The Association of Anaesthetists have recently issued guidelines regarding infection in Anaesthesia. The use of single use laryngoscope /images is supported. Please click here to download the document.
[i] Presence of protein deposits on 'cleaned' re-usable anaesthetic equipment
Miller DM, Youkhana I, Karunaratne WU, Pearce A
Anaesthesia 2001; 56(11): 1069-72
Twenty previously used and supposedly clean, sterilised laryngeal mask airways, five bougies and five Magill forceps from the operating theatre, and 61 laryngoscope blades from different sites within a single hospital were randomly collected and stained with erythrosin B dye, which stains proteins if present on surfaces. All 20 laryngeal mask airways had been used before and were stained: four (20%) showed heavy staining, five (25%) moderate staining and 11 (55%) mild staining. Two unused laryngeal mask airways used as controls were without staining. Thirty-four of 44 (77%) laryngoscope blades taken from the operating theatres, six of seven (86%) from the overnight intensive recovery room and all 10 (100%) from the wards were stained. None of the other items was totally clean. These findings suggest that current cleaning methods do not remove all proteinaceous material.
[ii] Disposable laryngoscope blades
Babb M, Mann S
Anaesthesia 2002; 57(8): 827
[iii] Randomized evaluation of the performance of single-use laryngoscopes in simulated easy and difficult intubation
Twigg SJ, McCormick B, Cook, TM
Br J Anaesth 2003; 90: 8–13
Background: Single-use laryngoscopes are becoming used more widely.
Methods: We compared six types of single-use laryngoscope with the standard Macintosh laryngoscope using the Laerdal SimManTM patient simulator. Twenty anaesthetists attempted to intubate the simulator with standardized airway settings allowing a full view of the vocal cords (‘easy intubation’). The airway settings were then changed so that only the posterior part of the glottis was visible (‘difficult intubation’) and the anaesthetists were asked to intubate the simulator again.
Results: The time to intubate with the standard laryngoscope was less in both easy (P<0.05) and difficult (P<0.01) intubations. The performance of five laryngoscopes during easy intubation (P<0.01) and four during difficult intubation (P<0.001) was significantly worse than that of the Macintosh. There was a significant difference in Cormack and Lehane grading between the laryngoscopes tested in both easy (P<0.05) and difficult (P<0.05) intubation. The percentage of glottic opening visible (POGO score) also differed between laryngoscopes in both the easy (P<0.01) and difficult (P<0.001) groups. The highest POGO scores were obtained with the Macintosh laryngoscope. During the difficult intubation simulation, the reusable Macintosh laryngoscope needed less use of a bougie and had fewer failed intubations than the single-use laryngoscopes, but these differences did not reach statistical significance.
Conclusions: Of the laryngoscopes tested, the standard reusable Macintosh laryngoscope performed best. The Europa was the best single-use laryngoscope. Some single-use laryngoscopes tested were significantly inferior to the Macintosh. This raises concern over their use in clinical practice, particularly if intubation is difficult.