Summaries of Emerging Evidence (SEE) Sample Question
According to a recent study, repeated application of an alcohol-based hand sanitizing solution to nitrile examination gloves is MOST likely to produce which of the following complications? Read the discussion.
(A) Microperforation of the gloves
(B) Impairment of dexterity
(C) Increased stickiness of the fingertips
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Anesthesiologists are commonly exposed to surface and aerosolized pathogens from patients, especially during procedures such as induction and intubation. While use of a surgical mask, gloves, and eye protection is common, it is well known that the exterior surfaces of the clinician’s gloves become rapidly contaminated, with subsequent spread of pathogens to the anesthesia workstation, medication syringes, monitoring equipment, and intravenous tubing.
One strategy proposed to improve infection control during intubation is frequent application of a sanitizing solution to the exterior of the clinician’s gloves. Until recently, there has been a dearth of understanding of how this might affect the integrity of the gloves or the ability of the user to perform normal activities. A group of investigators recently reported on a simulation study to address this question. Fifty-one pairs of nonsterile nitrile examination gloves were tested for integrity by a blinded evaluator trained in the US Food and Drug Administration water-leak test; 1 pair was rejected due to a preexisting microperforation. An alcohol-based hand sanitizer was applied and rubbed into the gloves at 15-minute intervals for a total of 8 applications while the participant performed normal activities. After each application, the dexterity of the participant was objectively tested by picking up a quarter from a flat surface. Participants were also asked to subjectively report stickiness.
None of the 50 pairs of gloves developed microperforations over the course of the study. Objective dexterity was unimpaired, although participants reported a sensation of increased stickiness in the glove fingertips over time. This study suggests that frequent application of hand sanitizer to the exterior of examination gloves does not compromise glove integrity or manual dexterity when applied to the nitrile gloves intraoperatively.
1. Birnbach DJ, Thiesen TC, McKenty NT, et al. Targeted use of alcohol-based hand rub on gloves during task dense periods: one step closer to pathogen containment by anesthesia providers in the operating room. Anesth Analg. 2019;129(6):1557-1560. doi:10.1213/ANE.0000000000004107
2. Gropper MA, Cohen NH, Eriksson LI, et al, eds. Miller’s Anesthesia. 9th ed. Elsevier; 2020:2779.