Choi Jae Hyung, Cho Young Soon, Lee Jung Won, Shin Hee Bong, Lee In Kyung
Department of Emergency Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea.
J Prev Med Public Health. 2017;50(3):158-164. doi: 10.3961/jpmph.17.013.
To identify bacterial contamination rates of laryngoscope blades and handles stored in emergency crash carts by hospital and area according to the frequency of intubation attempts.
One hundred forty-eight handles and 71 blades deemed ready for patient use from two tertiary hospitals were sampled with sterile swabs using a standardized rolling technique. Samples were considered negative (not contaminated) if no colonies were present on the blood agar plate after an 18-hour incubation period. Samples were stratified by hospital and according to the frequency of intubation attempts (10 attempts per year) using the χ2-test and Fisher exact test.
One or more species of bacteria were isolated from 4 (5.6%) handle tops, 20 (28.2%) handles with knurled surfaces, and 27 (18.2%) blades. No significant differences were found in microbial contamination levels on the handle tops and blades between the two hospitals and two areas according to the frequency of intubation attempts. However, significant differences were found between the two hospitals and two areas in the level of microbial contamination on the handles with knurled surfaces (p<0.05).
Protocols and policies must be reviewed to standardize procedures to clean and disinfect laryngoscope blades and handles; handles should be re-designed to eliminate points of contact with the blade; and single-use, one-piece laryngoscopes should be introduced.
根据插管尝试频率,按医院和区域确定存放在急诊抢救推车上的喉镜镜片和手柄的细菌污染率。
使用标准化滚动技术,用无菌拭子从两家三级医院中抽取148个手柄和71个准备用于患者的镜片作为样本。如果在18小时培养期后血琼脂平板上没有菌落生长,则样本被视为阴性(未被污染)。使用χ2检验和Fisher精确检验,按医院并根据插管尝试频率(每年10次尝试)对样本进行分层。
从4个(5.6%)手柄顶端、20个(28.2%)有滚花表面的手柄以及27个(18.2%)镜片中分离出一种或多种细菌。根据插管尝试频率,两家医院和两个区域的手柄顶端和镜片的微生物污染水平没有显著差异。然而,两家医院和两个区域在有滚花表面的手柄的微生物污染水平上存在显著差异(p<0.05)。
必须审查相关规程和政策,以规范喉镜镜片和手柄的清洁和消毒程序;应重新设计手柄,以消除与镜片的接触点;应引入一次性一体式喉镜。