Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2013
Investigation of current infection-control practices for ultrasound coupling gel: a survey, microbiological analysis, and examination of practice patterns.
Ultrasound coupling gel may serve as a vector for the spread of bacteria and has been the causative agent for significant health care-associated infections. The purpose of this study was to document existing infection-control procedures and level of contamination present within nonsterile ultrasound gel from several clinical departments at a single institution. A second purpose was to examine the effectiveness of clinician education and manufacturer-based ultrasound additives on ultrasound gel contamination and in vitro bacterial proliferation, respectively. ⋯ The source of contamination for in-use ultrasound gel may be of manufacturer or human origin. Because additives to the ultrasound gel are not bactericidal, sterile ultrasound gel should be used for invasive and high-risk cases, and improving infection-control policies is warranted.
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Reg Anesth Pain Med · Sep 2013
Estimating the incidence of suspected epidural hematoma and the hidden imaging cost of epidural catheterization: a retrospective review of 43,200 cases.
Hematoma associated with epidural catheterization is rare, but the diagnosis might be suspected relatively frequently. We sought to estimate the incidence of suspected epidural hematoma after epidural catheterization and to determine the associated cost of excluding or diagnosing an epidural hematoma through radiologic imaging. ⋯ Approximately 1 in 430 patients undergoing epidural catheterization will be suspected to have an epidural hematoma. The cost of excluding the diagnosis, when suspected, is relatively low when allocated across all patients undergoing epidural catheterization.