laryngoscopes

[rpm911]

Hello,

I'm currently reviewing our laryngoscopes for possible replacement. We are currently using the Greenline disposables. However, we have had some issues with them... mainly fractured light tubes.

I've looked at a number of reusable and disposable systems, and I'm curious if anyone has insight they would like to share. We are only looking at traditional mac/miller at this time, so adaptability with specialty blades is not a big issue at this time.

One main problem I'm facing here is that infection control procedures are going to mandate that any reusable systems are sterilized or we have to show some other effective method of disinfection that will cover c-diff.

Thanks and thoughts....

[HERBIE1]

Never used the disposable type- always the big, clunky metal ones that could be used as weapons.

I would LOVE to be able to try the fiber optic variety- I've heard rave reviews about them.

[rpm911]

Never used the disposable type- always the big, clunky metal ones that could be used as weapons.

I would LOVE to be able to try the fiber optic variety- I've heard rave reviews about them.

I really have not been impressed with our current disposables, the light tubes break off all the time. One broke off while I was intubating. This was AFTER we removed all the recalled lot numbers. The reusable fiberoptics are great, but it would be a 15,000+ capital expense to get enough to have spares while the used go to be sterilized.

The traditional ones are good enough, but the light bulbs tend to break, explode, get crud stuck in the socket.

[Spock]

If you need to replace the equipment you have currently the extra expense of the fiberoptic scopes is well worth it. I have yet to find a disposable laryngoscope that I thought was worthwhile but that doesn't mean they don't exist.

Live long and prosper.

Spock

[FireMedic65]

I have used quite a variety of laryngoscopes. Perks of doing clinicals at numerous locations. I have to agree with the disposable blades. Do not bother with them. If you want to replace them, great. A suggestion though would be to keep them around as a back up for those "just in case" situations.

Now on to the case at hand. Are you a hospital based system, private or what? A lot of my clinicals were done from hospital based system, so we had the luxury of the autoclaves to clean our blades. I'm sure they would clean them for you too if you asked them at your local hospital. I personally prefer the reusable blades, the are more reliable in my opinion. Currently, we are using fiber optics and I love them.

[rpm911]

We are a hospital-owned entity, but we are not truly a hospital based system. Yes, we can easily have our parent hospital auto-clave. The problem lies in the way our system is designed it is not practical to get them back in a timely manner due to geography.

I guess the biggest thing is finding out people's experiences with different types of disposables. The ones we have now would be great if the acrylic didn't crack. It's been about 10 years since I last used any other disposables, they were white plastic. I do not recall the brand but the plastic was way to pliable, but they fit to a standard handle...

Anyone have any good disinfection techniques for laryngoscopes you're using now esp. regarding C. Difficile?

Edited May 7, 2009 by rpm911

[CBEMT]

Anyone have any good disinfection techniques for laryngoscopes you're using now esp. regarding C. Difficile?

Where are you sticking them that C diff. is an issue?? :blink:

[Just Plain Ruff]

Well I guess if they are so impacted and F.O.S. that it's coming out the In Hole then maybe there is a problem.

[rpm911]

Where are you sticking them that C diff. is an issue?? :blink:

Our parent hospital is on a big C. Difficile kick, and actually, I can't argue the logic. The spores can only be killed by high-level disinfection or sterilization. Hence, your glove touches an infected surface, you touch the airway bag.... The dormant spores are killed readily by soaking in Cidex, etc. But only Sterilization or Hypochlorite 2% or greater will kill the active buggers, and there are quite a few to be found!

It is said that, (forgive me for not having the source readily at hand, as I read 100 docs on the subject yesterday) as much as 75% of antibiotic related diarrhea is due to a presence of C. Diff and as much as 95% of cases of Colitis. In a contaminated house or pt. room virtually EVERYTHING that can be touched is contaminated.... rails, doorknobs, drink containers, IV clamps.

Given that it is very easily transmitted, the current recommendations are that all endoscopic, laryngoscopic, and other mucous contacting equipment receive at least high level decon. That's where it gets vague.

Short of an autoclave or disposable blades, there's not much on what's acceptable as high level decon for that type of equipment.

...but yeah, I've had a few patients that I would like to have found a new home for the scope on!

[Arctickat]

I know, I'm resurrecting a semi-dead thread, but that's what we do, right?

Just wondering, has anyone seen or used the Res-Q-Scope? I'm considering adding this to my airway kits and some experienced input would be nice.

Edited July 21, 2009 by Arctickat