Bacteria-carrying particles and exhaled anaesthetic gases are the two contaminants found in the air flow patterns of operating rooms. Their origin, direction and speed were illustrated by a motion picture using Schlieren photography and smoke tracers. Compared with a conventionally well air conditioned operating theatre, it was shown that a downward flow of clean air reduced the number of bacteria-carrying particles at the wound site by sixty times. The Exflow method of achieving this without the restriction of any side panels or floor obstruction was described. The total body exhaust worn by the surgical team was shown to reduce the bacteria count by a further eleven times. Clinical results show that when both these systems are used together, patient infection was reduced from 9 per cent to between 0.3 per cent and 0.5 per cent, even when no pre-operative antibiotics were used. Anaesthetic gas pollution was measured and shown to be generally 1000 p.p.m. at the head of the patient, in induction, operating and recovery rooms, also in dental and labour rooms. A high volume low pressure active scavenging system was described together with its various attachments including one specially for paediatric scavenging. Results showed a reduction of nitrous oxide pollution to between zero and 3 p.p.m. The economy and cost effectiveness of both these pollution control systems was shown to be good due to the removal of health hazards from patients and theatre staff.
Observational audit of sevoflurane consumption during paediatric anaesthesia
