The proper use and an understanding of aseptic technique are critical for the care of patients in the Emergency Department (ED). Aseptic technique dovetails with prescribed universal precautions and is central to our practice. Knowledge of proper aseptic technique ensures that procedures performed in the ED provide maximal protection for both the patient and the physician while keeping the risk of contamination as low as possible.1–15
Wound infection and sepsis are the two major complications resulting from poor and improper aseptic technique. Other complications that may contribute to the patient's morbidity and mortality include increased length and cost of hospital stay, patient discomfort, scarring, and even death. With this is mind, it is clear that aseptic technique is warranted except in the most dire circumstances.
Numerous terms are used to describe the establishment and maintenance of a “sterile” environment. These include aseptic, sterile technique, and disinfection, to name a few. Many people often, and incorrectly, interchange these terms. The proper definitions of the terms used to describe aseptic technique or associated with it can be found in Table 2-1.
Table 2-1 Definitions of Terms Used to Describe Aseptic Technique or Associated Processes ||Download (.pdf)
Table 2-1 Definitions of Terms Used to Describe Aseptic Technique or Associated Processes
|Aseptic||Freedom from infection. Prevention of contact with microorganisms. Involves the use of sterile technique and skin disinfection|
|Clean technique||The practice of using nonsterile equipment to perform procedures. This is considered as part of the universal body fluid precautions|
|Disinfection||The cleaning of an area to make it free of pathogenic organisms and microbes|
|Sterile field||The zone in which strict sterile technique is maintained. Generally consists of an area 3 to 10 times larger than the area of the primary procedure|
|Sterile technique||The practice of utilizing sterile equipment and procedures to maintain an aseptic environment|
|Super aseptic||Ultrahigh state of an aseptic environment. Usually, this is achievable only in the operating room|
The skin and hair are colonized with various organisms. The stratum corneum layer of the epidermis is colonized with a polymicrobial flora. This includes Staphylococcus aureus, Staphylococcus epidermidis, various Streptococcus species, viruses, yeasts, and molds. Many of these organisms are nonpathogenic, even when placed in environments considered appropriate for infection. S. aureus is the most common cause of wound infections. It can result in an infection when introduced into deeper skin layers. Some species, such as S. epidermidis, are pathologic only when inoculated into deeper layers of the skin and soft tissue. For most infections, a significant inoculation is required to create a critical level for microbial growth to occur. Aseptic technique decreases bacterial exposure and reduces the level of potentially pathologic organisms.
The role of aseptic technique in the ED is primarily for invasive procedures. Despite this, invasive procedures require varying degrees of aseptic technique. Placement ...