Have you noticed a change in your airway box recently?  No, it’s not the new McGrath or C-MAC or any other cool high-tech tool. It’s a more subtle change.

It used to be when you prepared for a sick patient to arrive that you opened up the box, grabbed a handle, and slapped on your go to metal blade to check the bulb before the patient arrived. If that patient didn’t need intubation the blade went back in the box.

Not anymore. Emerging concerns about cross-contamination  and increased scrutiny by regulatory groups has led to some changes in equipment and also a need for changes in practice. Blades need to be appropriately cleaned, sterilized and sealed; once opened they can’t be put back.

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The problem is that the traditional metal blades often had light issues related to multiple use and sterilization techniques – hence the habit all Emergency Physicians have of checking the blade prior to the arrival of a sick patient.

At my institution, the solution has been new disposable blades that are sealed and packaged (and look a lot like the old reusable metal blades) which is why the old habit is hard to break. These disposable blades rarely have bulb issues and there is more than one blade available if you happen to run across a broken one. We also added a non-sterile (not for patient use) blade to check the handle battery function.

So resist the urge to open that packaged blade and check the bulb, because now you can’t put it back in the box. Well, you can but you’ll just be asking for a JAHCO citation.

The Bundle – Clinical resources you can use

Five Things The Joint Commission Thinks You Should Know About Laryngoscopes and Endotracheal Tubes by Linda Hertzberg, M.D.