General practice and accident and emergency department care: does the patient know best?

inappropriate. In most accident and emergency departments the core of resuscitation teams is drawn from the staff working within the unit, and by the very nature of the emergency presentation there is often very little time to protect personal clothing and exposed skin. Not only are invasive procedures carried out in the resuscitation room but wound management elsewhere in the department results in appreciable risk of contamination. Nevertheless, it is impossible to anticipate all potential incidents, and staff are often unaware of contamination when it occurs. An NHS report on the choice of reusable fabrics for operating theatres places emphasis on certain performance specifications which should meet British Standards.5 Synthetic fabrics ofpolyester, for example, are now available which meet these criteria. Protective clothing produced from such fabric acts as an efficient bacterial barrier and is liquid repellent. We are currently exploring the feasibility of providing our medical and nursing staff with theatre-style uniforms made from this material. This study highlights the inappropriate practice of wearing personal clothing in the accident and emergency department and the inadequate protection provided by traditional uniforms. We recommend that accident and emergency staff should be protected by clothing of appropriate design and fabric.