We appreciate the comments of Chalifoux and Feuer regarding our recent Images in Anesthesiology article.1We agree that identifying a specific site to isolate contaminated items is the key point, and that anesthesiologists may choose different options in meeting the goal. In our experience, we have found the chest to be a convenient location that allows us to keep our patient under continuous direct vision. We have not found the towel containing the contaminated equipment to interfere with auscultation and confirmation of endotracheal tube placement, and the towel allows for easy and rapid removal of the equipment after placement is verified. Using the anesthesia machine is an alternative, but we find this requires turning away from the patient, although we have colleagues who prefer that configuration. We agree that the chest is not ideal for small pediatric patients, but in that case there is generally room on the operating table for the towel. A Mayo stand or similar mobile tray is an excellent alternative, but requires additional workspace and may not be convenient in all anesthetizing locations. The crux of our proposal is to have a convenient space clearly identified as dirty to reduce anesthesia workspace contamination after intubating a patient. Anesthesia providers should create a systematic approach that works for their unique set of circumstances.

Mecham EM, Hopf HW: A proposal to minimize work area contamination during induction. ANESTHESIOLOGY 2012; 116:712