# OPAs aren't sterile?



## Vikus (Mar 29, 2016)

How come OPAs aren't kept sterile? They're just in loops in the BLS bag, not in any sort of package.


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## DesertMedic66 (Mar 29, 2016)

Because OPAs only go in the mouth. Think about all the different non-sterile things people put in their mouths on a daily basis with no issue or complications.


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## Inspir (Mar 29, 2016)

DesertMedic66 said:


> Think about all the different non-sterile things people put in their mouths



Giggity


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## Akulahawk (Mar 29, 2016)

Vikus, the OPA only needs to be kept clean. Almost everything that people put into their mouths aren't sterile. You likely have shelves/a pantry/refrigerator/freezer full of stuff that's not sterile... that you gleefully put in to your mouth every day. The OPA doesn't break/pierce the skin nor does it go past the glottis... therefore sterility isn't necessary.


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## PotatoMedic (Mar 29, 2016)

My MAC blade is not sterile, nor is my Miguell(sp?) Forceps.  My ET tubes are but it is only a clean procedure not a sterile procedure.


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## NomadicMedic (Mar 29, 2016)

FireWA1 said:


> My MAC blade is not sterile, nor is my Miguell(sp?) Forceps.  My ET tubes are but it is only a clean procedure not a sterile procedure.


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## DesertMedic66 (Mar 29, 2016)

DEmedic said:


> View attachment 2753


You have to much time on your hands


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## redundantbassist (Mar 29, 2016)

DEmedic said:


> View attachment 2753


Post of the year award goes to...


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## Vikus (Mar 29, 2016)

DesertMedic66 said:


> Because OPAs only go in the mouth. Think about all the different non-sterile things people put in their mouths on a daily basis with no issue or complications.


True, never really thought of it that way ( and by that way, I mean with common sense ) However, and I'm sure this varies by department, those OPAs tend to stay in the bag a lot, and never really get cleaned, especially the less popular sizes. I can't help but wonder what gross, abnormal stuff is on them. From what I've seen online, many places keep OPAs in a clear box, not just in elastic loops at the sides or top of the bag.


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## akflightmedic (Mar 29, 2016)

LOL....I hail from the days when we used to rinse this stuff off and reuse it!


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## DesertMedic66 (Mar 29, 2016)

Vikus said:


> True, never really thought of it that way ( and by that way, I mean with common sense ) However, and I'm sure this varies by department, those OPAs tend to stay in the bag a lot, and never really get cleaned, especially the less popular sizes. I can't help but wonder what gross, abnormal stuff is on them. From what I've seen online, many places keep OPAs in a clear box, not just in elastic loops at the sides or top of the bag.


Ours are kept in the elastic loops inside our intubation bag.


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## NomadicMedic (Mar 29, 2016)

You haven't lived until you've rinsed puke out one of these...






And the idea of washing and reusing a laryngoscope blade almost made one of the new medics I work with gag.


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## COmedic17 (Mar 29, 2016)

Vikus said:


> True, never really thought of it that way ( and by that way, I mean with common sense ) However, and I'm sure this varies by department, those OPAs tend to stay in the bag a lot, and never really get cleaned, especially the less popular sizes. I can't help but wonder what gross, abnormal stuff is on them. From what I've seen online, many places keep OPAs in a clear box, not just in elastic loops at the sides or top of the bag.


Ours are in elastic loops. You probably come in contact with way nastier things from touching door handles and touching your face/eating.


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## MonkeyArrow (Mar 29, 2016)

Pretty much everything you do in the field is going to be clean, not sterile. As soon as you open the packaging, the item is no longer sterile anyways. If OPA insertion was to be sterile, you'd have to scrub, don a cap, mask, surgical gloves, use aseptic technique throughout, prep the mouth with betadine, etc.


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## Tigger (Mar 29, 2016)

DEmedic said:


> You haven't lived until you've rinsed puke out one of these...
> 
> And the idea of washing and reusing a laryngoscope blade almost made one of the new medics I work with gag.


All the places I work at still do this, even a large AMR operation...

#dislike.


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## COmedic17 (Mar 29, 2016)

Tigger said:


> All the places I work at still do this, even a large AMR operation...
> 
> #dislike.


Really? Ours are disposable.


