When I went to medical school, I was taught that asepsis had its beginnings with Oliver Wendell Holmes, Lord Joseph Lister, and Ignaz Semmelweis. Holmes introduced the concept that puerperal sepsis was spread from patient to patient by physicians. Lister developed the concept that surgical infection was of bacterial origin. Semmelweis proved that childbed fever was transmitted on the contaminated hands of the attendant. In 1846 he effectively used a chloride as an antiseptic for the first time.

Moreover, Semmelweis, on hearing of the death of Professor Kolletschka following a finger pinprick by a scalpel that had been used in an autopsy, noted that the symptoms and outcome were identical to puerperal sepsis. Thus, he established that “cadaverous particles” had lethal potential.

Many new medical devices have been introduced into the market over the last two decades with the aim of improving medical care. Recently, a new device, Trach Care’”, has been introduced by Ballard Medical Products. device has been designed to allow endotracheal suctioning of intubated patients on ventilatory support without having to disconnect the patient from the ventilator.

‘The Trach Care’” device has three major components. The T-piece is the component nearest the patient. It has a limb for connection to the endotracheal tube or tracheos-torny, a limb for connection to the ventilator, and a limb for introduction of the catheter. The remaining limb is covered by a plastic cap. On the limb through which the catheter is introduced, there is a port for infection of irrigation fluid. The second component is the catheter with its protective sheath. The third component, a control valve, is connected to the opposite end of the catheter and sheath. Opposite the insertion of the catheter on the control valve there is a port for connection to the wall suction tubing. When the control valve is opened, the vacuum from the wall suction tubing is applied to the catheter. The control valve may be locked in the “off position. When the Trach Care™ device is placed into the ventilator circuit, the trachea can be suctioned without interruption of ventilatory support.