Laryngoscope Illuminance in a Tertiary Care Medical Center

Abstract

Twenty-eight percent of laryngoscopes in a tertiary care hospital exhibit substandard illuminance; these results corroborate the findings of our inaugural study on this subject. Consequently, our hospital is instituting changes to reduce the likelihood of substandard performance by laryngoscopes in circulation.

The illuminance of laryngoscopes at two central hospitals

“…The findings of this study were in keeping with previous studies, 5,7,14 as well as the clinical impression of poor laryngoscope illuminance. Only 8 (18.6%) laryngoscopes of the 43 tested met the ISO Standard after 10 minutes.…”

“…Studies previously conducted have shown that the light produced may be of varying intensity and that the laryngoscopes functionality may not always be reliable. [3][4][5][6][7][8] The two most common lighting mechanisms of laryngoscopes are the "bulb-on-blade" or incandescent type, and the "bulbin-handle" or fibreoptic type. The light source or bulb of an incandescent laryngoscope is mounted on the blade of the laryngoscope.…”

“…9 Studies have demonstrated the superior illuminance of the fibreoptic laryngoscopes when compared to the incandescent type. 4,7,8 Illuminance is the amount of light falling on a particular object, measured in lumens per square meter, or lux. Factors have been identified which influence the illuminance of laryngoscope light, and include the lighting mechanism (incandescent or fibreoptic), wear and tear of components due to repetitive cleaning and the battery life as well as type of battery used.…”

“…The ISO Standard 7376:2009 is in the process of being updated, with more detailed instructions on demarcating the illuminance field described in the draft version. 13 A study by Murphy et al 7 of 691 laryngoscopes found that 28% did not meet the minimum required 500 lux at 10 minutes. Baker et al 14…”

Implicações na qualidade do atendimento cirúrgico diante da não manutenção dos equipamentos hospitalares

“…Sabe-se que mais da metade dos eventos adversos com equipamentos cirúrgicos podem ser evitados com a manutenção em dia e a verificação de tais aparelhos antes de cada cirurgia pela própria equipe multiprofissional [6][7][8][9][10][11] . Apesar da ocorrência de eventos adversos durante intervenções cirúrgicas ser reconhecida como um problema de saúde pública, tal problema ainda não é reconhecido pelas instituições de saúde [6][7][8][9][10][11] . Isso se deve a deficiências na gestão organizacional, econômica e financeira das instituições, sobretudo nos países em desenvolvimento.…”