EWWWW, something doesn't seem right to me here!!

Specialties Emergency

Published

I have yet another question...

In ER yesterday, we had to intubate a patient. anyway, ater all was said and done, I called to have the blades sent for sterilization so I cuold get the crash cart put back in order. Central sterile said that they don't sterilize the blades. The ER nurses are supposed to wash them with SOAP and WATER??!

What are your thoughts on this? Isn"t it a :nono: ?? One nurse said to me, "Oh it's just the mouth, everbodys mouths are dirty." But I view this as using the same yankauer on each patient as long as you use soap and water between.. Just seems NASTY!!

b eyes

Specializes in ER, Med-surg, ICU.
I'll find out what the solution is and let you know.

I do know that the fiber optics in the blades present an issue, i.e., we don't drop them into the same "green stuff" that other used instruments go into.

Oh see, that's interesting, because central sterile told me yesterday that if I did not like the idea of just using soap and water, I COULD drop them into the "green stuff" HMMMM...

Thank you, by the way I will be looking for the solution from you.

Specializes in ER, Med-surg, ICU.
Interesting discussion--in our RSI bags and crash carts we have blades lying in the drawers open to air and also other blades in sealed sterile plastic. How's that for a conundrum??!!:rolleyes:

Had to edit to say it brings up some good points...I was wondering the other day along these same issues about using alcohol preps to cleanse ports before accessing IVs, and the new nurse in me wants to stick to always wiping ports because it is the right thing to do for the patient....however, I see in codes it does not always happen, yet I can't say it really matters during that sort of situation---I mean, if someone is getting intubated because they are dying then not wiping a port is the least of their problem.

Do I always wipe ports? Yes, that is how I practice, and I always have wipes in my pocket. Do I think the blades should be sterile? No, I do not think they need to be sterile, but they should be clean---more than soap and water clean.

Good discussion, I am looking forward to all the replies. Sometimes it is tough to reconcile reality with practice.

Our peds crash cart has sterile disposable blades. And I agree with you about if someone is dying, and wiping a port, but just think if they survive, It's just going to make their recovery that much more dificult. we don't think about that at the time though. We just think, oh please dear god, let my shaky hands guide this needle where it needs to go!! But I have seen it done that way as well and getting the heart going is always what is on our minds!!

Specializes in NICU, Infection Control.

The green stuff is probably Cidex. If you use Cidex, you need to really scrub the instrument well before you put it in the solution. It should not have saliva or blood on it.

Call your Infection Control person. I'd be willing to bet real $$ that's not the way s/he wants it done.

Specializes in ER, Med-surg, ICU.
The green stuff is probably Cidex. If you use Cidex, you need to really scrub the instrument well before you put it in the solution. It should not have saliva or blood on it.

Call your Infection Control person. I'd be willing to bet real $$ that's not the way s/he wants it done.

Sorry if this is a dumb question but, can you explain why saliva or blood should not be on the instrument before going in the Cidex?

Specializes in NICU, Infection Control.

Because the 'organic debris' can get in the way of the Cidex from killing all the germs. Cidex is a glutaraldahyde cold sterilizing solution. Before you do any sterilizing, you have to clean the item.

This is from the APIC (Association for Professionals in Infection Control) website: http://www.apic.org/AM/Template.cfm?Section=Search&section=Brochures&template=/CM/ContentDisplay.cfm&ContentFileID=2558

It's an Adobe document and I can't seem to copy and paste the pertinent part. You will have to make it bigger--125% works well.

The part that pertains to laryngoscopes is the 2nd section, semi-critical.

Specializes in ER, Med-surg, ICU.
Because the 'organic debris' can get in the way of the Cidex from killing all the germs. Cidex is a glutaraldahyde cold sterilizing solution. Before you do any sterilizing, you have to clean the item.

This is from the APIC (Association for Professionals in Infection Control) website: http://www.apic.org/AM/Template.cfm?Section=Search&section=Brochures&template=/CM/ContentDisplay.cfm&ContentFileID=2558

It's an Adobe document and I can't seem to copy and paste the pertinent part. You will have to make it bigger--125% works well.

The part that pertains to laryngoscopes is the 2nd section, semi-critical.

Thank you. And that was a great site. Answered my question.

Specializes in ICU-Stepdown.

When I was a paramedic, we had our own blades -we washed them in a soap/enzyme solution to sterilize them. This was in the '90s. But I THINK (really not sure) our facility starilzes these implements.

Specializes in ICU, ER.

All of our blades are sterilized and packaged until used.

Specializes in NICU, Infection Control.

I would tell the Central Supply person that JACHO would expect proceedures recommended/endorsed by APIC to be followed.

I think Central Supply/Sterile Processing has an Association or Society of their own, but don't know what it's called. It probably has standards also.

Dental instruments are sterilized, would you go to a dentist that just washed them with soap and water? Yuck. I don't care that it is no longer sterile after it touches MY mouth, I just don't want anything left over from the last patient!

Also, everyone has a different standard when it comes to cleaning, right? One nurse may scrub and scrub until it is almost sterile, while another may just wipe it down.

Heck, why bother? What some phlegm between friends? :uhoh21: :uhoh3: :devil: :trout: :( :barf01: :barf02: :barf02: :barf02: :barf01: :barf01: :barf01:

I totally agree with the scrubbing off of the debris and then using Cidex. Probably best to go over to disposable blades. In this day and age, I can't imagine using a blade on more than 1 patient.

We don't sterilize ours...we just scrub the heck out of them with a betadine scrub and rinse them off. I'm not sure why we don't sterilize though...maybe it's a cost thing...don't want to have to keep more than one set of blades around.

OK I have to admit this caught my eye. And after reading everyones replys thus far I must agree with the others. When your in a life or death situation does it really matter. I do see the point you are trying to make however, as long as they are clean. They are not stored in sterile wraping anyways.

This Is a little gross when you think of it. :uhoh3:

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