Infection Prevention and Control (CAMCAH / Critical Access Hospitals)
How should we process and store laryngoscope blades?
New | October 24, 2011
According to the CDC’s Healthcare Infection Control Practices Advisory Committee (HICPAC), laryngoscope blades are “semicritical” items, which are defined as, “Items that directly or indirectly contact mucous membranes of the respiratory tract. They should be sterilized or subjected to high-level disinfection before reuse.” Read HICPAC’s document entitled Guidelines for Preventing Healthcare-Associated Pneumonia
The last page of the guideline lists laryngoscope blades as semicritical items. Recommendation IIIA1b (pages 57-58) states how semicritical items must be processed and packaged:
“Whenever possible, use steam sterilization (by autoclaving) or high-level disinfection by wet heat pasteurization at >158oF (>70oC) for 30 minutes for reprocessing semicritical equipment or devices (i.e., items that come into direct or indirect contact with mucous membranes of the lower respiratory tract) that are not sensitive to heat and moisture (see examples in Appendix). Use low-temperature sterilization methods (as approved by the Office of Device Evaluation, Center for Devices and Radiologic Health, FDA) for equipment or devices that are heat- or moisture-sensitive (307;309;310;314;315). After disinfection, proceed with appropriate rinsing, drying, and packaging, taking care not to contaminate the disinfected items in the process (308;310). CATEGORY IA”
Joint Commission surveyors will evaluate processes related to laryngoscope blades to ensure that they are safe for use on the next patient. They will check that laryngoscope blades are:
- Processed via either sterilization or high-level disinfection.
- Packaged in some way. HICPAC guidelines do not specify the manner in which laryngoscope blades should be packaged.
- Stored in a way that would prevent recontamination. Examples of compliant storage include, but are not limited to, a peel pack post steam sterilization (long-term) or wrapping in a sterile towel (short-term). Examples of noncompliant storage would include unwrapped blades in an anesthesia drawer, as well as unwrapped blades on top of a code cart.
Please note that laryngoscope handles are considered contaminated after use and must be processed prior to use on the next patient. Most manufacturers suggest a low-level surface disinfectant be utilized on the surface of the handle, but processes vary by manufacturer. As is the case with all medical devices, the manufacturer’s indications for use (IFU) must be followed. Please also check your state for additional law or regulation; we are aware of at least one state that requires additional processing.