A Study of Bacterial Flora Present on Disinfected Crash Cart Laryngoscopes

Abstract

Background: Laryngoscope is an instrument to facilitate placement of endotracheal tube which finds its use both in OTs and in crash carts for emergency resuscitation of patients. The blade of the instrument comes in contact with the mucosal surface during this procedure. Yet, there is an absence of clear cut guidelines for disinfection of different parts (blade and handle) of this instrument. Materials and methods: This observational prospective study was conducted over a period of 5 months on previously used and disinfected laryngoscopes placed in the crash carts of various areas (emergency, ICUs) of our hospital. Swabs were collected from three different parts of each laryngoscope: surface of the blade (A), front part of the handle top (B), and front part of the handle's knurled surface (C). Bacterial growth and identification were noted using standard microbiological techniques. Data were entered and analyzed using standard MS Excel sheet. Results: In the study, 213 samples (71 each from A, B, C sites) were obtained from laryngoscopes from various areas of the hospital of which 32.4% were contaminated. The highest percentage of contaminated laryngoscopes belonged to Emergency department, a known high throughput area. Swabs from blades were positive in 16.9% (12/71) cases, from light in 14.08% (10/71) cases and from handle in 18.3% (13/71) cases. Among the organisms isolated, Coagulase negative Staphylococcus was the commonest (37.1%) followed by MSSA (22.9%) and MRSA (20%) from various sites of the laryngoscopes. Conclusion: A sensitization towards proper cleaning of laryngoscopes from crash carts is a must. Centralized disinfection services of all the parts of this instrument are a must for ensuring proper sterility.