Presence of protein deposits on ‘cleaned’ re‐usable anaesthetic equipment

Abstract

SummaryTwenty 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.

A comparison of the Glidescope®, Pentax AWS®, and Macintosh laryngoscopes when used by novice personnel: a manikin study

“…27,28 This complies with the guidelines of the Association of Anaesthetists of Great Britain and Ireland, which state that ''single use intubation aids'' should be used where possible 29 due to difficulties in ensuring that all proteinaceous material has been removed during cleaning and sterilization. 27,30 A number of important limitations exist regarding this study. First, we acknowledge that some potential for bias exists, as it is impossible to blind the novice laryngoscopists to the device being used.…”

A comparison of the disposable Ambu® AuraOnce™ Laryngeal Mask with the reusable LMA Classic™ laryngeal mask airway*

“…Prions demonstrate a profound resistance to standard sterilisation methods used in surgical practice [1]. Proteinaceous material has been found in a majority of autoclaved laryngeal masks and cleaned laryngoscope blades [2]. This may have implications for the safety of multiple-use surgical and anaesthetic instruments.…”

Brief review: The Cobra Perilaryngeal Airway (CobraPLA®) and the Streamlined Liner of Pharyngeal Airway (SLIPA™) supraglottic airways

“…6 Moreover, the need for disposable devices, to avoid transmission of infective organisms and prion proteins, cannot be ignored. 7 The clinical use of the LMA Classic™ has been extensively reviewed. 6 Several disposable variants of the SGA have been developed including: the Ambu® AuraOnce™ Laryngeal Mask (Ambu Inc, Glen Burnie, MD, USA); Portex® Soft-Seal® Laryngeal Mask (Smiths Medical International Limited, Hythe, UK); and the air-Q™ (Mercury Medical, Clearwater, FL, USA).…”