E C Pigman1, D B Karch, J L Scott. 1. Department of Emergency Medicine, George Washington University, Washington, DC.
Abstract
STUDY OBJECTIVE: Pressurized jet irrigation is commonly used to cleanse traumatic wounds but results in splatter of blood, a biohazard. Three inexpensive irrigation devices were compared to assess the degree of splatter produced: a 1.25-in. 18-gauge angiocath, an Irrijet Irrigation System with a 12.7-cm splash shield, and a Zerowet Splashield held directly against the wound (Zerowet-C) and held 4 to 10 cm from the wound, an incorrect technique (Zerowet-I). DESIGN: A standard laceration was created in pieces of beef. This wound model was placed 1 m from the floor. Paper grid sheets were placed on the irrigator's face and chest. Six grid sheets were suspended at the 9:00, 12:00, and 3:00 positions 1 m from the wound model and 1 and 1.5 m from the floor to simulate exposure to nearby individuals. Two grid sheets were placed flat on the floor, at the 10:30 and 1:30 positions, 1 m from the base of the wound model stand. The study area was contained in a 3 x 2 x 2 m plastic sheet enclosure to prevent air drafts. INTERVENTION: Ten irrigations were performed with the angiocath, Irrijet, Zerowet-I, and Zerowet-C. Each run used 200 mL methylene blue solution delivered with a 50-mL syringe by one-hand pressure. The methylene blue splatter on each of the grids was counted by size (diameter, less than 1 mm, more than 1 mm and less than 5 mm, more than 5 mm and less than 10 mm, and more than 10 mm). RESULTS: There was significantly less splatter onto the irrigator's face and chest with Irrijet, Zerowet-I, and Zerowet-C. No facial splatter occurred with Zerowet-C. There was significantly less splatter at the 9:00 and 12:00 positions at both heights, and on the floor with Irrijet, Zerowet-I, and Zerowet-C. Less significant splatter difference was noted at the 3:00 position. CONCLUSION: Irrijet, Zerowet-I, and Zerowet-C were superior to the angiocath in preventing splatter during this wound model irrigation. The correct use of Zerowet (Zerowet-C) was particularly effective in preventing splatter onto the irrigator's face.
STUDY OBJECTIVE: Pressurized jet irrigation is commonly used to cleanse traumatic wounds but results in splatter of blood, a biohazard. Three inexpensive irrigation devices were compared to assess the degree of splatter produced: a 1.25-in. 18-gauge angiocath, an Irrijet Irrigation System with a 12.7-cm splash shield, and a Zerowet Splashield held directly against the wound (Zerowet-C) and held 4 to 10 cm from the wound, an incorrect technique (Zerowet-I). DESIGN: A standard laceration was created in pieces of beef. This wound model was placed 1 m from the floor. Paper grid sheets were placed on the irrigator's face and chest. Six grid sheets were suspended at the 9:00, 12:00, and 3:00 positions 1 m from the wound model and 1 and 1.5 m from the floor to simulate exposure to nearby individuals. Two grid sheets were placed flat on the floor, at the 10:30 and 1:30 positions, 1 m from the base of the wound model stand. The study area was contained in a 3 x 2 x 2 m plastic sheet enclosure to prevent air drafts. INTERVENTION: Ten irrigations were performed with the angiocath, Irrijet, Zerowet-I, and Zerowet-C. Each run used 200 mL methylene blue solution delivered with a 50-mL syringe by one-hand pressure. The methylene blue splatter on each of the grids was counted by size (diameter, less than 1 mm, more than 1 mm and less than 5 mm, more than 5 mm and less than 10 mm, and more than 10 mm). RESULTS: There was significantly less splatter onto the irrigator's face and chest with Irrijet, Zerowet-I, and Zerowet-C. No facial splatter occurred with Zerowet-C. There was significantly less splatter at the 9:00 and 12:00 positions at both heights, and on the floor with Irrijet, Zerowet-I, and Zerowet-C. Less significant splatter difference was noted at the 3:00 position. CONCLUSION: Irrijet, Zerowet-I, and Zerowet-C were superior to the angiocath in preventing splatter during this wound model irrigation. The correct use of Zerowet (Zerowet-C) was particularly effective in preventing splatter onto the irrigator's face.