Healthcare is constantly evolving and as we become more sophisticated in our infection control practices we have learned how significant the potential for cross-contamination is from both laryngoscope blades and handles. Since it was shown that prions associated with vCJD were detectable in the lymphoid tissue of asymptomatic carriers of the disease, including the tonsils1, it has become common practice to use single use laryngoscope blades, as recommended by the AAGBI2.
The AAGBI Safety Guideline on Infection Control in Anaesthesia2 makes a number of recommendations related to laryngoscopes. These include recognising that “Laryngoscope handles also become contaminated with micro-organisms and blood during use, and they should be washed ⁄ disinfected and, if suitable, sterilised by SSDs after every use”, that “single-use disposable equipment will remove the difficulties of re-use and decontamination procedures. The use of such equipment is to be encouraged.” And goes on to recommend that "There are an increasing number of inexpensive, single use laryngoscope blades and handles of improving design available, and their use is to be encouraged.”
As a sterile single use laryngoscope, BritePro Solo removes the risk of cross-contamination, while offering the user excellent in-use performance.
The death of a UK patient in 2011 that was traced to the use of a contaminated laryngoscope resulted in an MHRA alert3 which highlighted the AAGBI Infection Control in Anaesthesia Guidelines and the need for appropriate decontamination between each patient.
Several studies show that impregnated wipes are ineffective in decontaminating laryngoscope handles, and that the handles of “patient ready” laryngoscopes where heavily contaminated.
One study4 showed that one or more bacteria wet isolated from 86% of handles tested that had been sprayed with chlorhexidine spray or wiped down with detergent or alcohol wipes and allowed to dry after each use.
Another study5 demonstrated that 75% of handles tested were positive for bacterial contamination despite being prepared for use with either a hospital germicide or disposable towels that came pretreated with iisobutyl-phenoxy-ethoxy-ethyl-dimethyl-benzyl ammonium chloride and isopropanol.
These studies clearly show that wiping down laryngoscope handles between patients is not effective and patients remain at risk. Sterile packed single use BritePro Solo is not only convenient, but also offers maximum patient safety.
The cost reprocessing and sterilising a reusable laryngoscope by a SSD, as recommended in the AAGBI Infection Control Guidelines2, will vary from hospital to hospital. However, the sterilisation process involves many steps, is labour intensive, and can be unreliable. There is the cost of additional instruments that need to be purchased to ensure that instruments are available when required while others are passing through the system, or simply to replace what gets lost6. The cleaning, disinfection and sterilisation can also damage components and lead to reduced functionality7 or failure at point of use, as well as incurring a cost of repair or replacement.
BritePro Solo is always ready for use - simply open the sterile pack when required. Reliability is guaranteed as Solo is new every time and the light can be tested in-pack before opening.
BritePro Solo is available with Macintosh blade sizes 1-4 and Miller blade sizes 00-4. However, Solo handles are available individually, which can then be matched to any compatible fibre optic (“green spec”) blade. The size and shape of the handle is not determined by the size of the battery, and its unique design makes BritePro Solo suitable for all patients, with the option of BritePro Solo Mini for neonates and small infants.
BritePro Solo has an advanced LED light that produces a bright natural white light that provides excellent tissue visualisation and differentiation. In tests, Solo was 4 times brighter than equivalent laryngoscopes.
BritePro Solo provides over 1 hour of continuous light that can be turned on and off by engaging and disengaging the blade. Even in the most challenging cases you will have ample battery life and illumination to intubate your patient.
Surprisingly, BritePro Solo is more environmentally friendly than utilising reusable laryngoscope blades and handles. Reusable laryngoscopes undergo cleaning and disinfection using harmful detergents and chemicals as part of the sterilisation process, which will end up entering into the environment. Additionally, transport, packaging, heat and energy use also increase the negative environmental impact. BritePro Solo can be included in any existing hospital recycling programme. Even if not recycled, the lightweight construction and use of non-hazardous materials means a smaller environmental footprint than the process associated with reprocessing reusables.
Laryngoscope handles are a known source of contamination and wiping down a reusable handle between case has been shown to be ineffective, with between 86%4 and 75%5 of patient ready handles positive for bacteriological contamination.
The AAGBI Guidelines on Infection Control2 clearly recommend that handles are either “sterilised by SSDs after every use” or that “single-use disposable equipment will remove the difficulties of re-use and decontamination procedures. The use of such equipment is to be encouraged.”
Using BritePro Solo not only means a new laryngoscope each time, reliable functionality and great convenience, but, as the AAGBI states in their Guidelines2; “will remove the difficulties of re-use and decontamination procedures. The use of such equipment is to be encouraged.”
There are many drawbacks to sterilising reusable handles: Significant capital outlay to increase inventories to accommodate the reprocessing cycle time and the process of sterilisation can result on significant failure rates. Hospitals that reprocess reusable handles report failure rates of up to 30% of the handles subjected to reprocessing.6 Increased failure rates of both conventional and fibre optic laryngoscope handles reduces significantly the success rate of “first attempt intubations” and can cause a “simple intubation” to quickly become a “difficult intubation”. 8
All BritePro Solo products are 100% sterile packed.
BritePro Solo’s packaging is designed to allow the light to be tested easily without breaking the sterile seal.
BritePro Solo is designed exclusively for single use. Once used it should be disposed of in accordance with local procedures and protocols for infected clinical waste.
|1||Hill et al. Investigation of variant Creutzfeldt-Jakob disease and other human prion diseases with tonsil biopsy samples. Lancet 1999 Jan 16;353|
|2||Gemmell L, et al AAGBI Safety Guideline: Infection Control in Anaesthesia. Anaesthesia (2008) 63; 1027-36|
|3||MHRA Medical Device Alert. Medicines and Healthcare products Regulatory Agency (2011) 27 September|
|4||Williams D, Dingley J, Jones C, Berry N. Contamination of Laryngoscope Handles. Journal of Hospital Infection (2010) 74, 123-128|
|5||Call T, Auerbach F, Riddell S, Kiska D, Thongrod S, Tham S, Nussmeier N. Nosocomial Contamination of Laryngoscope Handles: Challenging Current Guidelines. International Anesthesia Research Society (2009) Vol. 109, No. 2|
|6||Vasquez C. Cost of Reprocessing Reusable Laryngoscopes. Glendale Adventist Hospital (2012)|
|7||Nishiyama T. Changes in the Light Intensity of the Fiberoptic Laryngoscope Blade by Steam Sterilization. International Anesthesia Research Society. Vol. 104, No. 4, April 2007|
|8||Amour J, Le Manach Y, Borel M. Comparison of Single-use and Reusable Metal Laryngoscope Blades for Orotracheal Intubation during Rapid Sequence Induction of Anesthesia. Anesthesiology (2010) 112:325–32|