Key parts and key sites must be protected to decrease risk of infection.
Aseptic technique aims to prevent pathogenic organisms, in sufficient quantity to cause infection, from being introduced into susceptible body sites by the hands of staff, surfaces of equipment. It protects patients during invasive clinical procedures by utilising infection prevention and control measures that minimise the presence of micro-organisms. Aseptic technique is achievable in pre-hospital settings by applying the five principles of aseptic technique, and modifying practice to mitigate infection risks.
Aseptic technique is to be maintained when performing invasive procedures, such as:
- Blood Glucose Testing
- Suctioning secretions from orpharynx
- Oropharyngeal Airway (OPA)
- Supraglottic Airway (SGA)
- Endotracheal Intubation
- Vascular Access, including administration of medication and fluids
- Removal of Foreign Body Upper Airway (Direct Laryngoscopy Clinical Skill)
- Cricothyrotomy
- Nasopharyngeal Airway
- Intramuscular Injection
- Suturing
- Needle Aspiration Thoracocentesis
- Finger Thoracostomy
- Minor Injury & Epistaxis
- Obstetrics
There may be situations, such as a requirement to perform immediate interventions for a time critical patient such as haemorrhage control, that will supersede the maintenance of aseptic technique. When these situations arise, there should be attempts at minimising potential pathogen contamination to key sites and key parts. Once the immediate threat has been resolved, further deviation from aseptic technique is not warranted. When there is unavoidable contamination or inability to maintain aseptic technique, document on ePCR and mention at handover.
Key Aseptic Terms
| Key Aseptic Terms | |
|---|---|
| Asepsis | Absence of pathogenic micro-organisms |
| Aseptic Technique | Aseptic Technique describes the work practices taken during invasive clinical procedures to prevent the transfer of microorganisms from the clinical staff, procedure equipment or the immediate environment to the patient. This is necessary to:
|
| No-Touch Technique | Technique ensuring key sites and key parts are not touched prior to use, or are disinfected prior to use without being touched again. |
| Aseptic Field | A hygienic and controlled working space for invasive procedures. |
| Critical Micro Aseptic Field | Protection of key parts by syringe caps, sheathed needles, sterile packaging |
| Key Site | Include any non intact skin including open wounds, insertion and access sites of invasive devices such as PIVC, urinary catheters |
| Key Part | Sterile components of equipment used during invasive procedure that will come in to contact with the key site, for example bungs, needle hubs, syringe tips, wound dressings. |
Rationale for Practicing Aseptic Technique
Utilising aseptic technique in pre-hospital care will reduce the risk of healthcare associated infections in patients.
| Five Principles of Aseptic Technique | |
|---|---|
| Sequence | Sequencing refers to a series of actions that ensures each procedure is performed in a safe and appropriate manner. This includes assessing for risks to the safety of the patient and to the healthcare worker, identifying strategies for risk mitigation prior to beginning the procedure, environmental preparation, equipment selection and preparation, and preparing the patient and gaining consent for the procedure. Consideration should be given to plan for potential breaches of aseptic technique, and the mitigation strategies. |
| Environmental Control | Consideration must be given to the environment in which the clinician will be performing the procedure. Identification of potential risks, such as environmental contamination as well as other factors such as location procedure is going to be performed (for example a patients house compared to the ambulance), can assist with maintaining aseptic technique. Environmental controls include ensuring the work area is clean, wiping down work surfaces with a detergent/disinfectant wipe, use of disposable absorbent pads ("blueys") |
| Hand Hygiene | This is a crucial principle in the maintenance of aseptic technique. Ensure you follow all five moments of hand hygiene to ensure aseptic technique is achieved. Please refer to Hand Hygiene for more information. Hand hygiene at the appropriate time also decreases risk of contact with blood and body fluids. |
| Maintenance of Aseptic Field | It is the clinician’s responsibility to ensure that the aseptic field, key parts, and key sites are always protected. This can be achieved by:
|
| Personal Protective Equipment | PPE is important both for the protection of the patient and of the clinician. Consideration must be given to the appropriate level of PPE for the planned procedure. |
Benefits of Aseptic Technique
- Aseptic technique, when performed correctly will:
- Maintain asepsis of key sites
- Protect patients from their own pathogenic microorganisms that may cause infection
- Reduce the transmission of microorganisms
- Maintain the sterility of equipment and key parts used for aseptic procedures
Key Terms & Links
Document Control
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