title: Chlorhexidine to maintain cleanliness of laryngoscope handles: an audit and laboratory study.
abstract: BACKGROUND
  Laryngoscope handles are a potential vector for infection transmission and require adequate decontamination.
  
  
  OBJECTIVE
  To establish an effective cleaning regimen for laryngoscope handles.
  
  
  METHODS
  Three laboratory studies and an audit cycle.
  
  
  METHODS
  The Queen Elizabeth Hospital, King's Lynn, UK.
  
  
  METHODS
  Twenty Heine laryngoscope handles.
  
  
  METHODS
  Twenty laryngoscope handles were contaminated with microbial broth and then disinfected with chemical wipes, either using Sani-Cloth CHG 2% (chlorhexidine 2%/alcohol 70%) or Tuffie 5 wipes. This was repeated with an interval of 24 h between cleaning and contamination. A further experiment repeatedly re-contaminated the handles at varying time intervals after cleaning. The audit established the current level of contamination of laryngoscope handles within the hospital, and this was repeated following a change in cleaning protocol.
  
  
  METHODS
  Bacterial growth on agar plates was counted as the number of colony forming units.
  
  
  RESULTS
  Both Sani-Cloth CHG 2% and Tuffie 5 wipes were effective against microorganisms, including methicillin-resistant Staphylococcus aureus, immediately following wiping (P = 0.002). However, the chlorhexidine wipes also had a residual effect such that after wiping, the handle remained sterile following further contamination and this effect persisted for 24 h. Audit following the introduction of this practice showed significant improvements in the incidence and extent of contamination compared with the previous disinfection practice (P<0.002).
  
  
  CONCLUSIONS
  Decontamination with Sani-Cloth CHG 2% wipes confers additional advantages over routine autoclaving or handle disposal, due to a residual effect. Autoclaving handles may be desirable on a scheduled basis and if Clostridium difficile is encountered.
authors.affiliation: From the Department of Critical Care,The Queen Elizabeth Hospital, King's Lynn, Norfolk, UK. vhowell@doctors.org.uk
authors.forename: Victoria
authors.initials: V
authors.lastname: Howell
authors.forename: Anita
authors.initials: A
authors.lastname: Thoppil
authors.forename: Holly
authors.initials: H
authors.lastname: Young
authors.forename: Sunil
authors.initials: S
authors.lastname: Sharma
authors.forename: Mark
authors.initials: M
authors.lastname: Blunt
authors.forename: Peter
authors.initials: P
authors.lastname: Young
mesh_terms: D002710:Chlorhexidine / Q000494:pharmacology*; D003666:Decontamination / Q000379:methods*; D004202:Disinfectants / Q000494:pharmacology*; D020704:Laryngoscopes; D008485:Medical Audit
chemical_list: D004202:Disinfectants; D002710:Chlorhexidine