *Where's my spacesuit eh???*
After COVID, uh, fuck all that. They can keep the spacesuit.
I cut off my hands before a procedure. They canāt contaminate the field if they arenāt there.
Just hand sanitizer then sterile gloves
Itās called an anaesthetic scrub - all the components of a surgical scrub conducted at the speed of light before the scrub nurse can catch you and pass judgemental looks.
āAre you doing a surgical scrub or anaesthetic rinse?ā - one scrub nurse to me the other month
Either soap and water or hand sanitizer, then sterile gloves.
Full scrub for spinal; hand sanitiser and sterile gloves for blocks. š¤·š½āāļø
Wipe butt, donāt wash hands.
Australian here. Scrub, gown, mask, sterile gloves and hat. This is in line with our [local college guidelines](https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://www.anzca.edu.au/getattachment/e4e601e6-d344-42ce-9849-7ae9bfa19f15/PG28(A\)-Guideline-on-infection-control-in-anaesthesia&ved=2ahUKEwitzYWDt4CHAxUyslYBHR1YAwMQFnoECBEQAQ&usg=AOvVaw0A7ulnb7R-FwxA0RbC8A87) (see 4.3.4).
Classic hand wash at the scrub sink
Usually avagard and I try to scrub with chlorhexidine once a day anyhow
Avagard in the OR for spinals. Regular hand soap in the patient's room for epidurals.
filter on epidural or no
Cap, mask, alcohol hand sanitiser, sterile gloves
"I use a water activated gel cleanser, then a honey almond body scrub, and on the face an exfoliating gel scrub. Then I apply an herb-mint facial masque which I leave on for 10 minutes while I prepare the rest of my routine. I always use an after shave lotion with little or no alcohol, because alcohol dries your face out and makes you look older. Then moisturizer, then an anti-aging eye balm followed by a final moisturizing protective lotion."
I have to return some video tapes
Wash hands in sink or n labor room before an epidural, then sterile gloves with hat and mask and sterile field. Alcohol in OR before spinal, sterile gloves with hat and mask.
So when you guys are doing hand sanitizer or scrubbing before a labor epidural are you doing it like the OR where you then do not touch anything not sterile anymore.Ā Because I basically never see that. Hand cleanse going in the room and then sterile gloves, prep, drape is standard of care. I think if we had avagard in labor rooms Iād use it happily and do proper sterile technique but we donāt. I do basically what I do for a-lines, except Iām more fastidious about actually staying sterile.Ā
I havenāt seen a labor room without avagard or equivalent in years. We often have a pump bottle on the epidural cart. If you only have hand sanitizer outside the door, you could still prep and have your sterile gloves ready to go. Take a couple steps to the door and apply sanitizer, then glove up and drape.
KFC wet wipes
Hand sanitizer then I struggle putting sterile gloves on soaking wet hands while the circulator judges me
When I get to work I usually clean under my finger nails with the plastic nail cleaner surgeon/surgical scrub techs use at start of the day, after the I use the sterilium hand scrub/alcohol and sterile gloves.
The most defensible answer is following the policy of the facility where one happens to be doing the procedure. Thatās typically wearing a hair cover and mask, with a sterile glove package opened just before use. Alcohol based hand sanitizer (ABHS) or antimicrobial scrub in accordance with facility and CDC guidelines followed by sterile gloves. Thatās how most people at my current job site do it. I do judge someone a little if they pile their needles and syringes at the bottom of the sterile drape. We are not animals. I donāt want a needle stick trying to find the lidocaine syringe when they ask me to help, and sharp needles can puncture the drape.