title: A prospective study of blood splatter in ENT.
abstract: Surgeons face an occupational risk of daily exposure to blood and body fluids. Potential sources of infection include sharps injuries and mucocutaneous contact. The transmission of blood-borne viruses, in particular human immunodeficiency virus (HIV), Hepatitis B and Hepatitis C from the patient to healthcare workers is well documented in the literature. We studied the incidence and degree of blood splash in all otolaryngology (ENT) procedures undertaken in a single unit over a 12 week period. In addition, we investigated which intraoperative factors might predict the degree of splash. We undertook a prospective, non-blinded study of 102 patients undergoing a range of 'routine' elective ENT within one department over 12 weeks. A surgical mask with visor attached was worn in all procedures. Following each procedure, all splatter masks were collected and examined macroscopically and microscopically for blood splash. In addition, the procedure performed, technique used, total blood loss, operating time and grade of surgeon was noted. 54% of procedures resulted in splash mask contamination. The median number of splash spots per mask was 4.7 (range 0-63). Tonsillectomy was the most commonly performed procedure, accounting for over one-third of total procedures investigated. Each mask had an average of 8.2 splash marks. Tonsillectomy had a splash rate of 76.9%. Although the risk of developing HIV is low the operating surgeon has a duty to take all precautions to protect themselves during a procedure and therefore a protective mask and visor or suitable goggles must be worn.
authors.affiliation: Department of ENT and Head and Neck Surgery, St George's Hospital, Blackshaw Rd, London, SW17 0QT, UK, drlakhani@doctors.org.uk.
authors.forename: Raj
authors.initials: R
authors.lastname: Lakhani
authors.forename: Yiwen
authors.initials: Y
authors.lastname: Loh
authors.forename: Ting Ting
authors.initials: TT
authors.lastname: Zhang
authors.forename: Prasad
authors.initials: P
authors.lastname: Kothari
mesh_terms: D000328:Adult; D017848:Blood-Borne Pathogens; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission; D006282:Health Personnel / Q000706:statistics & numerical data; D006526:Hepatitis C / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D008297:Male; D016273:Occupational Exposure / Q000517:prevention & control*; D010036:Otolaryngology / Q000379:methods / Q000592:standards; D013517:Otorhinolaryngologic Surgical Procedures / Q000592:standards*; D000067393:Personal Protective Equipment; D011446:Prospective Studies; D017751:Safety Management / Q000379:methods; D006113:United Kingdom; D016635:Universal Precautions