How Clean Is Your Stethoscope?

AJ Hidell

AJ Hidell

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This ties well into the current discussion here about cleaning our equipment.
The Prevalence of MRSA Transmission by Stethoscope
Keith Wesley, MD, FACEP
Street Science
2009 Mar 9

The authors of this study swabbed 50 stethoscopes of EMS providers presenting to their emergency department (ED) with patients. The swabs were then cultured to detect the presence of methicillin-resistant staph aureus (MRSA). They found 16 (32%) colonized with MRSA. When asked, none of the 16 (32%) could recall the last time their stethoscope had been cleaned.​
Read the full article at: http://www.jems.com/news_and_articles/columns/Wesley/is_mrsa_on_your_stethoscope.html
 
I wipe mine down with Cavi-wipes, after every pt. Plus I use a DRG, which uses the Safeseal covers. They are antimicrobe and get changed every two weeks.

It may still have something on it, but I try to keep it to a minimum.
 
I am appalled by the response of one hundred percent of those whose stethoscopes cultured positive for MRSA!

When asked, none of the 16 (32%) could recall the last time their stethoscope had been cleaned.
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That's insane! Not only is it a danger to their patients, but they are hanging those things around their necks and sticking them in their ears too!
 
AJ Hidell said:
I am appalled by the response of one hundred percent of those whose stethoscopes cultured positive for MRSA!


That's insane! Not only is it a danger to their patients, but they are hanging those things around their necks and sticking them in their ears too!
Click to expand...

Those type of providers need to be removed from EMS. Anything that is in that environment needs cleaned after every patient.
 
I have been made fun of for my OCD equipment cleaning, hand-washing and BSI precautions but when the stakes are so high for my life and the lives of others I find it shocking that so many people out there don't feel the same way. I hope these people now realize the implications of their failure to clean. This article makes me want to go clean my 'scope, even though it doesn't really need it.
 
Just had a conversation with my mum (RN in Boston) who's employer is participating in an internal CQI regarding MRSA and cell phones that the RN's and MD's are given during shift. Similar results, along with "I thought xyz cleaned it before and after I got them"
 
I posted it over there, but it needs to be repeated, "Meh. What should we expect from a health care field where the majority of don't have, nor care to take, a microbiology course?"
 
All of our hospitals and ambulances carry the super-crazy-eat-your-skin-if-you're-not-wearing-gloves wipes and I use one every time we drop a patient off. Or if it's a no transport I use the wipes in the ambulance.

I wouldn't be shocked if my stethoscope had MRSA coming into the ED. If the pt had MRSA, my stethoscope will have MRSA, and just walking in the door I haven't had a chance to wipe it off yet.
 
How many have a cover on their stethoscope? No way to wash those every call.
 
This is why I don't hang my stethoscope around my neck regardless of how well I clean my scope after each patient. I have seen providers get some nasty wounds in this area.

I also replace the rings and diaphragms frequently. After a few wipings with the heavy chemicals, they can get more porous or develop tiny cracks which makes cleaning thoroughly more difficult. It is also very difficult to clean under the ring when stuff starts to accumulate. The diaphragm covers which can be easily cleaned and disposed of frequently can be beneficial.
 
good idea vent.
 
Im wondering if they could make autoclavable scopes, which can be sterilized at the end of a shift.

I use wipes on mine after every patient, and then use a full decon of rubbing alcohol at the end of a shift. Occasionally if I feel in more of a "green" mood, I'll rub down the whole thing with hydrogen peroxide which kills bacteria but is generally safe with humans. However the scope is not close to being sterile, just cleaner.
 
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Honestly, I'm a little more lax. I wipe down the bell and diaphram after every patient with alcohol wipes, and at the end of each shift cancer wipe the whole thing down.

However, after that article and the points some have made, I think I'll start to wipe it down after every patient!
 
Here is an overview of some disinfectants including hydrogen peroxide which can damage some surfaces on the stethoscope or even make them more difficult to clean.:

http://www.engenderhealth.org/ip/instrum/in15c.html

Hydrogen peroxide (6%)
Although the commonly available 3% solution should not be used for HLD, it is suitable for disinfecting surfaces. The use of stronger solutions for HLD has not been well studied. Hydrogen peroxide rapidly loses effectiveness when exposed to heat and light and requires careful storage. For this reason, the World Health Organization recommends that hydrogen peroxide not be used in tropical areas or warm climates. In addition, this solution may cause corrosion, which may damage laparoscopes and metal, rubber, and plastic items.
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I use these products which come in the large canisters and easy to carry packets.

http://www.pdipdi.com/healthcare/surface_disinfect.aspx

I use what will work on whatever virus or bacteria I am aware of. If you are transporting a patient at a hospital or NH where there are known Clostridium difficile (C-diff) precautions, see what they are using since this particular bacteria is resistant to many regular disinfectants.
 
BTW, my previous post was not an endorsement of that product. However, it is a good product and it clearly lists what it is effective against.

When choosing a product, make sure it lists what it will be effective against. One bottle may not be the solution to all.
 
reaper said:
I wipe mine down with Cavi-wipes, after every pt. Plus I use a DRG, which uses the Safeseal covers. They are antimicrobe and get changed every two weeks.

It may still have something on it, but I try to keep it to a minimum.
Click to expand...

I use the cavi-wipes too, and I use a bottle of bleach water to spray down my scope, pens, boots after every shift before I get in my POV. I don't want to take any of that crap home to my daughters.
 
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