Standard precautions are meant to reduce the risk of transmission of bloodborne and other pathogens from both recognized and unrecognized sources. (WHO) It is also recommended to assume that every person is potentially infected or colonized with an organism that could be transmitted in the health-care setting and apply the following infection control practices during the delivery of health care. (Guideline recommendation). Personal Protective equipment are to be used as one such measure. But I am unable to find whether the OT table and floor should also be covered with plastic? Please give your opinion with logic (reasoning) and evidences.
Reference: http://www.who.int/csr/resources/publications/EPR_AM2_E7.pdf
https://www.ncbi.nlm.nih.gov/books/NBK305277/
The built environment should be appropriate to allow cleaning and disinfection e.g. Impervious and intact surfaces for floors , walls , coverings on the mattresses, that allow ease of cleaning and prevent ingress. The principles of environmental decontamention after any patient is based on cleaning then disinfection if needed Including after spillage of blood or body fluids or patient known to be infected e.g. MRSA! CPE etc . All medical devices which includes the theatre table and any device used for treatment and therapy must be provided with manufacturer instructions for decontamination which must include method, product for risk levels of contamination low, medium, high risk!. In the UK, decontamination is guided by medical devices directives and Health technical memorandum's on decon. There are also national standards for environmental cleanliness and infection control in the built environment guidance to refer to. Therefore plastic covering for floor and table is not needed as the environment should be appropriate to prevent infection and allow decontaminationalongside management and decontamination of equipment and medical devices.
Thank you very much Gail Lusardi for your elaborated answer. I also agree with Luis Rodrigo sir. As it is easier to decontaminate OR table, floors and sterilize the instruments.. (when disposables are not used or available) it appears that plastic covering of the operating table, floor is not required. But in India, the practice appears to be variable. It is probably because we don't have a national guideline on this. Or, if any such guidelines or directives are there, I shall be happy if shared. Thank you
When the seropositive status is known, it is best that the special disposable kits are used - these contain the gowns, goggles, drapes etc. There are always extra drapes, because each individual involved in the surgery requires the protective gear (which means one kit per person, and each kit comes with drapes). The same drapes are used to cover the OT table.
Its not overuse, rather its avoiding waste. Once opened to obtain the gowns, the rest of the pack either must be used or discarded (not autoclave-able). Having been opened in a "Septic" theatre, they cannot be reutilised elsewhere either, So instead of disposing of them without use, they can be used for additional protection.
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