Do Double Gloves Protect Against Contamination During Cannulation of Blood Vessels? A Prospective Randomized Study

Abstract

StreszczenieWstęp: Nienaruszone rękawiczki medyczne zabezpieczają personel medyczny przed kontaktem z płynami fizjologicznymi pacjenta. Chronią w ten sposób osobę udzielającą pomocy przed kontaminacją skóry dłoni potencjalnie skażonym materiałem biologicznym. Celem pracy jest ocena występowania przekłuć, perforacji i uszkodzeń rękawiczek medycznych podczas kaniulacji naczyń obwodowych. Materiał i metody: W badaniu przeanalizowano 303 pary rękawiczek użytych podczas kaniulacji naczyń obwodowych w warunkach symulowanej resuscytacji. Badanie miało charakter prospektywny randomizowany. Rękawice testowano metodą testu wycieku wody. Wyniki: Testem wodnym wykryto dodatkowo 44 przypadki uszkodzenia rękawiczek stosowanych podczas kaniulacji naczyń obwodowych. Zauważono istotne różnice między częstością uszkodzeń zewnętrznej pary rękawic i pojedynczej pary rękawic a częstością uszkodzeń wewnętrznej pary rękawic. Wnioski: Przeprowadzone badanie wykazało, że stosowanie podwójnych rękawiczek zapewnia większy poziom bezpieczeństwa ratownikowi medycznemu niż stosowanie jednej pary rękawiczek, jednak obniża jego zręczność manualną. Ponadto duża liczba uszkodzeń rękawiczek podczas zabiegu nie jest zauważana przez personel medyczny. Med. Pr. 2014;65(2):271-278 Słowa kluczowe: rękawiczki, podwójne rękawiczki, perforacja, ochrona przed zakłuciem, medycyna pracy Abstract Background: Undamaged medical gloves protect medical personnel from contact with physiological fluids of the patient. Thus they protect the assistance provider from hand skin contamination with potentially infectious biological material. The aim of the study was to evaluate the occurrence of pierce, perforations or damage of medical gloves during cannulation of blood vessels. Materials and Methods: In the prospective randomized study 303 pairs of gloves, used during cannulation of blood vessels under simulated resuscitation, were analyzed. Gloves were tested by the water leak test. Results: The water test revealed 44 cases of damage to the gloves used during cannulation of blood vessels. Significant differences were noted in the frequency of damage to both the outer and single pairs of gloves and the inner pair of gloves. Conclusions: The study showed that the use of double gloves provides a higher level of security for a paramedic than the use of a single pair of gloves, however, double gloves reduce the manual dexterity of a paramedic. A large number of damages to gloves are not noticed by medical personnel during surgery. Med Pr 2014;65(2):271-278

Glove failure in elective thyroid surgery: A prospective randomized study

“…In this study the middle finger an ring finger on the left hand of the surgeon were most likely part of glove to be punctured or torn. Other studies have shown similar results [4,9,17]. That is because surgeons usually hold sharp tools in the right hand, and it can lead to accidental damage to the left glove.…”

“…They protect against bloodborne pathogens, such as human immunodeficiency virus (HIV), hepatitis B virus (HBV) or hepatitis C virus (HCV). The risk of acquiring a virus from 1 percutaneous needle stick is 0.3-0.4% for HIV, 6-30% for HBV, and 2.7-10% for HCV [2][3][4][5]. Compared to other clinical fields, surgeons are at a higher risk of glove perforation due to the frequent manipulation of surgical instruments and the use of sharp tools during operative treatment.…”

What to do after needlestick injury?

“…22 Anxiety, stress, being in a hurry, fatigue and carelessness may also increase the risk of NSI. 15,23,24 Studies conducted by Osazuwa-Peters et al suggest that most often injuries occur due to a lapse in concentration (14.8%) and unexpected patient movement (12.3%). …”

“…25 Wearing two pairs of gloves significantly reduces the risk of the inner gloves' perforation and is far safer for the operator than a single pair, but similar to one pair of thicker, orthopedic gloves. 23,25 Even more protection is ensured by triple gloving, knitted outer gloves and glove liners. 25 Most of the studies do not show a significant relationship between double gloving, lower dexterity of the operator and more perforations of gloves, but in a group of medical rescuers, double gloving significantly reduced dexterity.…”

“…25 Most of the studies do not show a significant relationship between double gloving, lower dexterity of the operator and more perforations of gloves, but in a group of medical rescuers, double gloving significantly reduced dexterity. 23,25 It is obvious that regular training on educational courses or in seminars reduces the risk of exposure and facilitates proper PEP. Amongst the educational interventions, a face-to-face training was the most effective form.…”