Latex-free reservoir bags: exchanging one potential hazard for another

The reservoir bag on the anaesthetic breathing circuit is a safety feature that can protect the patient. It is highly distensible, pressures within the breathing circuit rarely exceeding 3.9 kPa (40 cmH2O) even when the adjustable pressure-limiting valve is inadvertently left closed. In providing a safe latex-free environment in our anaesthetic rooms, the traditional latex rubber reservoir bag is substituted by a latex-free one. To investigate the safety features of several latex-free reservoir bags already in use in our hospital, we assessed the in-circuit pressures obtained at stepped fresh gas flows using a lung simulator. Four out of five of the latex-free bags exceeded pressures of 4.4 kPa (45 cmH2O), raising the possibility that, in trying to avoid an occupational hazard, we might be compromising patient safety. We found that, of the five latex-free systems we tested, only the Intersurgical complete respiratory system provided an adequate safety mechanism for the patient and thus did not potentially compromise patient safety.