Microbial safety of vapocoolant spray on sites for arterial line and epidural placement

This investigation evaluated if skin sterility is maintained following application of Gebauer's Ethyl Chloride^® vapocoolant spray. In this prospective, blinded, controlled study, the medial forearm (site of arterial line placement) and lower back (site of epidural placement) were swabbed before and after sterilisation and treatment with vapocoolant. Data were collected from 72 participants. There was no difference in microbial abundance between samples obtained from the wrist with ChloraPrep™ versus ChloraPrep + Gebauer's Ethyl Chloride (P>0.99), or in positive cultures (P=0.317). On the lower back, there was no difference in microbial abundance following ChloraPrep versus ChloraPrep + Gebauer's Ethyl Chloride (P=0.317), or in positive cultures (P=0.317). Supply chain shortages of lidocaine have prompted consideration of alternative local anaesthetics. These findings support use of Gebauer's Ethyl Chloride as an alternative to lidocaine for minimally invasive procedures such as placement of arterial lines and epidurals. Further investigation is necessary to explore the safety of vapocoolants in more invasive procedures.