Experimental Study to Develop a Method for Improving Sample Collection to Monitor Laryngoscopes after Reprocessing

BACKGROUND/AIMS: The microbiological surveillance of endoscopes and automated flexible endoscope reprocessing have been proven to be two of the most difficult and controversial areas of infection control in endoscopy. The purpose of this study was to standardize a sampling method for assessing the effectiveness of standard reprocessing operating procedures for flexible fiberoptic laryngoscopes (FFLs). METHODS: First, the sampling devices were directly inoculated with Bacillus atrophaeus spores; second, tissue non tissue (TNT) wipes were tested on artificially contaminated surfaces and on FFLs. RESULTS: Comparison of the sponges, cellulose, and TNT wipes indicated that the TNT wipes were more effective in releasing spores (93%) than the sponges (49%) and cellulose wipes (52%). The developed protocol provides a high efficiency for both collection and extraction from the stainless steel surface (87% of the spores were removed and released) and from the FFL (85% of the spores were removed and released), with relatively low standard deviations for recovery efficiency, particularly for the analysis of the FFL. CONCLUSIONS: TNT wipes are more efficient for sampling surface areas, thereby aiding in the accuracy and reproducibility of environmental surveillance.

Kinked J-tip guidewire within the tracheal lumen during retrograde intubation: A case report

Retrograde intubation is an alternative option for gaining airway access for patients with a difficult airway.We report a successful management of a kinked J-tip guidewire within a tracheal lumen with flexible fiberoptic laryngoscope in a patient with type II odontoid fracture.It is helpful to adjusting the depth of angiocatheter and handling of J-tip guidewire if J-tip guidewire does not come out into the oral cavity at the expected length during retrograde intubation.

Difficult Intubation in Post-Orthognathic Surgical Patient / 대한마취과학회지

This 17 year-old male patient had an experience of a difficult intubation problem on miniplate removal operation after orthognathic surgery, but he didn't have the same problem on a previous orthognathic surgery 1 year before. He suffers from mental retardation and speaking disability due to congenital brain damage. I think difficult exposure of the larynx was caused by the imbalance of neck muscle force and jaw instability, as result from surgery. The preoperative airway evaluation is very important because findings may dictate choice of intubation technique. A flexible fiberoptic laryngoscope may be the most useful aid to awake intubation in the patient with a known difficult airway.

Use of the flexible fiberoptic laryngoscope to change endotracheal tube / 대한마취과학회지

The fiberscope is no longer an experimental instrument, and it is a state-of-the-art technique for airway management in the operating room, recovery room, and intensive care unit. Changing the oral tube to a nasal one is often necessary if the trachea is to be intubated for a long period. A nasal tube is better tolerated by the patient, is easier to secure when the patient is moved, and is easier to attach to the respiratory care equipment. We describe three cases report changing the oral tube to a nasal one in neurosurgical pa- tient post operatively under flexible fiberoptic laryngoscope, while the interruption of venti- lation is minimized.