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## DesertMedic66 (Mar 29, 2016)

Every now and then I'll find a metal blade inside a kit. If we use it then we will toss it. All of our restock ones are plastic. 

So really the only metal ones we still have are the blades we don't use very often


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## Tigger (Mar 30, 2016)

All the blades are reusable metal. For as far as the eye can see.


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## akflightmedic (Mar 30, 2016)

I remember having to get an emesis basin to soak my blades in some bleach for a few minutes on the rear step of the ambulance while we cleaned and finished reports. Then a little towel dry and back in the kit they go! 

Rinsing off a face mask for the BVM and don't even get me started on the C-collars....man we had some nasty ones pop up here and there from reuse!


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## ThadeusJ (Mar 30, 2016)

As a (now former) manufacturer, everyone is right in that they don't need to be sterile, but clean (but kept clean until needed).  We sold them individually bagged however this can tick off those who want rapid access to them.  Several years ago there was an incident where the OPA was used to rip through the bag (another manufacturer's product) and a small piece of the bag formed around the tip of the OPA.  When the provider bagged the patient, it blew the plastic down the airway.  So please be mindful of how you access the device.

Regarding sterile OPA's, the packaging and regulatory issues drive the price up these devices 2-3 times of non-sterile ones...so a company that places sterile OPA's on their list is costing the system a lot more than they need to spend.


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## jwk (Mar 30, 2016)

Vikus said:


> True, never really thought of it that way ( and by that way, I mean with common sense ) However, and I'm sure this varies by department, those OPAs tend to stay in the bag a lot, and never really get cleaned, especially the less popular sizes. I can't help but wonder what gross, abnormal stuff is on them. From what I've seen online, many places keep OPAs in a clear box, not just in elastic loops at the sides or top of the bag.


Y'all are lucky you don't have to deal with The Joint Commission.

They DEMAND that all our airway devices be kept clean/sterile and individually wrapped until time for use.  We used to have oral and nasal airways loose in a drawer, and disposable laryngoscope blades loose in another drawer.  No longer.  The rationale was/is that we might reach in the drawer with a contaminated gloved hand and touch more than one item at a time.  So now, airways are wrapped until needed.  Our laryngoscope blades are individually wrapped.  In theory, if we open them or (god forbid)  ET tubes or LMAs in advance, we are supposed to write the DATE and TIME on the wrapper.  For our OB setups, which always have airway supplies "open and ready", we check the ETT cuff and attach a laryngoscope blade to the handle, then close it all up in a ziplock bag, dated and timed, which according to them is good for a week.  

Freaking absurd!!!


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## Bullets (Mar 30, 2016)

Both the agnecies have i work for have pretty good relations with the local hospitals, so we can drop off anything we used and either have it directly replaced, like BVMs or NRBs, NCs ect or we can have Environmental Services take it and they will clean it, autoclave it and return it. Some stuff is shared so they just put it back into the hospital rotation. Things like metal larygnoscope blades and handles, iv pumps, and it all comes back in a vacuum sealed bag


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## Tigger (Mar 30, 2016)

jwk said:


> Y'all are lucky you don't have to deal with The Joint Commission.
> 
> They DEMAND that all our airway devices be kept clean/sterile and individually wrapped until time for use.  We used to have oral and nasal airways loose in a drawer, and disposable laryngoscope blades loose in another drawer.  No longer.  The rationale was/is that we might reach in the drawer with a contaminated gloved hand and touch more than one item at a time.  So now, airways are wrapped until needed.  Our laryngoscope blades are individually wrapped.  In theory, if we open them or (god forbid)  ET tubes or LMAs in advance, we are supposed to write the DATE and TIME on the wrapper.  For our OB setups, which always have airway supplies "open and ready", we check the ETT cuff and attach a laryngoscope blade to the handle, then close it all up in a ziplock bag, dated and timed, which according to them is good for a week.
> 
> Freaking absurd!!!


The OPAs in the ORs here are just in bins, guess the commission has not been around lately.


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## jwk (Mar 31, 2016)

Tigger said:


> The OPAs in the ORs here are just in bins, guess the commission has not been around lately.


Ah, your time will come.    As always, they have to come up with new rules and regulations and standards to justify their ongoing existence.  

