Reducing the risk of prion transmission in anaesthesia

Walsh, E.

doi:10.1111/j.1365-2044.2005.04476.x

Cited by 6 publications

(6 citation statements)

References 15 publications

(14 reference statements)

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“…These findings echo the results of a US survey in which 82% of all nurses and 71% of all surgeons questioned reported that they would feel wary if a reprocessed device were used on them [31]. Similarly, Walsh [32] carried out his own 'straw-poll' of UK theatre staff, and found that 'almost all would prefer an unused laryngeal mask airway for their anaesthetic, because they see them contaminated with blood and secretions'.…”

Section: Resultssupporting

confidence: 64%

“…A number of authors have argued that the extent of iatrogenic risk from contaminated devices has been overstated, and they cite the lack of any firm evidence that demonstrates the presence of a health hazard [33,34]. Walsh [32] recently suggested that if the risk from airway devices such as breathing circuits and laryngeal masks had been significant, the consequences would already have been evident. The long-term safety and efficacy of reuse is still unknown because of the long incubation period of prion-related diseases [35,36].…”

Section: Discussionmentioning

confidence: 99%

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The use of single‐use devices in anaesthesia: balancing the risks to patient safety*

Rowley¹,

Dingwall

2007

Anaesthesia

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SummarySingle‐use devices are designed, manufactured and sold to be used once and then discarded. This paper addresses growing concerns about the quality of some devices. Single‐use devices, manufactured at a lower cost to justify their disposal, are perceived to have a lesser efficacy, which may threaten patient safety through iatrogenic harm. There is, in addition, growing scepticism about the actual risk of contracting variant Creutzfeldt‐Jakob disease and other blood‐borne diseases from reused surgical instruments. Interview data suggests that when choosing to use a single‐use device, clinicians balance concerns about the risk of infection against those about the risk of injury. However, despite reservations about induced harm and the unknown risk of an iatrogenic disease, most clinicians would want single‐use devices used on themselves and their family if they were patients.

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Section: Resultssupporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

The use of single‐use devices in anaesthesia: balancing the risks to patient safety*

Rowley¹,

Dingwall

2007

Anaesthesia

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“…If it is seen as a challenge it is one seemingly welcomed and accepted by many healthcare professionals, including Anaesthetists, where they perceive it appropriate. As we show, Anaesthetists typically agree with the principle of SUDs on the understanding that they are in the 'best interests' of the patient (Walsh 2006). …”

Section: Discussionmentioning

confidence: 92%

Narratives of professional regulation and patient safety: The case of medical devices in anaesthetics

Currie¹,

Humpreys²,

Waring³

et al. 2009

Health, Risk & Society

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Government prescription for the management of clinical risk and patient safety relies upon the development of a shared perspective between stakeholders engaged in the delivery of healthcare about what constitutes clinical risk and what mechanisms are suitable to manage such risk to ensure patient safety. However, there are tensions arising from notions of clinical risk and its management, specifically between healthcare professionals and those managers given responsibility for implementation of policy. Central to these tensions are issues of legitimacy, power and identity in claims about how risk should be managed. Aligned with an emerging body of literature that takes a narrative approach to change in healthcare systems (e.g. Currie and Brown 2003), including patient safety (e.g. McDonald et al. 2005McDonald et al. , 2006, our paper examines how healthcare professionals make sense of the regulation of single use medical devices (SUDs) in anaesthesia. Our study indicates that there is considerable resistance to detailed surveillance of SUDs. It appears that doctors author a narrative that privileges clinical judgement over managerial control in the use of SUDs, and this has come to be adopted by other healthcare professionals and managers. This may undermine future policy aspirations for the tighter regulation of clinical autonomy.

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“…A number of publications have debated whether an optimal medical device should be multiple or singleuse [17,[33][34][35]. The AAGBI [9] recommends use of disposable equipment due to concerns over infection risk.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, a number of authors have argued that the risk from contaminated equipment has been overstated [34, 35]. It was also suggested that the consequences of using re‐usable equipment would already have been evident if the risk had been significant [33]. A number of practical questions need to be resolved before this debate is settled.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of tracheal tube introducers in simulated difficult intubation*

Janakiraman¹,

Hodzovic

Reddy

et al. 2009

Anaesthesia

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SummaryIn a randomised cross-over study, 72 anaesthetists attempted to place Pro-Breathe, new Portex, and Frova single-use tracheal tube introducers and an Eschmann multiple-use introducer in the trachea of a manikin set to simulate a grade 3 laryngeal view. Successful placement (proportion, 95% confidence interval) of either the Frova (78%, 67-86%) or the Eschmann introducer (64%, 52-74%) was significantly more likely (p < 0.0001) than with the Pro-Breathe (4%, 1-12%) or the new Portex introducer (13%, 7-22%). The difference between the success rates for the Frova and the Eschmann introducers (p = 0.08) was not significant. A separate experiment revealed that the peak force that could be exerted by the Pro-Breathe, new Portex and Frova single-use introducers were three to six times greater than that which could be exerted by the Eschmann introducer (p < 0.0001). The single-use introducers are more likely to cause tissue trauma during placement, particularly if held close to the tip.

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Reducing the risk of prion transmission in anaesthesia

Cited by 6 publications

References 15 publications

The use of single‐use devices in anaesthesia: balancing the risks to patient safety*

The use of single‐use devices in anaesthesia: balancing the risks to patient safety*

Narratives of professional regulation and patient safety: The case of medical devices in anaesthetics

Evaluation of tracheal tube introducers in simulated difficult intubation*

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