The effect of sterilisation on the plasticity of multi-use Eschmann gum elastic bougies: a bench and manikin study*

Abstract

Summary We investigated the deterioration in plasticity of the multi‐use Portex Tracheal Guide (‘bougie’) with repeated sterilisation. Six bougies were prepared by washing them between 0 and 100 times (in accordance with the manufacturer’s guidelines). Two tests were employed: a bench test in which rapid serial photographs were taken of the bougies uncoiling from a preformed curve; and a manikin‐based test in which the six bougies were used in a simulated difficult airway. The bench test demonstrated a progressive deterioration in plasticity with repeated washing. However, the manikin‐based test showed no significant difference between bougies in the incidence of oesophageal placement (p = 0.74). Time to placement differed significantly only between the two most‐washed bougies but was broadly similar. We suggest therefore that the manufacturer’s limit of five washings may be unnecessarily cautious. You can respond to this article at http://www.anaesthesiacorrespondence.com

Chlorhexidine cleaning of re-usable bougies

“…A baseline evaluation was followed by laboratory assessment and service evaluation of the use of a Sani‐Cloth CHG 2% wipe‐based cleaning regimen in affecting the level of bacterial bougie contamination in our hospital. In addition, we assessed the physical and functional properties of individual bougies after numerous sterilisation episodes, to confirm previous research as to whether bougies can remain functional after many more sterilisation episodes than the manufacturers recommend . Finally, we assessed the potential utility of chlorhexidine wipes by conducting a regional telephone survey of current practice.…”

An assessment of introducers used for airway management

“…In this respect, a particular angle of curvature that can be maintained for a particular length of time could be included as minimum requirements in a particular standard for introducers. In the present study, a series of sequential photographs were taken to indicate how the introducer uncoiled following initial shaping, following earlier studies [5,22,23]. Siena et al devised a method to assess the maintenance of curvature, which could be included in a standard for introducers [24,25].…”

Re-introduction of the Eschmann Tracheal Tube Introducer

“…However, there is clearly a balance to be struck, as the evidence for cross‐infection with the Eschmann is not robust and likely to be due to a failure in proper decontamination . In addition, the manufacturer's recommendation limiting the number of uses of the Eschmann to five is, I believe, unnecessarily cautious; it actually performs comparably well after 25 uses .…”