anaesthetic query

RE: anaesthetic query

Lindsey Edwards — Fri, 26 Oct 2018 21:51:01 GMT

A groomers helper/frame and straps could suspend above table and feed circuits through? I use a similar frame (over table drip stand) for suspending patients head if examining throat or occasionally if intubating single handed - only need to open lower jaw/tongue with one hand and intubate with the other

RE: anaesthetic query

Alison Clare Hickman — Thu, 25 Oct 2018 01:08:05 GMT

Lindsey Edwards

I wasn't as clear as I could be... Dunking or soaking together with cleaning by cloth and brush to dissolve/remove debris etc. Agitation and rinsing... and so on. The usual efficient and effective cleaning routines deployed by a keen nurse to achieve sparkling, theatre-worthy, cleanliness for equipment/instruments.

Agree has many surfaces. Agree takes a little bit of effort to clean but, imo, not massively fiddly at all if using a flexibly stranded brush and a cloth...

Certainly a small table clamp with less surfaces would likely be an easier clean though. An autoclaveable one even better! Please will you let me know if you find one / invent one / repurpose something. Am always on look out for tips! Thanks.

RE: anaesthetic query

Lindsey Edwards — Wed, 24 Oct 2018 19:19:06 GMT

[quote user="Chris Geddes"]

Villagevet - I've not had feedback from users about it being difficult to disinfect. Admittedly I haven't used it in a clinic myself, but the head could go in a low temp autoclave if you wanted. I think most people wash the whole thing (including tripod) in Milton or similar. Probably easier to disinfect than beanbags or whatever other alternative is used?

Chris

[/quote]

it looks to have MANY grooves/channels and irregular surfaces to accumulate biofilm and getting a brush to mechanically clean will be seriously time consuming - dunking in any sort of cold sterilant/antiseptic will merely clean the dirt/blood/secretions etc and also many plastics and rubber do not like harsh sterilants

I try and keep circuits as parallel as possible to prevent gravity from pulling or dislodging them, occasionally tie in to underblanket with towel clamps if it won't behave!

A holder clamped onto table sounds interesting though

RE: anaesthetic query

Alison Clare Hickman — Wed, 24 Oct 2018 15:47:34 GMT

Bob Russell - hiya, I've used the circuit holder as depicted by Rob Loxley - as a nurse and when monitoring anaesthetics.

http://docsinnovent.com/products/product/d-grip-tube-holder

Using it as a free standing unit works very well (no pole required). Cleaning - it's light, not huge and very easy to handle so it can therefore be dunked in disinfectant in a sink/bowl/bucket etc and/or use a cloth/brush to clean in and around it as appropriate. Is sturdy, bendy, stable and I love it. I should have liked to have had something like this years ago to stop the circuits disappearing off the op table/having to use sandbags and so on!

Hope this helps you decide

RE: anaesthetic query

Bob Russell — Wed, 24 Oct 2018 14:09:24 GMT

We don't have a suitable pole so that one is not going to work I am afraid.

I have been looking at the clamp type used in human hospitals but still undecided.

RE: anaesthetic query

Chris Geddes — Wed, 24 Oct 2018 14:04:55 GMT

Hi Bob,

As they take up a bit of space, some people wrap the legs round a nearby horizontal or vertical pole - see pic for example.

Chris

RE: anaesthetic query

Bob Russell — Wed, 24 Oct 2018 13:09:40 GMT

We are discussing whether to get one of these but they appear to take up quite a lot of space of the table.

Perhaps we need a version that clamps on the end of the table.

We have been changing a lot of things at the same time so i admit I am hating the theatre at the moment. Too set in my ways apparently!

RE: anaesthetic query

Chris Geddes — Wed, 24 Oct 2018 11:01:06 GMT

In what way do you think it could be simplified Nicola?

Chris

RE: anaesthetic query

Rob Loxley — Tue, 23 Oct 2018 20:13:24 GMT

[quote user="Nicola M"]Someone really over-thought that design![/quote]

It's a bit of plastic and rubber attached to a Gorillapod tripod?

RE: anaesthetic query

Thomas Johnson — Tue, 23 Oct 2018 17:06:52 GMT

[quote user="Nicola M"]

[quote user="robloxley"]

[quote user="patrick murphy"]sorry, I only wanted a plastic circuit holder, like the one that Medline does, in US, not UK. just to assist in holding circuit in better manner while in use[/quote]

One of these? http://docsinnovent.com/products/product/d-grip-tube-holder

[/quote]

Someone really over-thought that design!

