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Correspondence  |   October 2012
Table Your Contaminated Equipment during Induction
Author Affiliations & Notes
  • Thomas M. Chalifoux, M.D.
    *
  • *University of Pittsburgh School of Medicine, Magee-Womens Hospital of University of Pittsburgh Medical Center, and Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Article Information
Correspondence
Correspondence   |   October 2012
Table Your Contaminated Equipment during Induction
Anesthesiology 10 2012, Vol.117, 922-923. doi:10.1097/ALN.0b013e31826a0dcc
Anesthesiology 10 2012, Vol.117, 922-923. doi:10.1097/ALN.0b013e31826a0dcc
To the Editor: 
Mecham's and Hopf's “A proposal to minimize work area contamination during induction” brought up some interesting points.1 Preparing an area to isolate items contaminated during anesthesia induction is a good idea that deserves attention. However, we propose that the clean towel not be placed on the patient's chest, as depicted. Rather, the towel should be placed “at a site easily reached,” as the authors also suggested.1 A towel on the chest, covered with contaminated and bulky items (such as gloves, mask, laryngoscope), will need to be moved to confirm endotracheal tube position via  auscultation of breath sounds and the epigastrium, crucial parts of the intubation process.2,3 The patient's chest is not always a stable, flat surface, thus items may fall off of the towel and onto the floor. Using a Mayo stand or similar mobile table would accomplish the authors' goal, with minimal interference in patient care. Such a practice could also be standardized, allowing for situations in which placing items on the patient's chest is not practical (e.g.  , pediatrics).
References
Mecham EM, Hopf HW: A proposal to minimize work area contamination during induction. ANESTHESIOLOGY 2012; 116:712
Salem MR: Verification of endotracheal tube position. Anesthesiol Clin North America 2001; 19:813–39
Schwartz DE, Matthay MA, Cohen NH: Death and other complications of emergency airway management in critically ill adults. A prospective investigation of 297 tracheal intubations. ANESTHESIOLOGY 1995; 82:367–76