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 ICU, SDU, OR, RR, Ortho, Hospice RN.

I dunno why but reading whether or not blades should be sterilized versus cleaned with soap and water made my tummy hurl.. LOL.. I guess if I was the one being intubated just revive me please but hmmmmm I may carry my own around with me LOL;)

Specializes in NICU, Infection Control.

Physically cleaning the blades and then placing them in Cidex for the recommended time (2 hours, I think) cold sterilizes them. Then place them in a clean bag (the type you would normally use for steam sterilization), and then into the crash cart or where ever you keep them.

Dentists for years didn't think they had to sterilize their equipment--until there was a horrendous outbreak of AIDS traced back to one particular dentist.

If your facility is not processing stuff according to some published standard (like APIC), I sure hope Risk Management knows so they can start saving up for one killer lawsuit.

I know, I know, "anything goes in a life or death emergency", but if the pt survives and then acquires Hep B, C, or some other potentially lethal virus, the hospital can expect to get sued.

Specializes in Emergency Room.
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:

Not picking on you, but I wanted to respond to the premise here.

In a code/resus situation, I don't sterilize med ports, often don't clean the skin as I should before IV insertion. That is, to me, acceptable. I can't

pre-clean the IV ports and have them ready and "sterile" just in case the pt codes.

We can, however, have sterile blades available for intubation. It isn't like we are rushing to grab the nearest set of blades that are dirty and don't have time to clean them. If that's the case then please tube me with dirty blades. But if the question is not wanting to take the time while the ED is quiet to clean the blades correctly (meaning the CS people, not the OP) then that is just laziness and nuts.

That's just my opinion, but it is the difference between preparation and chaos.

while many of us(myself included) are going "ewwwwww" over this, a thought I just had - while a field or ER intubation is usually a life or death situation, what are the protocols on blades used in the OR when one is under for general anesthesia?

Specializes in cardiology-now CTICU.

interesting discussion guys. at my facility we send the blades down for sterilization but they always come back to us in bags that are open. :uhoh3:

oh well, at least they started out sterile and will remain clean. i agree with the previous poster who brought up different people's different standards of clean. i would think that if the facility has the policy of handwashing blades, there would be a written policy on what solution, how long to soak/scrub to avoid these variances. if not, maybe the OP can spearhead the development of one!

Specializes in Emergency Dept, ICU.

Yeah I would deff agree that you would need to make an incident report on that and have a little consult w/ sterile processing.

Wow, I've never even thought about it. We use sterile disposable blades in the ER and on the ambulance. However, in the ER the OPA's lay on the most disgusting shelf. It's not so bad when their bagged but when you grab one and their in the open, you're not so sure. I have actually seen someone wipe one off, write the size on the side with a sharpie, and stick up for the next patient. So much for clean and disposable.:uhoh3:

Specializes in Emergency.

ED RNs normally place them in a cidex solution so that they never leave the department............i'm sure this is for cost effectiveness......I work in a 58 bed ED.

they arent necessarily have to be sterile. in an emergency, sterility will have to take a back seat or two to preserve the patient's life

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

The mouth may not be sterile, but the blades still need to be sterilized, not to be kept sterile afterwards, but to go through the sterilizing process!

We wash ours with an instrument cleaning solution, scrub brushes and water first, then were sterilize them.

JACHO would be very interested to hear about that. ;)

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
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.

They do. And i can probably dig up the literature that states how blades should be cleaned. But i'll do that later, once i get some sleep.

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

Here's 2 articles to chew on:

https://www.aorn.org/journal/2005/decci.htm (scroll down)

http://www.infectioncontroltoday.com/articles/412/412_551cover.html.html

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