As the anesthesia community deals with the propofol shortage, many clinical options remain; obviously newer medications such as fospropofol give the unique advantages over some of the older choices.
One thing remains clear, if you have been able to continue to use propofol during these challenging times; don't practice unsafe injection techniques.
As president of our state ambulatory surgery society (GSASC.org), I have been besieged by a number of centers who fail to understand APIC guidelines and sterile injection techniques.
One of the reasons why we may have the shortage was the judgement against TEVA for millions of dollars stemming from unsafe injection practices... THis was the well known case of a Las Vegas Endoscopy center that was being unsafe.
ONE VIAL: ONE NEEDLE: ONE SYRINGE: ONE PATIENT
It is imperative to practice this technique even if it costs the center/hospital more money. There are a number of references out there regarding transmission of hepatitis from poor and unsafe practices.
DOn't let your guard down even during these times where you may feel the urge to double dip. The tempation is there; especially with the availability of propofol sometimes only in 50 ml or 100ml vials to do the unsafe thing... Please be aware of the consequences. THe federal government and state agencies are focusing on these issues and infection control. It is extremely important to find sedatives that have those properties and packaging that can be used in the appropriate clinical manner and protect your patients!
Just my take... look forward to yours.
Some resources for safe injection practices:
1. APIC; www.apic.org (association for professionals in infection control and epidemiology)
2. CDC.gov
3. Safe injection practices
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