This Issue's Rounds Question -
"What technique/materials do you employ while performing a cast wedge?"
(responses to be published in next issue)

In the last issue of Body Cast, Rounds asked:
Is it a necessary protocol to clean your scissors and cast saw blades?

The following responses were received:

From Edward Clancy:
Cleaning scissors and cast saw blades on a regular basis is a necessary protocol and is a part of our daily plan. Wiping with antiseptic after use helps to prevent cross infection between patients and health care workers. Each day we see patients with dressings or other skin problems. These may be covered by a cast that has to be cut off. With MRSA so prevalent, we, as orthopaedic technologists, must do our part to prevent any more spread.

From Lena Head:
Absolutely, it is a necessary protocol to clean your scissors and cast saw blades. Like any well-kept tool, they must be kept free from dirt, grime and dust that plaster and fibreglass produce.
Just in one day, scissors and cast saw blades can accumulate quite a bit of build-up, causing them to work improperly, jamming up or sticking. If this happens, it causes the user of the equipment to work harder and in most cases causes accidents.

This is not only a health and safety issue, but also can cause serious damage to the patient or the tech. If the cast saw blades are covered with plaster or fibreglass, it creates a prime opportunity for an accident to happen.

Also, if the filter to the vacuum is not kept clean, the filter plugs up and dust is expelled into the air that we breathe and this, as we all know, causes serious lung problems.
All equipment requires regular maintenance in order to provide a safe and product-free environment to work in, both for the tech and the patients.

From May Anne Lash:
It is necessary to clean your scissors and cast saw as it is easy for cross-contamination. When cutting off dressings or removing casts, our scissors and cast saw come in contact with blood or any drainage from incisions below. It is like washing your hands between patients. You would not like to possibly infect another patient by using dirty equipment. Always protect your patient and yourself for the best outcome

From Lori MacDonald, James Carragher and Blair_Matheson:
Aside from the regular casting procedures and fracture reductions. the cast room is also a treatment area for pin removal, external fixator removal and wound care. The orthopaedic technologist is responsible for maintaining a safe environment. including that of eliminating the spread of pathogens/contaminants. The tools we use, such as scissors, cast spreaders and cast saws can be a primary source of pathogens/contaminants. Often times, the cast saw and scissors are in contact with drainage from an incision, fracture blister or diabetic ulcer. It is very pertinent as orthopaedic technologists, that we make every effort to wipe down our scissors, cast blades and spreaders between each patient care. Alcohol swabs or isoprop} 1 alcohol are the most commonly used products to cleanse these instruments/tools. As well, good hand washing technique has proven to be the most effective method in controlling the spread of contamination.

From Gary Marshall:
Yes, blades and scissors should be cleaned. When we have MRSA patients, they are put into a private room and all equipment is left in the room and cleaned by our housekeeping staff. Patients with infectious disease have their charts flagged and, again. blades and scissors will be cleaned. Our scissors are sent monthly to SPD for sterilization.

From Joe Niaulucci:
Yes. it is necessary to clean your scissors and cast saw blades between patients. It reduces the spread of infectious disease.

It is a good protocol to disinfect the blades and scissors even with just alcohol, then, at the end of the day, perform a good wash and disinfect these instruments. I do admit during a heavy clinic day I do overlook at times to wipe the saw blades or scissors: But responding to this topic, I will be vigilant between patients disinfecting my equipment.

Responses were also received from Livain Arseneau, Tony Bellon, Ed Clancey, Adrian Crossman, Mark Florian, Richard Grenier, Mary Anne Lash, Brian Lavallee, Cam Longphee, Gary Marshall, Leroy Martin, Joe Maulucci, Javad Movasseli, Earl Oborowsky, Mary Perkins, James Punwassie, Cheryl Rivers, Vital Robichaud, Bert Sheppard, Shawn Vienneau, Angela Wentzell, Joan Wilson, Neuville Yao and Tom Yorke