[/quote]

We've got one and I really like it, the only problem is that the clear plastic of the upper part has cracked.

RE: anaesthetic query

Nicola Cole — Tue, 23 Oct 2018 15:26:03 GMT

[quote user="robloxley"]

[quote user="patrick murphy"]sorry, I only wanted a plastic circuit holder, like the one that Medline does, in US, not UK. just to assist in holding circuit in better manner while in use[/quote]

One of these? http://docsinnovent.com/products/product/d-grip-tube-holder

[/quote]

Someone really over-thought that design!

RE: anaesthetic query

Lindsey Edwards — Tue, 23 Oct 2018 14:23:56 GMT

they look like a nightmare to disinfect thoroughly!

RE: anaesthetic query

Chris Geddes — Tue, 23 Oct 2018 13:56:35 GMT

[quote user="robloxley"]

[quote user="patrick murphy"]sorry, I only wanted a plastic circuit holder, like the one that Medline does, in US, not UK. just to assist in holding circuit in better manner while in use[/quote]

One of these? http://docsinnovent.com/products/product/d-grip-tube-holder

[/quote]

Haha!

If you were looking for the D-grip as Rob kindly points out...I'm not clear if you're based in UK or US from what you say...but they are available from Millpledge in GB, Duggan in NI and ROI, and Jorvet in the US.

Chris

RE: anaesthetic query

Rob Loxley — Tue, 23 Oct 2018 13:30:57 GMT

[quote user="patrick murphy"]sorry, I only wanted a plastic circuit holder, like the one that Medline does, in US, not UK. just to assist in holding circuit in better manner while in use[/quote]

One of these? http://docsinnovent.com/products/product/d-grip-tube-holder

RE: anaesthetic query

patrick murphy — Tue, 23 Oct 2018 12:56:18 GMT

sorry, I only wanted a plastic circuit holder, like the one that Medline does, in US, not UK. just to assist in holding circuit in better manner while in use. sorry.

RE: anaesthetic query

Chris Geddes — Tue, 23 Oct 2018 10:05:35 GMT

Michael, my post was not intended to be inflammatory or critical, trying to be helpful.

I'm not aware of any evidence supporting putting a circuit in a drawer rather than hung on a wall, but I haven't looked for it as it seems to me to be common sense - when it's suggested to most people they seem to see the logic and go with it. I don't know about folklore but it is written in various texts and I believe for certain inspections it's not allowed to have ET tubes hanging on walls for the same reason. Drawers tend to be cheap and readily available and so not a lot of justification needed?

Interesting that circuits are labelled as "semi" disposable. I'll look into them being reused in people, I do find that surprising. Wouldn't like to have a used one myself.

EDIT - just spoke to human anaesthetist. You're right, sometimes they are re-used, sometimes for a day's patients, sometimes for a week's patients, but then they do use filters (NEVER re-used, link below) on both patient and machine side (link below), and they have procedures for sterilising and auditing (swabbing and culturing etc).

https://www.intersurgical.com/products/airway-management/breathing-filters

RE: anaesthetic query

Michael Woodhouse — Tue, 23 Oct 2018 09:52:27 GMT

[quote user="Chris Geddes"]Best to store in a drawer away from airborne bacteria and dirt once spun to remove water droplets and hung somewhere clean until dry.[/quote]

C'mon, evidence based medicine, can you back that up? I would agree daft hung next to the dental machine aerosol but generally in a corner or on the back of a door. Anything suggesting a draw is better?

Big believer in best practice but things like this get made up by someone once, and it becomes somehow enshrined in veterinary folklore and I really don't like that.

[quote user="Chris Geddes"]Although of course technically they're single use.[/quote]

The ones we get are 'semi disposable'. They reuse them in humans and I believe they were reclassified as such so they can be re-used in the human hospital environment.

https://www.jakmarketing.co.uk/semi-disposable-ayres-t-piece-circuit

https://www.eickemeyer.co.uk/Anaesthesia-and-Critical-Care/Anaesthesia-Circuits/Anaesthetic-Circuit-Parallel-LACK-Semi-Disposable.html

RE: anaesthetic query

Chris Geddes — Tue, 23 Oct 2018 09:44:14 GMT

I presume you're using the holder to dry the circcuit rather than store it? Best to store in a drawer away from airborne bacteria and dirt once spun to remove water droplets and hung somewhere clean until dry. Although of course technically they're single use.

RE: anaesthetic query

Michael Woodhouse — Mon, 22 Oct 2018 21:03:35 GMT

coat hooks