Berry A J, Greene E S
Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia 30322.
Anesthesiology. 1992 Nov;77(5):1007-21. doi: 10.1097/00000542-199211000-00025.
Anesthesiologists are at risk for acquiring blood-borne infections through contact with blood or body fluids. From prospective studies, the greatest risk of transmission is through a percutaneous exposure such as needlestick injury. Personal protective equipment such as gloves and gowns do not completely prevent these exposures. Although educational efforts can reduce the frequency of recapping of needles, they generally have not decreased the incidence of needlesticks. Therefore, in addition to practicing universal precautions, anesthesiologists can attempt to reduce their risk of needlestick injuries by eliminating nonessential unprotected needle use, through the use of needleless or protected needle devices (engineering controls) and by modifying anesthetic procedures requiring needles (work practice controls). Needleless or protected needle products are commercially available for use in many procedures performed by anesthesiologists. For tasks that require the use of needled devices, the practitioner should use safe techniques for handling (i.e., one-handed recapping if recapping is needed) and disposal (i.e., puncture-resistant containers) of these devices. Evaluation of the efficacy, cost, and safety of needleless or protected needle products should be continued as they are introduced into wider use. Additionally, anesthesiologists should be encouraged to report needlestick injuries so that appropriate postexposure treatment can be given and so that the incident can be studied to permit design of a work protocol or device to prevent similar accidents in the future.
麻醉医生有通过接触血液或体液而感染血源性疾病的风险。前瞻性研究表明，传播风险最大的途径是经皮暴露，如针刺伤。手套和手术衣等个人防护装备并不能完全防止此类暴露。尽管开展教育活动可以减少重新盖帽的频率，但总体上并未降低针刺伤的发生率。因此，除了采取普遍预防措施外，麻醉医生还可以通过消除不必要的无保护针头使用、使用无针或带保护装置的针头（工程控制）以及修改需要使用针头的麻醉操作（工作规范控制），来降低针刺伤的风险。无针或带保护装置的针头产品在市场上有销售，可供麻醉医生在许多操作中使用。对于需要使用带针装置的任务，从业者应采用安全的操作技术来处理（即如需重新盖帽则采用单手操作）和处置（即使用防穿刺容器）这些装置。随着无针或带保护装置的针头产品得到更广泛应用，应持续评估其有效性、成本和安全性。此外，应鼓励麻醉医生报告针刺伤事件，以便能给予适当的暴露后治疗，并对该事件进行研究，从而设计出工作流程或装置，以防止未来发生类似事故。
