One of such practices is sterilization of a blade of a laryngoscope after use for administration of anesthesia or resuscitation. I spoke to a number of anesthetists about it over years. But the practices persisted. The following chart shows the practices in different OTs.
I talked to people in different institutes. I found the practice of scrubbing and washing with water even in some corporate starred hospitals. One semi government hospital did use gluteraldehyde.
“Why do you not use gluteraldehyde?” I asked anesthesiologists.
“It is not necessary” one from a corporate hospital told me.
“We have always done it this way” another one said.
“The bulb would get damaged” another one said.
“Actually that thought never occurred to us” one said apologetically.
“There are too many patients. There are not enough laryngoscopes to go around, if we use gluteraldehyde” another one said.
In one study, out of all blades or handles without any visible blood on them after use, 20% tested positive for blood on chemical analysis. Thus the risk of transmission of nosocomial and blood borne infections from patient to patient is real when the laryngoscope is not sterilized after use. The CDC guidelines are quite clear on sterilization of laryngoscopes. Unfortunately they are just there, not necessarily read or followed. I managed to implement the technique of cleaning with povidone-iodine scrub, washing with water and disinfecting with gluteraldehyde in our operation theaters. But what about the rest of the world? If I have to undergo surgery, I will have to ask how they sterilize their laryngoscopes, amongst other things, even if it is a starred hospital, because it is manned by the same people who have passed out from places where tradition prevails.
