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decontamination has been in use to guide infection control procedures for various instrumentation depending on the type of tissue contact, otherwise known as the Spaulding classification. According to Spaulding, disinfection levels and techniques, stratified from low to high, were expected to be effective on bacteria, fungi, and enveloped/lipid or nonenveloped/nonlipid viruses. 8 The level of processing required for instruments used in anesthesia care is placed at “high-level disinfection.” For instance, laryngoscope blades, classified as semicritical by the CDC and

disinfected with chlorhexidine before intubation and extubation. The following antibiotics were also administered: amoxicillin 900 mg 2 hours before surgery, ampicillin 700 mg immediately before surgery, and amoxicillin 200 mg 3 times a day for 4 days following surgery. The patient's perioperative course was uneventful, and she was discharged 1 day after treatment. No signs or symptoms of infection were observed during hospitalization or throughout the 1-week postdischarge period ( Table ). Table. Perioperative WBC, CRP, and

and that Pseudomonas aeruginosa could survive for 1 hour, your editor considered sanitizing the keys on his laptop computer before eating, but that disinfection plan was rejected because of possible damage to the computer. Thus, this editorial was created by the repetitive process of typing a few words, rubbing the hands with a sanitizer, and taking a few bites. We should not be concerned about being labeled as having an obsessive-compulsive disorder or being a “germ-a-phobe” like Howard Hughes. Hand sanitizers are good and should be used frequently.

. THE MODIFIED TWIN BLOCK TECHNIQUE The surface landmark for the twin block injection site is located by palpating for the depression created by the greater wing of the sphenoid bone at the superior border of the zygomatic process and approximately 1 cm posterior to the posterior border of the frontal process of the zygomatic bone ( Figure 3 a, target site denoted by “x”). This site is first disinfected with alcohol wipes prior to inserting a 27- or 25-gauge long dental needle (32 mm). Angled 35–45° away from the calvarium (skull) and perpendicular to the

agent. Alternatively, a stopcock could be used without taking the syringe off, although it is much harder to clear the residual propofol in the port once the syringe is removed and the stopcock disinfected and capped. This is considered an inferior solution, although with strict aseptic technique it can be acceptable. Whenever possible, single-use vials of medication should be used. This is reasonable and, for drugs such as midazolam, ondansetron, and fentanyl, not cost prohibitive. Dexamethasone is an exception for commonly used drugs where the cost for

complications. These included unplanned extubations in two 11-month-old patients intubated using 3.5-mm Microcuff® tubes, which were thought to have resulted from extension of the head and neck during intraoral disinfection before palatoplasty. One patient experienced postoperative hoarseness. Kinking of the endotracheal tube nearest the proximal end-anesthesia circuit connector, attributed to the use of a Dingman mouth gag, was observed in 1 patient. Patient Demographics and Study Data* At our

aerosolization. This review of the literature identifies 8 evidence-based practices for preventing and controlling operating room infections. Steps 1 through 4 include designation of clean and dirty workplace areas and containers for receiving used instruments and careful surface disinfection, double gloving prior to induction, disinfection of the surgical site and oral cavity before surgery, and use of a closed lumen intravenous delivery system. Step 5 includes environmental monitoring for the presence of Staphylococcus aureus , Enterococcus , Klebsiella , Acinetobacter

of viral infection to near nil, which may be the expectation of some, many additional steps must also be taken. Currently concerns abound regarding the time the COVID-19 virus remains viable on clinical surfaces and in the air, prompting the recommendation of a three-hour waiting period between patients to allow time for aerosol deposition, coupled with extensive disinfection of the dental treatment environment. Employing a rotation of separate, isolated (ie, closed-off) clinical spaces can improve efficiency and access to care while minimizing risk of exposure and

easily disinfected, economically feasible, and environmentally friendly if rechargeable batteries are used. The benefits of PTS are numerous and abundantly clear. It has been my experience that PTS comes with a fairly unique learning curve. New users commonly complain about the added noise and distraction. But they quickly adapt and overcome any initial reservations, typically growing so accustomed to PTS feedback that they become unsettled if it is unavailable during a case. Interestingly, new users usually are unaware of their dependence on PTS until it is

preoxygenation, continuous infusions of remifentanil 0.5 lg/kg/min and propofol using the target-controlled infusion (TCI) function were started. The patient was induced once the effective-site concentration of propofol was 1.9 lg/mL, and rocuronium 40 mg was then administered. After confirming paralysis via neuromuscular monitoring (a train-of-four 0 count), intranasal disinfection and nasal passage patency confirmation were conducted using cotton swabs immersed in 0.01% benzalkonium chloride disinfectant solution. A preformed, cuffed, 6.5-mm nasal ETT was inserted through