Foot pedals control various medical devices in the operating room, such as electrocautery devices and power tools. While foot pedals provide a hands-free option for surgeons and healthcare providers to control these instruments during procedures, there can be potential risks associated with foot pedal contamination.
We swabbed foot pedals before and after surgery while COVID pandemic cleaning protocols were enforced and found Bacillus cereus and Paenibacillus pabuli. The former is a catalase-positive, facultatively anaerobic, spore-forming, toxin-producing, gram-positive bacilli known to cause illness in man, and the latter can cause opportunistic infections.
Contaminated foot pedals are associated with the following risks:
1. Transmission of pathogens: Foot pedals can harbor and transmit pathogens if they become contaminated with bodily fluids, such as blood or tissue. If healthcare providers come into contact with these contaminated foot pedals and then touch other surfaces or objects, there is a risk of cross-contamination and the potential spread of infections. Most manufacturers recommend the use of foot pedal covers for each case. Frequently, this still needs to be done. Foot pedals, most of which are not waterproof, are often exposed to blood and other body fluids during surgery and, since they cannot be immersed in cleaning fluid, are often contaminated. OR staff are advised to wear gloves when handling foot pedals, but often they do not.
2. Surgical site infections (SSIs): Foot pedals contaminated with microorganisms can be a source of SSIs. If the surgical team touches the foot pedals or comes into contact with sterile instruments or surgical drapes, there is a risk of introducing bacteria or other pathogens into the surgical site. More likely, and more concerning, is the potential for contamination of airborne particles, which could land in the surgical site and become a source of infection. Searching for the foot pedal under the table could stir up contaminated particles causing them to become airborne vectors that can lead to SSIs. Studies have shown that airborne particles contaminated by contact with non-sterile surfaces can become airborne vectors that may cause SSIs. Of all of the foot pedals under the table, the bipolar forceps foot pedal is used throughout the cases and, according to our surveys, requires staff to crawl under the table to move the foot pedal 2.3 timers per case.
3. Occupational hazards for healthcare providers: Foot pedals contaminated with bodily fluids can pose a risk to healthcare providers. If a provider touches a contaminated foot pedal, they may risk exposure to potentially harmful substances or suffer injuries due to losing balance. I have personally observed staff move foot pedals without gloves. Typically, the call to push a foot pedal during surgery is made urgently because the surgeon has encountered hemorrhaging within the operative field.
Mitigating these risks requires implementing proper infection control measures in the operating room, including using foot pedal coves and regular cleaning and disinfection protocols for foot pedals. Unfortunately, hospitals and ambulatory surgery centers rarely employ disposable foot pedal covers. Additionally, healthcare providers rarely adhere to strict hand hygiene practices before and after using foot pedals and often do not wear appropriate personal protective equipment (PPE) to minimize the risk of contamination and cross-infection.
BiPAD Surgical technology can convert existing bipolar forceps and generators to hand switching, thus avoiding the above risks and eliminating one source of foot pedal-related SSIs. Converting to hand-switching is cost-effective with no capital expense.