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3 results

  • Chapter 37 - Decontamination of Airway Equipment

  • from Section 3 - Airway Management: Organisation
  • Edited by Tim Cook, Michael Seltz Kristensen
  • Book:
    Core Topics in Airway Management
    Published online:
    03 October 2020
    Print publication:
    03 December 2020, pp 316-320

  • Summary

    Healthcare-associated infection is a global concern and imposes a huge economic burden on the health industry. Anaesthesiologists must be aware of their role in mitigating infection at the work place. This chapter looks at the potential sources and causes of infection and how an anaesthetic event may result in cross-infection. Good practices including hand-washing, decontamination of equipment and maintenance of work surfaces and anaesthetic machines between cases are described. Terminologies such as single use, single patient use, reusable equipment, decontamination and sterilisation are defined. Management of reusable components of video and direct laryngoscopes and the use, maintenance and transport of flexible optical bronchoscopes are discussed. We hope this chapter would be of use to the career anaesthesiologists and also to trainees preparing for their certificate exams.

  • A comparison of the laryngeal tube-S™ and Proseal™ laryngeal mask during outpatient surgical procedures

  • F. Zand, A. Amini, S. E. Sadeghi, M. Gureishi, A. Chohedri
  • Journal:
    European Journal of Anaesthesiology / Volume 24 / Issue 10 / October 2007
    Published online by Cambridge University Press:
    01 October 2007, pp. 847-851
    Print publication:
    October 2007
  • Background and objective

    The Laryngeal Tube Sonda® (LTS) and the ProSeal® Laryngeal Mask Airway (PLMA) are two new devices introduced for maintaining the airway during controlled ventilation under general anaesthesia. The present investigation compared their performance in a randomized controlled study.

    Methods

    One hundred ASA I–II patients, aged 18–60 yr undergoing elective minor surgery, were randomized to receive either an LTS (n = 50) or PLMA (n = 50) for airway management. After induction of general anaesthesia, the devices were inserted, its correct placement was verified and airway leak pressure was measured. Ease of insertion, quality of airway seal, fibre-optic view and postoperative pharyngeal morbidity were examined.

    Results

    There were no differences in patient characteristics for both groups. First-time and second-time success rates were comparable for both groups (86 vs. 88% and 96 vs. 98% in LTS and PLMA groups, respectively). The airway of one patient in each group could not be managed with these devices after three attempts. Time until delivery of first tidal volume for LTS and PLMA was 24.5 ± 6.9 and 28.8 ± 10.3 s. Fixation and manipulation time was 54.9 ± 15.2 and 73.2 ± 25 s, respectively (P < 0.05). Airway seal pressure (cm H2O) for LTS and PLMA was 20 ± 8.6 and 24.1 ± 10.8, respectively (P = 0.04). Patients were questioned on a variety of postoperative pharyngeal morbidities. Only hoarseness was more frequent in the LTS group.

    Conclusions

    Both devices provide a secure airway, are similar in clinical utility and are easy to insert. Better airway seal was detected in the PLMA group.

  • A simple in vitro method for the evaluation of an ultrasonic nebulizer for drug delivery to intubated, ventilated patients and the effect of nebulizer and ventilator settings on the uptake of fluid from the nebulizer chamber

  • L. Williams, G. C. Fletcher, M. Daniel, J. Kinsella
  • Journal:
    European Journal of Anaesthesiology / Volume 16 / Issue 7 / July 1999
    Published online by Cambridge University Press:
    16 August 2006, pp. 479-484
    Print publication:
    July 1999

  • Little is known about the performance of ultrasonic nebulizers during different ventilation patterns when these nebulizers are used to deliver drugs to intubated, ventilated patients. A method that enables the performance of an ultrasonic nebulizer to be evaluated is described. We used an in vitro model to examine the performance of the DeVilbiss Ultra-Neb 2000 ultrasonic nebulizer under positive pressure ventilation. Performance was measured at different rates of nebulization and under changing conditions of positive end-expiratory pressure (PEEP), inspiratory flow rate, inspiratory time and minute volume. The volume of saline nebulized was unchanged by variations in positive end expiratory pressure from 0 to 5 cm to 10 cm H2O, in minute ventilation and in inspiratory flow rate. An increase in the inspiratory time resulted in an increase in the volume of saline nebulized and this volume was greater as the power setting of the nebulizer was increased. We conclude that ultrasonic nebulizers may be affected by different patterns of ventilation and that this simple in vitro assessment of nebulizer function in an intensive care setting may be of value prior to nebulizer use.