Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 25:16:2433-2439.
doi: 10.2147/IDR.S405537. eCollection 2023.

Risk of Bacterial Exposure to the Anesthesiologist's Face During Intubation and Extubation

Sei Han Song  1 , Seung Ho Choi  2 , Hae Ri Park  1 , Soo Yeon Jeon  1 , Seung Hyun Kim  2
Affiliations

Risk of Bacterial Exposure to the Anesthesiologist's Face During Intubation and Extubation

Sei Han Song et al. Infect Drug Resist. .

Abstract

Introduction: Anesthesiologists are exposed to the risk of infection from various secretions or droplets from the respiratory tract of patients. We aimed to determine bacterial exposure to anesthesiologists' faces during endotracheal intubation and extubation.

Methods: Six resident anesthesiologists performed 66 intubation and 66 extubation procedures in patients undergoing elective otorhinolaryngology surgeries. Sampling was performed by swabbing the face shields twice in an overlapping slalom pattern, before and after each procedure. Samples for pre-intubation and pre-extubation were collected immediately after wearing the face shield at the time of anesthesia induction and at the end of the surgery, respectively. Post-intubation samples were collected after the injection of anesthetic drugs, positive pressure mask ventilation, endotracheal intubation, and confirmation of intubation success. Post-extubation samples were collected after endotracheal tube suction, oral suction, extubation, and confirmation of spontaneous breathing and stable vital signs. All swabs were cultured for 48 h, and bacterial growth was confirmed by colony forming unit (CFU) count.

Results: There was no bacterial growth in either pre- or post-intubation bacterial cultures. In contrast, while there was no bacterial growth in pre-extubation samples, 15.2% of post-extubation samples were CFU+ (0/66 [0%] vs 10/66 [15.2%], p=0.001). All the CFU+ samples belonged to 47 patients with post-extubation coughing, and the CFU count was correlated with the number of coughing episodes during the process of extubation (P < 0.01, correlation coefficient= 0.403).

Conclusion: The current study shows the actual chance of bacterial exposure to the anesthesiologist's face during the patient awakening process after general anesthesia. Given the correlation between the CFU count and the number of coughing episodes, we recommend anesthesiologists to use appropriate facial protection equipment during this procedure.

Keywords: bacterial exposure; cough; extubation; face shield; intubation.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Face shield.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Vijendren A, Yung M, Sanchez J. Occupational health issues amongst UK doctors: a literature review. Occup Med. 2015;65(7):519–528. doi:10.1093/occmed/kqv088 - DOI - PubMed
    1. Roberge RJ. Face shields for infection control: a review. J Occup Environ Hyg. 2016;13(4):235–242. doi:10.1080/15459624.2015.1095302 - DOI - PMC - PubMed
    1. Siegel JD, Rhinehart E, Jackson M, Chiarello L. 2007 Guideline for isolation precautions: preventing transmission of infectious agents in health care settings. Am J Infect Control. 2007;35(10 Suppl 2):S65–164. doi:10.1016/j.ajic.2007.10.007 - DOI - PMC - PubMed
    1. Lindsley WG, Noti JD, Blachere FM, Szalajda JV, Beezhold DH. Efficacy of face shields against cough aerosol droplets from a cough simulator. J Occup Environ Hyg. 2014;11(8):509–518. doi:10.1080/15459624.2013.877591 - DOI - PMC - PubMed
    1. Greenland KB, Tsui D, Goodyear P, Irwin MG. Personal protection equipment for biological hazards: does it affect tracheal intubation performance? Resuscitation. 2007;74(1):119–126. doi:10.1016/j.resuscitation.2006.11.011 - DOI - PMC - PubMed