Infection control guidelines for the cardiac catheterization laboratory: Society guidelines revisited

Abstract

In the early years of diagnostic cardiac catheterization, strict sterile precautions were required for cutdown procedures. Thirteen years ago, when the original guidelines were written, the brachial arteriotomy was still frequently utilized, femoral closure devices were uncommon, “implantables,” such as intracoronary stents and PFO/ASD closure devices, were in their infancy, and percutaneous valve replacement was not a consideration. In 2005, the cardiac catheterization laboratory is a complex interventional suite with percutaneous access routine and device implantation standard. Despite frequent device implantation, strict sterile precautions are often not observed. Reasons for this include a decline in brachial artery cutdown, limited postprocedure follow‐up with few reported infections, limited use of hats and masks in televised cases, and lack of current guidelines. Proper sterile technique has the potential to decrease the patient infection rate. Hand washing remains the most important procedure for preventing infections. Caps, masks, gowns, and gloves help to protect the patient by maintaining a sterile field. Protection of personnel may be accomplished by proper gowning, gloving, and eye wear, disposal of contaminated equipment, and prevention and care of puncture wounds and lacerations. With the potential for acquired disease from blood‐borne pathogens, the need for protective measures is as essential in the cardiac catheterization laboratory as is the standard Universal Precautions, which are applied throughout the hospital. All personnel should strongly consider vaccination for hepatitis B. Maintenance of the cardiac catheterization laboratory environment includes appropriate cleaning, limitation of traffic, and adequate ventilation. In an SCAI survey, members recommended an update on guidelines for infection control in the cardiac catheterization laboratory. The following revision of the original 1992 guidelines is written specifically to address the increased utilization of the catheterization laboratory as an interventional suite with device implantation. In this update, infection protection is divided into sections on the patient, the laboratory personnel, and the laboratory environment. Additionally, specific CDC recommendation sections highlight recommendations from other published guidelines. © 2005 Wiley‐Liss, Inc.

2012 American College of Cardiology Foundation/Society for Cardiovascular Angiography and Interventions Expert Consensus Document on Cardiac Catheterization Laboratory Standards Update

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Hybrid stage I palliation for hypo-plastic left heart condition without a hybrid suite: Suggestions for developing nations

“…To allow sternotomy in the CL, it is imperative to follow the infection control guidelines and maintain the environment in the CL like in OR. 15 10. Postoperatively these infants are not as sick as the Norwood candidates and convalescence is more rapid, thus reducing the cost.…”

Percutaneous vascular closure device of the femoral access site after coronary interventions for acute coronary syndrome -immediate and short term follow-up

“…For controlling infection during cardiac catheterization, it is recommending to use aseptic technique, including a cap, mask, sterile gown, sterile gloves, and a large sterile sheet. 21 Moreover, apt measures should be taken while placement of VCD and the risk of vascular complications can be avoided by taking into consideration, the multiple factors (both patient related and device related) applicable during the procedure.…”