Hostname: page-component-848d4c4894-5nwft Total loading time: 0 Render date: 2024-05-13T08:27:22.704Z Has data issue: false hasContentIssue false
  • English
  • Français

Disposable laryngoscope blades do not interfere with ease of intubation in scheduled general anaesthesia patients

Published online by Cambridge University Press:  11 July 2005

M. Galinski ,
F. Adnet ,
D. Tran ,
Z. Karyo ,
H. Quintard ,
D. Delettre ,
E. Lebail ,
B. Guignard ,
C. Lebrault  and
M. Chauvin
M. Galinski
Affiliation:
Avicenne Hospital, Samu 93 – UPRES UA 34-09, Bobigny cedex, France
F. Adnet
Affiliation:
Avicenne Hospital, Samu 93 – UPRES UA 34-09, Bobigny cedex, France
D. Tran
Affiliation:
Ambroise Paré Hospital, Department of Anaesthesiology, Boulogne-Billancourt, France
Z. Karyo
Affiliation:
Ambroise Paré Hospital, Department of Anaesthesiology, Boulogne-Billancourt, France
H. Quintard
Affiliation:
Ambroise Paré Hospital, Department of Anaesthesiology, Boulogne-Billancourt, France
D. Delettre
Affiliation:
French Ministry of Health, Departmental Nosocomial Infections Warning Corresponding, Moulins cedex, France
E. Lebail
Affiliation:
Ambroise Paré Hospital, Department of Anaesthesiology, Boulogne-Billancourt, France
B. Guignard
Affiliation:
Ambroise Paré Hospital, Department of Anaesthesiology, Boulogne-Billancourt, France
C. Lebrault
Affiliation:
Ambroise Paré Hospital, Department of Anaesthesiology, Boulogne-Billancourt, France
M. Chauvin
Affiliation:
Ambroise Paré Hospital, Department of Anaesthesiology, Boulogne-Billancourt, France
Get access

Extract

Summary

Background and objective: Intubation of the trachea has been a risky cross-contamination procedure over the past decade because no perfect decontamination procedures exist. Infectious agents found on laryngoscopic devices have the potential for devastating spread of the human immunodeficiency virus, hepatitis viruses B and C and transmissible non-conventional agents. The purpose of this prospective observational study was to assess the quality of endotracheal intubation with disposable laryngoscope blades, under normal intubating conditions.

Methods: Anaesthetists were asked to complete daily questionnaires regarding the difficulty of intubation experienced using the Vital View® disposable laryngoscope blade (Vital Signs Inc, Totowa, NC, USA). The choice of the type of blade (conventional or disposable blade) for the first attempt at intubation depended only on the operating room assignment. Glottic visualization during laryngoscopy was assessed by the modified Cormack and Lehane classification. Difficult tracheal intubation was evaluated by the intubation difficulty scale (>5, procedure involving moderate to major difficulty).

Results: The anaesthetic staff recorded 219 intubations. One hundred-and-nineteen of first attempts at laryngoscopy were with disposable blades (DB group) and another 100 with conventional blades (CB group). There were no significant differences between the two groups for Cormack and Lehane score 3, for intubation difficulty scale scores >5 and for intubation difficulty scale score 0. There were 12 blade changes before successful intubation.

Conclusions: In routine use, the Vital View® disposable laryngoscope blade appears to be an efficient device because it does not modify the ease of endotracheal intubation in most cases. Nonetheless, it may be advisable to maintain conventional laryngoscopes in reserve for difficult intubations.

