Improvement in emergency airway equipment transport.
BACKGROUND
Airway management out of the operating room in many major institutions is often performed by teams, requiring airway providers to carry their own materials at all times. The bag containing airway equipment must be light enough to be carried easily, while containing sufficient equipment to manage airways in various settings. Additionally, transport of the bag throughout the hospital raises concern about transmission of infection. We hypothesized that a new system of multiple, smaller bags would decrease weight, facilitate prompt location of equipment, and reduce the risk of bags acting as fomites.


METHODS
The service purchased small, nylon laryngoscope bags with dividers to keep equipment organized. The contents of the original bag and a new replacement bag were cataloged and both bags were weighed. Fourteen clinicians working on emergency airway consults at the time of the study were timed as they searched the bags for predetermined equipment with 2 scenarios and intubated a mannequin. The surfaces of the bags were swabbed for culture.


RESULTS
Clinicians were significantly faster to locate equipment with the new compared to the original bag, with a difference of 39 s (P < .001, 95% CI 19-58 s) in the first scenario, and 22 s (P < .001, 95% CI 13-32 s) in the second. The cultures from the original bag demonstrated coagulase-negative Staphylococcus, enterococcus, Bacillus species, alpha-hemolytic Streptococcus, non-hemolytic Streptococcus, and a Staphylococcus species of a second type. The culture of the new bag after clinical use but before cleaning grew rare Aspergillosis species. The culture of the new bag after undergoing proper cleaning demonstrated no growth.


CONCLUSIONS
Exchanging a large canvas bag for several smaller nylon bags has improved the transport of emergency airway equipment, with benefits in carrying the bag, locating equipment, and reducing the transport of pathogens throughout the hospital.
Wilcox
Susan R
SR
Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston MA 02114, USA. swilcox1@partners.org
Bittner
Edward
E
George
Edward
E
Buckley
Valerie Farias
VF
Schmidt
Ulrich H
UH
D004866:Equipment Contamination / Q000517:prevention & control; D004867:Equipment Design / Q000295:instrumentation*; D004869:Equipment Safety; D006801:Humans; D017053:Infection Control; D008348:Manikins; D012121:Respiration, Artificial / Q000295:instrumentation*; D014187:Transportation of Patients