Supplies not on the floor?  Check.  Supplies at least 18 inches from the ceiling?  Check.  Timeout before all procedures?  Check.  Hmmmm, what else can we find?   Ah, how about "all airways must be in an impermeable package until the moment of use".  Of course there are no studies that would indicate there is a problem, but that's not really important.  What's important is we have made a standard that must be followed.  

That's pretty much how they roll.  No rhyme or reason, no studies backing up the necessity for a standard.  Someone who sits behind a desk and has never been involved with patient care dreams up this crap.  And of course we have our "consultants" come through every few months just to see if we remember what to do.  We call those Fake-O.


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## EpiEMS (Mar 31, 2016)

ThadeusJ said:


> Regarding sterile OPA's, the packaging and regulatory issues drive the price up these devices 2-3 times of non-sterile ones...so a company that places sterile OPA's on their list is costing the system a lot more than they need to spend.



Who's buying them? Is it EMS agencies or generally non-EMS?


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## ERDoc (Apr 1, 2016)

Yeah, let's stick a sterile thing in a very non-sterile place.  Makes perfect sense to me.  I always wondered the same thing about Yankauers.  I always liked to keep one connected to the section, but stored in the packaging.  Suction is one of those things where you don't need it often but when you do you need it NOW.  Again, I was always told it had to remain sterile but no one could explain why when you were putting it somewhere non-sterile.


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## COmedic17 (Apr 1, 2016)

jwk said:


> Y'all are lucky you don't have to deal with The Joint Commission.
> 
> They DEMAND that all our airway devices be kept clean/sterile and individually wrapped until time for use.  We used to have oral and nasal airways loose in a drawer, and disposable laryngoscope blades loose in another drawer.  No longer.  The rationale was/is that we might reach in the drawer with a contaminated gloved hand and touch more than one item at a time.  So now, airways are wrapped until needed.  Our laryngoscope blades are individually wrapped.  In theory, if we open them or (god forbid)  ET tubes or LMAs in advance, we are supposed to write the DATE and TIME on the wrapper.  For our OB setups, which always have airway supplies "open and ready", we check the ETT cuff and attach a laryngoscope blade to the handle, then close it all up in a ziplock bag, dated and timed, which according to them is good for a week.
> 
> Freaking absurd!!!


We live in a world where it's common practice to put other people's genitals in your mouth, but people are scared of non-sterilized medical equipment...... Hm.


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## akflightmedic (Apr 1, 2016)

HA HA HA CO!! I had a joke earlier but refrained from it....basically a picture of a banana after it has started to brown "You will not eat this, however you will do this..."


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## Bosco836 (Apr 16, 2016)

Vikus said:


> How come OPAs aren't kept sterile? They're just in loops in the BLS bag, not in any sort of package.


They have to be sterile around here per our ministry equipment standards - screen shot attached for the exact requirements.


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## usalsfyre (Apr 19, 2016)

jwk said:


> Ah, your time will come.    As always, they have to come up with new rules and regulations and standards to justify their ongoing existence.
> 
> Supplies not on the floor?  Check.  Supplies at least 18 inches from the ceiling?  Check.  Timeout before all procedures?  Check.  Hmmmm, what else can we find?   Ah, how about "all airways must be in an impermeable package until the moment of use".  Of course there are no studies that would indicate there is a problem, but that's not really important.  What's important is we have made a standard that must be followed.
> 
> That's pretty much how they roll.  No rhyme or reason, no studies backing up the necessity for a standard.  Someone who sits behind a desk and has never been involved with patient care dreams up this crap.  And of course we have our "consultants" come through every few months just to see if we remember what to do.  We call those Fake-O.


Oklahoma was like this. Amazed me....

"So it's better to let my patient aspirate while I unpackage and hook up the suction than to risk something non-sterile being put somewhere....non-sterile? Cool, I guess..."


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## NUEMT (Apr 21, 2016)

FireWA1 said:


> My MAC blade is not sterile, nor is my Miguell(sp?) Forceps.  My ET tubes are but it is only a clean procedure not a sterile procedure.


I think mcgill


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## gotbeerz001 (Apr 22, 2016)

Magill...
McGill is a fish sandwich. 


Sent from my iPhone using Tapatalk


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