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Related Concept Videos

Hand hygiene01:23

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Asepsis is the practice of preventing or breaking the chain of infection. The nurse employs aseptic techniques to prevent the spread of microorganisms and reduce the risk of diseases. Hand hygiene is the cornerstone of aseptic techniques and is classified into medical and surgical asepsis. Medical asepsis includes hand hygiene and the use of gloves. Surgical asepsis, or the sterile technique, refers to practices that render and keep objects and areas free of microorganisms.
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Oxygen therapy is a pivotal aspect of medical care, particularly for patients with respiratory ailments. Two prominent oxygen-delivering systems include the Venturi mask and the transtracheal oxygen catheter.
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Transmission-based precautions are for patients infected or suspected to be infected (or colonized) with organisms posing a significant risk to others. The transmission precautions include airborne and protective environment precautions.
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Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
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Cleaning, disinfection, and sterilization are the methods that help to break the infection chain and prevent disease.
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Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
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No Decrease in Early Ventilator-Associated Pneumonia After Early Use of Chlorhexidine.

Terrence Wong1, Adam B Schlichting2, Andrew J Stoltze1

  • 1Terrence Wong is a medical student, Andrew J. Stoltze is a resident physician, Kari K. Harland is a biostatistician, and Azeemuddin Ahmed is a clinical professor, Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa. Adam B. Schlichting is a clinical assistant professor, Department of Emergency Medicine and Department of Internal Medicine, Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa Carver College of Medicine. Brian M. Fuller is a clinical assistant professor, Department of Anesthesiology, Division of Emergency Medicine and Division of Critical Care, Washington University School of Medicine, St Louis, Missouri. Amanda Peacock is an advanced registered nurse practitioner, Department of Anesthesia, Division of Critical Care, University of Iowa Carver College of Medicine. Nicholas Mohr is a clinical assistant professor, Department of Emergency Medicine and Department of Anesthesia, Division of Critical Care, University of Iowa Carver College of Medicine.

American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses
|March 3, 2016
PubMed
Summary
This summary is machine-generated.

Early administration of oral chlorhexidine did not reduce ventilator-associated pneumonia in intubated patients. This study found no significant difference in pneumonia rates based on the timing of chlorhexidine prophylaxis.

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Area of Science:

  • Critical Care Medicine
  • Infectious Disease Prevention
  • Respiratory Care

Background:

  • Oral chlorhexidine prophylaxis is known to reduce ventilator-associated pneumonia.
  • The optimal timing for administering oral chlorhexidine has not been fully investigated.

Purpose of the Study:

  • To determine if early oral chlorhexidine administration is linked to a lower incidence of early ventilator-associated pneumonia in intubated air ambulance patients.
  • Investigate the association between the timing of chlorhexidine prophylaxis and the development of early ventilator-associated pneumonia.

Main Methods:

  • A retrospective cohort study was conducted on intubated adults admitted to a surgical intensive care unit.
  • Exposure was defined as the time from helicopter retrieval to the first dose of oral chlorhexidine, with "early" defined as within 6 hours of departure.
  • The primary outcome was the clinical diagnosis of ventilator-associated pneumonia within 5 days of ICU admission.

Main Results:

  • Of 134 patients, 49% received chlorhexidine before 6 hours and 84% before 12 hours.
  • Early chlorhexidine administration (before 6 hours) was not significantly associated with a reduced incidence of early ventilator-associated pneumonia (15% vs. 8%, P = .21).
  • Median time to chlorhexidine administration did not differ significantly between patients who developed pneumonia (5.2 hours) and those who did not (6.1 hours).

Conclusions:

  • Early administration of oral chlorhexidine did not demonstrate a reduction in ventilator-associated pneumonia incidence in this surgical ICU population.
  • The study suggests that in settings with high rates of chlorhexidine administration within 12 hours, early prophylaxis may not offer additional benefits for preventing early VAP.