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March 20, 2009

Multidose vials of anesthetics appear to be the most likely factor in transmission of hepatitis C between patients undergoing arthroscopy and endoscopy

The authors investigated two episodes of hepatitis C transmission between patients who underwent diagnostic procedures.  In both events the common factor appeared to be open multidose vials that had been used for several patients.  “In the arthroscopy episode the anaesthetist re-used the drawing up needle left in the ampoule and syringe to withdraw additional medication.  In the endoscopy episode a new needle and syringe were used every time the ampoules were accessed.  However it is possible in the second case that an open multi-dose vial of fentanyl left adjacent to the sharps container might have become contaminated.”  The authors strongly suggest the use of single dose containers.  If multidose containers must be used they suggest that the drugs be drawn up into individual syringes prior to the commencement of patient care and that this be done in a “clean” area remote from where the anesthesia care will be provided.  Tallis GF et al: Evidence of patient-to-patient transmission of hepatitis C virus through contaminated intravenous anaesthetic ampoules.  J Viral Hep 2003;10:234-239

 

David S. Smith, M.D., Ph.D.

Posted at 12:17 PM in Clinical Care, Infection transmission, patient safety, Quality Improvement |

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  • Blogmaster
    This blog is organized and maintained by David S. Smith, M.D., Ph.D. Associate Professor of Anesthesiology and Critical Care, University of Pennsylvania. His subspeciality is anesthesia for patients undergoing neurosurgery. For the past 6 years he has had responsibilites for patient safety and clinical care quality improvment in a Department of over 65 faculty who provide anesthesia care for about 24,000 patients each year. Correspondance can be sent to [email protected]
  • Mission Statement
    The purpose of this blog is primarily to provide ongoing contact with former residents and faculty of the Department of Anesthesiology and Critical Care at the University of Pennsylvania, Philadelphia, PA, U.S.A. Others may also have an interest in the topics presented. We plan to discuss a variety of issues related to the practice of anesthesiology with an emphasis on patient safety, risk management and medical legal aspects of care.
  • Disclaimer
    The content and observations on this Weblog come mostly from members of the Department of Anesthesiology and Critical Care of the University of Pennsylvania. However this material does not represent the official opinion of that Department, the University of Pennsylvania or any of its other Departments or Divisions. Medicine is a rapidly changing field. We cannot guarantee that any of the material here is correct or up to date.
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