Are disinfecting hub protectors practical in the pre-hospital setting?

Mr Chris Edwards1, Mrs Ellie Golling1

1St John Ambulance Western Australia, Belmont, Australia


Paramedics from St John Ambulance Western Australia perform over 40,000 peripherally inserted cannulation attempts every year.  Paramedics are expected to use an aseptic technique, where practicable, for insertion and medication administration. Observationally, disinfection of the needleless connector (hub) using a disinfecting wipe was poor. A quality improvement review was undertaken to see whether the use of disinfecting hub protectors were practical in the pre-hospital environment.


Disinfecting hub protectors were distributed to a sample of Paramedics, selected on working location. Three large ambulance stations in the Perth metropolitan area, and two country locations, were given a 6 month supply. The protectors are impregnated with 70% isopropyl alcohol and require 1 minute contact to disinfect the hub. Surveys were sent to all staff rostered at these stations before and after the equipment review.


The pre-trial survey identified less than 20% of staff reported always disinfecting the hub before administering medication and over 60% report never receiving training in hub disinfection. Following the trial 70% of respondents found the equipment suitable for hub disinfection and would continue using them. The main issues reported were the caps were sometimes difficult to use due to their small size, impractical when frequent medication administration is required, and environmental concerns.


The use of hub protectors appear to be a practical solution to increasing compliance with hub disinfection in the pre-hospital setting. Although the aim of the trial was to improve hub disinfection, an overall improvement in all aspects of aseptic technique was reported.


Chris started working for St John Ambulance in 2010 through their Ambulance Officer program, becoming a Paramedic in 2012. Over the last few years his career has focused on education and improving clinical practice. In his current role as a Clinical Support Paramedic he responds to 000 calls while also conducting training, case audits, clinical reviews and equipment trials.

Away from work, Chris is married and has a 2 year old daughter with another baby due in July. In his spare time he loves spending time with his family, getting active and watching superhero movies.

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