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• W2002291119 abstract "In our hospital, the laryngeal mask airways were unpacked after sterilisation and stored in drawers and cupboards. The tracheal tubes were removed from their sterile packs before the start of the operating lists in readiness for an emergency. KY-Jelly-soaked green swabs were used to lubricate the tracheal tubes and laryngeal masks. We investigated whether contamination of this airway equipment was a possibility. Tracheal tubes, laryngeal masks, KY-Jelly-soaked swabs and drawers and cupboards where these were stored were randomly sampled from four operating theatres and were subjected to appropriate microbiological cultures (Fig. 6). The airway equipment and the storage sites sampled. Bacterial growth representing skin and environmental flora was obtained from all the laryngeal masks, tracheal tubes, drawers, shelves and green swab, except for one tracheal tube (Table 3, Fig. 7). Broth bottles show turbidity due to bacterial growth from tracheal tubes, except the one marked by an arrow, and contact plate showing bacterial colonies from a laryngeal mask. The manufacturers of laryngeal masks recommend that these should be sterilised after each use but there is no advice about their storage. Tracheal tubes come in sterile sealed packs and it is recommended that these should be unpacked just prior to use. The Association of Anaesthetists of Great Britain and Ireland in their recent booklet ‘Infection Control in Anaesthesia’[1] does not mention storage practice after sterilisation of laryngeal masks. Similarly, the Royal College of Anaesthetists does not provide any such guidance. However, both the Australia and New Zealand College of Anaesthetists [2] and the Hong Kong College of Anaesthetists [3] clearly recommend that laryngeal masks as well as tracheal tubes and nasal and oropharyngeal airways should be kept sterile until used. Stone et al. [4] have described transient bacteraemia after airway manipulation with clean laryngeal masks and tracheal tubes. In this study, the bacteria isolated represented patients' resident flora. Brimacombe et al.[5] have also studied bacteraemia following insertion of laryngeal mask airways in 100 fit patients, of which four blood cultures were positive. These studies suggest that airway manipulation with laryngeal masks and tracheal tubes may lead to bacteria entering the bloodstream either from the patient's own flora or from the surface of the airway devices. There may be an increased risk of bacterial transmission if the devices are used un-sterile. Insertion of contaminated devices in the patient's airway could result in colonisation with new organisms. We were unable to elucidate why the practice in our department involved removing laryngeal masks from their sterile packs for storage prior to use; perhaps it was because there are no clear recommendations in this area from within the United Kingdom. Removal of tracheal tubes from their packs in readiness for use in emergency situations, whilst understandable, resulted in a large number of tracheal tubes potentially being exposed to room air and the surfaces of anaesthetic machines. Our results show that our practice resulted in significant bacterial contamination. We have changed our practice; laryngeal masks are now sterilised and then packed individually. The packs of tracheal tubes and laryngeal masks are opened just prior to use. The use of green swabs to lubricate tubes and laryngeal mask airways has also been abandoned. In addition, we feel that there is a need for clear guidelines on storage practices of laryngeal masks and tracheal tubes in the UK." @default.
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• W2002291119 date "2003-09-10" @default.
• W2002291119 modified "2023-09-24" @default.
• W2002291119 title "An evaluation of safety of storage practices of laryngeal mask airways and tracheal tubes" @default.
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• W2002291119 doi "https://doi.org/10.1046/j.1365-2044.2003.03415_20.x" @default.
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