key: cord-0817365-ei8c8vdu
authors: Sellens, P.; Wellbelove, Z.; Wright, D.
title: Testing contamination and cleaning effectiveness in theatre during the COVID‐19 pandemic using UV fluorescent powder
date: 2020-07-09
journal: Anaesthesia
DOI: 10.1111/anae.15200
sha: 0ade65f9b38957887a96a3a5a42b5f68483c3557
doc_id: 817365
cord_uid: ei8c8vdu

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Testing contamination and cleaning effectiveness in theatre during the COVID-19 pandemic using UV fluorescent powder

The COVID-19 pandemic has forced institutions to change theatre systems in an attempt to protect staff and patients from COVID-19 infection. The Intensive Care Medicine/ Anaesthesia COVID-19 group [1] and Public Health England [2] have produced guidelines which our institution used to inform local protocol for the use of personal protective equipment (PPE), conduct of anaesthesia and the movement of patients, staff and equipment into and out of theatre. We used in-situ simulation with UV fluorescent powder (Glo Germ Company, Moab, UT, USA) to ascertain how effective these systems are in reducing the spread of contamination, from a patient with COVID-19 to staff, equipment and the environment within the theatre complex. This has given us insight into the effectiveness of our processes and highlighted areas which need additional decontamination measures. We believe that the findings from our simulation would be applicable to any institution where such patients are brought to theatre.

The simulation used a SimMan 3G (Laerdal Medical Ltd., Orpington, UK) wearing a patient gown, brought to theatre on a trolley with standard linen. The patient and trolley were seeded with Glo Germ TM to simulate contamination due to coughing, consistent with known distances for droplet spread [3] . The patient was moved into the theatre and This simulation identified areas particularly prone to contamination during a typical theatre case and suggests that our current COVID theatre cleaning protocol is not adequate. We believe it also reinforces the need for strict adherence to PPE guidance, as even staff peripherally involved in the case became contaminated. We have noted anecdotally that anaesthetists are changing their outer gloves less frequently when in PPE (compared with nonpandemic practice). This could be a major contributor to the contamination seen and we would suggest more frequent glove changes throughout a case, and specifically after airway procedures. There was no contamination beyond the outer theatre doors, so systems in place to reduce transfer of virus outside the theatre appear effective ('airlock system'). 

COVID-19 airway management principles

infection-prevention-and-control/reducing-the-risk-of-transmissionof-covid-19-in-the-hospital-setting

Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations. WHO Scientific Brief