Stethoscopes no longer need to touch patients

IF 1.2 4区 医学 Q3 EMERGENCY MEDICINE
W. Frank Peacock MD, FACEP, FACC, FESC
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引用次数: 0

Abstract

Background

It is clear that, while stethoscopes are commonly used in cancer patients, they are frequently contaminated with pathogens. Even 60 seconds of alcohol swab cleaning doesn't reliably provide sterile contact. Thus ultimately, stethoscopes are potential vectors that transmit pathogens when touching patients. A proposed draft of the new 2024 CDC guidelines mandates that if shared patient-care items are used (e.g., stethoscopes), they must be cleaned and disinfected between patients. This requires that the stethoscope must be cleaned and disinfected between every single patient contact, or a disposable option used. Unfortunately, studies demonstrate that disposable stethoscopes are inferior auscultation tools, vs. the personal stethoscope. Therefore, to be in compliance with 2024 CDC guidelines improvements in personal stethoscope hygiene are required. The DiskCover is a touch free applied single use disposable stethoscope barrier consistent with CDC guidelines. We performed an in vitro investigation the efficacy of the DiskCover (Asepticscope, Inc, San Diego, CA) in providing an aseptic patient auscultation.

Methods

This was a prospective, randomized evaluation of the ability of the DiskCover to prevent patient exposure to pathogens found on the stethoscope. Stethoscope diaphragms were inoculated with Candida Albicans (C. Albicans), Clostridioides Difficile (C. Diff), Extended- Spectrum B-Lactamase Producing Escherichia Coli (ESBL), Methicillin Resistant Staphylococcus Aureus (MRSA), Pseudomonas Aeruginosa (P. Aeruginosa), and Vancomycin- Resistant Enterococcus Faecium (VRE), then randomized to either DiskCover placement or control (no DiskCover). Stethoscope's then underwent aerobic or anerobic incubation.

Diaphragm cultures were obtained at 0.25, 0.5, 2, 4, and 24 hours of incubation, and placed on Blood, Chocolate, and MacConkey agar. Colony formation was subsequently manually counted.

Results

Stethoscope diaphragms with a DiskCover were sterile in 100% of cases, while those without Discover's had extensive pathogen contamination. Compared to all controls, for all species of pathogens, all DiskCover contacts were sterile (p<0.05 for all comparisons).

Conclusions

DiskCovers provided a sterile point of contact in all instances vs. control, which had large numbers of pathogenetic colonies.

听诊器不再需要接触病人
背景癌症患者常用听诊器,但显然听诊器经常受到病原体的污染。即使用酒精棉签清洁 60 秒,也无法保证无菌接触。因此,听诊器最终会成为接触病人时传播病原体的潜在载体。2024 年疾病预防控制中心新指南的拟议草案规定,如果使用共用的患者护理物品(如听诊器),则必须在患者之间进行清洁和消毒。这就要求听诊器必须在每次接触病人之间进行清洁和消毒,或使用一次性听诊器。遗憾的是,研究表明,与个人听诊器相比,一次性听诊器是较差的听诊工具。因此,为了符合 2024 年疾病预防控制中心指南的要求,必须改善个人听诊器的卫生状况。DiskCover 是一种符合美国疾病预防控制中心指南的一次性听诊器屏障。我们对 DiskCover(Asepticscope, Inc, San Diego, CA)在为患者提供无菌听诊方面的功效进行了体外调查。听诊器隔膜接种了白色念珠菌 (C.Albicans)、难辨梭状芽孢杆菌 (C.Diff)、产广谱 B 型内酰胺酶大肠埃希菌 (ESBL)、耐甲氧西林金黄色葡萄球菌 (MRSA)、绿脓杆菌 (P. Aeruginosa),以及耐甲氧西林金黄色葡萄球菌 (MRSA)。绿脓杆菌)和耐万古霉素肠球菌(VRE),然后随机分配使用 DiskCover 或对照组(不使用 DiskCover)。在培养 0.25、0.5、2、4 和 24 小时后获得膈培养物,并将其置于血液、巧克力和麦康凯琼脂上。结果带盘盖的听诊器膜片 100%无菌,而不带盘盖的听诊器膜片则有大量病原体污染。与所有对照组相比,对于所有种类的病原体,所有 DiskCover 接触点都是无菌的(所有比较的 p<0.05)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Emergency Medicine
Journal of Emergency Medicine 医学-急救医学
CiteScore
2.40
自引率
6.70%
发文量
339
审稿时长
2-4 weeks
期刊介绍: The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine
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