Laryngoscope decontamination techniques: A survey

Advancements in additive manufacturing for video laryngoscopes: a comprehensive scoping and technological review

The global healthcare crisis with the COVID-19 pandemic has placed a significant overwhelming demand for intubation procedures and the need for reliable and accessible video laryngoscopes. The purpose of this scoping and technological review is to provide a comprehensive overview of the current state of the art, covering the period from 2007 to 2022, pertaining to the manufacturing process, characteristics, and validation of video laryngoscopes produced using additive manufacturing techniques. Following the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), an exhaustive search was conducted across nine prominent databases (PubMed, Web of Science, Scopus, Cochrane, Prospero, Scielo, Embase, Lilacs, Virtual Health Libraries-VHL) and four patent databases (EPO/ESPACENET, WIPO/PATENTSCOPE, National Institute of Industrial Property (INPI), Google Patents). The main materials utilized for the impression, as well as the physical characteristics of the device are introduced at first. Crucial aspects to facilitate proper visualization of the anatomical structures during endotracheal intubation as the optimal angulation of the blade, the mechanical resistance of the device, traction force on the jaw, intubation time, and the experimental methods employed to validate its performance were reviewed in terms of their recent advances.

Disinfection of Reusable Laryngoscopes: A Survey about the Clinical Practice in Spain

Airway device-associated infections resulting from the cross-contamination of reusable laryngoscopes are one of the main causes of healthcare-associated infections. Laryngoscope blades are highly contaminated with various pathogens, including Gram-negative bacilli, which can cause prolonged hospitalization, high morbidity and mortality risks, the development of antibiotic-resistant microorganisms, and significant costs. Despite the Centers for Disease Control and Prevention and the American Society of Anesthesiologists' recommendations, this national survey of 248 Spanish anesthesiologists showed that there is great variability in the processing of reusable laryngoscopes in Spain. Nearly a third of the respondents did not have an institutional disinfection protocol, and 45% of them did not know the disinfection procedure used. Good practices for the prevention and control of cross-contamination can be ensured through compliance with evidence-based guidelines, education of healthcare providers, and audits of clinical practices.

Comparison of efficacy and cost-effectiveness of 0.55% ortho-phthalaldehyde and 2% glutaraldehyde for disinfection of laryngoscopes: A prospective pilot study

BACKGROUND AND AIMS

The laryngoscope is a potential source of cross-infection as it involves contact with the mucous membrane, saliva and occasionally blood. This study compared efficacy and cost-effectiveness of two Centre for Disease Control approved agents for disinfection of laryngoscope blades.

METHODS

One hundred and sixty patients requiring laryngoscopy and intubation for general anaesthesia were randomly allocated into two groups. After tracheal intubation, used laryngoscope blades were cleaned with tap water. The blades were then immersed in either 2% w/v glutaraldehyde for a contact time of 20 min or 0.55% w/v ortho-phthalaldehyde (OPA) for 10 min. The handles were wiped with 0.5% w/v chlorhexidine wipes. Samples were collected using sterile cotton swabs from the tip, flange and light bulb area of the laryngoscope blade and one from the handle. They were cultured aerobically on blood and McConkey agar.

RESULTS

In 2% glutaraldehyde group, of 240 samples sent from the blades, 2 (0.8%) showed the growth of methicillin-resistant coagulase-negative staphylococci (MRCONS) and Enterobacter. In OPA group, of 240 samples, 2 (0.8%) showed growth of MRCONS. Thus, 2% glutaraldehyde and 0.55% OPA were comparable in terms of efficacy of disinfection. Growth was seen on 4 out of 160 handles.

CONCLUSIONS

We suggest OPA for high-level disinfection of laryngoscope blades as it is equally efficacious as compared to glutaraldehyde, with a shorter contact time and available as a ready to use formulation.

Disinfection of laryngoscopes: A survey of practice

Background and Aims:

The laryngoscope is a common piece of equipment used by anaesthesiologists. It has been identified as a potential source of cross infection. Although guidelines exist regarding appropriate disinfection practices, recent reviews suggest ineffectiveness of current methods of disinfection and poor compliance with the established protocols. We conducted a questionnaire-based survey to study the current disinfection practices being followed by a cross section of anaesthesiologists.

Methods:

A simple questionnaire containing 13 questions was distributed amongst anaesthesiologists in an anaesthesia conference. Data were analysed with percentage analysis.

Results:

Out of 250 delegates who attended the conference, 150 submitted the completed questionnaires. Residents constituted 41% and 46% were consultants. Eighteen (12%) used only tap water for cleaning and 132 (88%) used a chemical agent after rinsing with water. Out of 132, 76 (51%) used detergent/soap solution, 29 (19%) would wash and then soak in disinfectant or germicidal agents (glutaraldehyde, povidone iodine and chlorhexidine) and 18 (12%) would wipe the blade with an alcohol swab. With respect to disinfection of laryngoscope handles, 70% respondents said they used an alcohol swab, 18% did not use any method, 9% were not aware of the method being used, while 3% did not respond.

Conclusion:

Our results indicate wide variation in methods of decontamination of laryngoscopes. Awareness regarding laryngoscope as a potential source of infection was high. We need to standardise and implement guidelines on a national level and make available resources which will help to improve patient safety.