[Maintenance and disinfection of equipment necessary for airway control and mechanical ventilation]

Retention of airborne latex particles by a bacterial and viral filter used in anaesthesia apparatus

We have developed a series of laboratory tests to evaluate the efficiency of a heat and moisture exchanger filter (Pall BB25) in retaining latex particles in order to protect allergic patients during anaesthesia. Latex particles were nebulised with cornstarch as a support and collected for assay in a flask, with or without the filter integrated into the experimental circuit. With the Pall BB25 filter in the circuit, no natural latex proteins were detected by measurement of either total protein or antigenic latex proteins. The Pall BB25 filter may represent a useful means of preventing inhalation of latex particles during anaesthesia in susceptible patients.

[Technical requirements for buying a heat and humidity exchanger for ventilation during anesthesia. French Society of Anesthesia and Intensive Care]

To prevent cross infection and to improve the management of anaesthetic circuits, the French society of anesthesia and intensive care recommended the use of heat and moisture exchange filter (HMEF). Buying a HMEF needs a procedure with different steps and a product request form must delineate precise needed requirements of the device. In the absence of standardized methods to assess filtration performance, required specifications are established from both manufacturer data and scientific published studies. Proposed purchasing method and criteria help the health care workers at the time of final decision for objective comparison between the different devices on the market.

[Laryngoscope. Evaluation of a device for preventing blade contamination]

OBJECTIVE

To evaluate the efficacy and the difficulty of use of a disposable sheath which prevents the contamination of blades.

STUDY DESIGN

Prospective bacteriological, virological and clinical evaluation.

MATERIAL

A translucid cover sheath, made of polyethylene enclosing the blade of the laryngoscope, and delivered in clean, non-sterile packaging (Prolam, Péters).

METHOD

1) A control of sterility performed by setting-up a culture derived from the solution used for rinsing the device before its use. 2) An in vitro study of the effectiveness of preventing contamination of the blades by a polio virus/RT-PCR technique. 3) Clinical evaluation: after 200 orotracheal intubations by 12 anaesthesiologists and 15 nurse anaesthetists, a questionnaire on the ease of use was completed.

RESULTS

The bacteriological study of the sheats before use showed an acceptable level of contamination. The sheath was an effective barrier against poliovirus, even after 12 h of immersion. Clinically, the sheath was easily adapted over the blade of the laryngoscope in 98% of the cases. Insertion in the mouth was considered as easy in 94% of the patients. The visualization was good or excellent in 83% of the cases and in 16% of the patients, the users experienced difficulties to intubate.

CONCLUSION

The laryngoscope blade sheath is simple and easy to use, efficient and not expensive.