A comparison of the forces exerted during laryngoscopy using disposable and non-disposable laryngoscope blades

The concern that re-usable equipment may be a source of cross-infection has prompted the increased use of disposable laryngoscope blades. We conducted a study investigating the duration of laryngoscopy and the peak force generated using various laryngoscope blades. Five blades were studied: one reusable Macintosh 3 blade, one disposable metal blade and three plastic disposable blades. Sixty anaesthetists performed laryngoscopy on a mannequin using each of the five blades presented in a random order. This was then repeated with a rigid collar applied to the mannequin. The mean force applied with the collar off with the metal blades was 32.8 and 30.8 N, and with the plastic blades 37.3, 39.6 and 41.5 N, respectively (p < 0.0001). The mean force applied with the collar on with the metal blades was 30.5 and 32.5 N, and with the plastic blades 35.5, 34.9 and 31.4 N, respectively (p < 0.0001). The mean duration of laryngoscopy with the collar off for the metal blades was 5.6 and 5.4 s, and with the plastic blades 10, 7.2 and 7.5 s (p < 0.0001). The duration of laryngoscopy with the collar applied for the metal blades was 7.1 and 7.5 s, and with the plastic blades 11.8, 9.7 and 9.0 s (p < 0.0001). The use of plastic blades results in both greater peak force and duration of laryngoscopy.