Keywords

ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES AND EQUIPMENT CATEGORY, equipment and supplies, disposable equipmentINTUBATION, INTRATRACHEAL
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 9 , September 2003 , pp. 731 - 735
Copyright
© 2003 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Phillips RA, Monaghan P. Incidence of visible and occult blood on laryngoscope blades and handles. AANA J 1997; 65: 241–246.Google Scholar
Morell RC, Ririe D, James RL, Crews DA, Huffstetler K. A survey of laryngoscope contamination at a university and a community hospital. Anesthesiology 1994; 80: 960.Google Scholar
Beamer JER, Cox RA. MRSA contamination of a laryngoscope blade: a potential vector for cross infection. Anaesthesia 1999; 54: 1010–1011.Google Scholar
Foweraker JE. The laryngoscope as a potential source of cross infection. J Hosp Infect 1995; 29: 315–316.Google Scholar
Neal TJ, Hughes CR, Rothburn MM, Shaw NJ. The neonatal laryngoscope as a potential source of cross-infection. J Hosp Infect 1995; 30: 315–317.Google Scholar
Abramson AL, Gilberto E, Mullooly V, France K, Alperstein P, Isenberg HD. Microbial adherence to and disinfection of laryngoscopes used in office practice. Laryngoscope 1993; 103: 503–508.Google Scholar
Hill AF, Zeidler M, Ironside J, Collinge J. Diagnosis of new variant Creutzfeldt–Jakob disease by tonsil biopsy. Lancet 1997; 349: 99–100.Google Scholar
Bazin JE, Sifreu A, Traore O, Laveran H, Schoeffler P. Laryngoscope. Evaluation d'un dispositif de prévention de la contamination des lames. Ann Fr Anesth Réanim 1999; 18: 499–502.Google Scholar
Asai T, Uchiyama Y, Yamamoto K, Johmura S, Shingu K. Evaluation of the disposable Vital View™ laryngoscope. Anaesthesia 2001; 56: 342–345.Google Scholar
Cormack RS, Lehane J. Difficult tracheal intubation in obstetrics. Anaesthesia 1984; 39: 1105–1111.Google Scholar
Adnet F, Borron SW, Racine SX, et al. The intubation difficulty scale (IDS): proposal and evaluation of a new score characterizing the complexity of endotracheal intubation. Anesthesiology 1997; 87: 1290–1297.Google Scholar
Casagrande JT, Pike MC, Smith PG. An improved approximate formula for calculating sample sizes for comparing two binomial distributions. Biometrics 1978; 34: 483–486.Google Scholar
Williams KN, Carli F, Cormack RS. Unexpected, difficult laryngoscopy: a prospective survey in routine general surgery. Br J Anaesth 1991; 66: 38–44.Google Scholar
Adnet F. In: Adnet F, ed. Contrôle des Voies Aériennes en Urgences. Paris, France: Arnete 1999: 1–16.
Adnet F, Racine SX, Borron SW, et al. Survey of tracheal intubation difficulty in the operating room: a prospective observational study. Acta Anaesthesiol Scand 2001; 45: 327–332.Google Scholar
Butler PJ, Dhara SS. Prediction of difficult laryngoscopy: an assessment of thyromental distance and Mallampati predictive tests. Anaesth Inten Care 1992; 20: 139–142.Google Scholar
Benson K, Hartz AJ. A comparison of observational studies and randomized, controlled trials. N Engl J Med 2000; 342: 1878–1886.Google Scholar
Maroudy D, Brosseau B, Planesse Y. Lames de laryngoscope, stérilisation, désinfection ou usage unique. Oxymag 2000; 53: 5–8.Google Scholar
Société Française d'anesthésie et de réanimation. Intubation difficile. Ann Fr Anesth Réanim 1996; 15: 207–14.
Janssens M, Hartstein G. Management of difficult intubation. Eur J Anaesthesiol 2001; 18: 3–12.Google Scholar
Circulaire DGS/DH n°100 du 11 décembre 1995 relative aux précautions à observer en milieu chirurgical et anatomo-pathologique face aux risques de transmission de la maladie de Creutzfeld–Jakob.
Circulaire DGS/5C/DHOS/E2/2001/138 du 14 mars 2001 relative aux précautions à observer lors de soins en vue de réduire les risques de transmission d'agents transmissibles non-conventionnels.
Comité Technique des Infections Nosocomiales. Désinfection des dispositifs médicaux en anesthésie et en réanimation. Ed: Ministère de la santé, de la famille et des personnes handicapées. Direction de l'hospitalisation et de l'organisation des soins. Direction générale de la santé.
Spaulding EH. Chemical disinfection and antisepsis in the hospice. J Hosp Res 1972; 9: 5–31.Google Scholar
Maroudy D, Brosseau B. Lames à usage unique, aspects économiques. Oxymag 2000; 53: 11–12Google Scholar