Petroleum Jelly for LMA/ETT

[Aether2000]

Setting up for first case in a surgery center that I rarely go to, reached for the lube for a LMA and noticed the only lube on the anesthesia cart in the drawer labeled lubrication was a tube of petroleum jelly that resembled our usual large tubes of water soluble lube. Around 1/4 of the petroleum jelly had been used. I threw the tube away and notified admin. I can’t imagine this on a ETT or LMA would be a good thing…..

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[secretasianman]

Gross.

 

[Toothpickwars]

Could potentially cause a lipoid pneumonia.

 

[Urzuz]

Very common is stand-alone surgery centers / ASCs as a cost saving measure (why buy single use packets when you can drive down to Costco and buy an XL tube of KY?)

I’ve seen people use petroleum jelly as well vs the water soluble jellies that we are used to.

Though I agree it’s gross, realistically there probably isn’t any harm. Plenty of ordinary people seem to have no issue reusing nonsterile tubes of jelly, even with frequent use in their mouths…

 

[jwk]

Why use anything?

 

[DocVapor]

Why use anything?

You shove LMA's in dry?

 

[pocafx]

Typically dry. Use tongue depressor

 

[NVO]

Very common is stand-alone surgery centers / ASCs as a cost saving measure (why buy single use packets when you can drive down to Costco and buy an XL tube of KY?)

I’ve seen people use petroleum jelly as well vs the water soluble jellies that we are used to.

Though I agree it’s gross, realistically there probably isn’t any harm. Plenty of ordinary people seem to have no issue reusing nonsterile tubes of jelly, even with frequent use in their mouths…

The VA Im at has 1 communal tube of lube, gotta hunt it down in the tech room whenever I need it

 

[DrOwnage]

Typically dry. Use tongue depressor

I bet pocafx spits on his LMAs before he puts them in

 

[UscGhost]

Typically dry. Use tongue depressor

Man that's rough

 

[GassYous]

You shove LMA's in dry?

I always go in dry

 

[coffeebythelake]

I always go in dry

We are still talking about LMAs right?

 

[DocVapor]

I'm glad people are picking up what I'm putting down here.

 

[jwk]

You shove LMA's in dry?

My bad - LMAs with lube, but never lube ETTs. Using vaseline would never occur to me for either.

 

[nimbus]

Very common is stand-alone surgery centers / ASCs as a cost saving measure (why buy single use packets when you can drive down to Costco and buy an XL tube of KY?)

I’ve seen people use petroleum jelly as well vs the water soluble jellies that we are used to.

Though I agree it’s gross, realistically there probably isn’t any harm. Plenty of ordinary people seem to have no issue reusing nonsterile tubes of jelly, even with frequent use in their mouths…

It’s funny that surgicenters use the cheapest possible supplies for the patients with the best insurance. Not only the lube but also the lowest grade Medline syringes, crappy tape, etc. We use better equipment and supplies for the border wall falls and the homeless patients at the hospital.

 

[coffeebythelake]

It’s funny that surgicenters use the cheapest possible supplies for the patients with the best insurance. Not only the lube but also the lowest grade Medline syringes, crappy tape, etc. We use better equipment and supplies for the border wall falls and the homeless patients at the hospital.

its all about the benjamins.
try to cut corners whenever they can, using the cheapest minimally acceptable tools.
anything they save goes directly to their bottom line

 

[anbuitachi]

like vaseline? does that even help? that stuff is rough

 

[nimbus]

its all about the benjamins.
try to cut corners whenever they can, using the cheapest minimally acceptable tools.
anything they save goes directly to their bottom line

But the patients don’t know they’ve been steered toward a freestanding surgicenter with cut-rate equipment because they have good insurance.

 

[Drwine]

My bad - LMAs with lube, but never lube ETTs. Using vaseline would never occur to me for either.

ETT cuffs aren't latex and commonly fold over and leave channels open. Lube is like brick mortar. If doing TEE or placing bougies intraop I insist on it. That would go for any aspiration risk case. A study was done years ago where methylene blue was instilled in the pharynx with lubed and unlubed ETT. Lots of blue bronchi in the unlubed tube group on bronchoscopy.

 

[coffeebythelake]

ETT cuffs aren't latex and commonly fold over and leave channels open. Lube is like brick mortar. If doing TEE or placing bougies intraop I insist on it. That would go for any aspiration risk case. A study was done years ago where methylene blue was instilled in the pharynx with lubed and unlubed ETT. Lots of blue bronchi in the unlubed tube group on bronchoscopy.

U have a link to that paper?

 

[Gern Blansten]

This one seems similar but without the methylene blue component of the experiment.

Tracheal fluid leakage in benchtop trials: comparison of static versus dynamic ventilation model with and without lubrication - PubMed

Gel lubrication, PEEP alone, and PPV + PEEP in the benchtop model had a much stronger protective effect than PPV alone on fluid leakage. Studies testing the fluid sealing efficiency of tube cuffs might be more conclusive in a static benchtop model without lubrication than in a dynamic model.

pubmed.ncbi.nlm.nih.gov

There are several studies out there comparing different variables that can impact how much gets past the cuff in animal models and methylene blue is a common marker for evaluating it as a simulated proxy for risk of aspiration.
The linked study did show a benefit to lubrication on the cuff. I had not previously seen this study until I searched it just now. Upon further analysis of this paper, the above description of the lubrication as brick mortar makes some logical sense.

 

[GassYous]

ETT cuffs aren't latex and commonly fold over and leave channels open. Lube is like brick mortar. If doing TEE or placing bougies intraop I insist on it. That would go for any aspiration risk case. A study was done years ago where methylene blue was instilled in the pharynx with lubed and unlubed ETT. Lots of blue bronchi in the unlubed tube group on bronchoscopy.

 

[2Fast2Des]

Ah yes, I just BLUE myself!

 

[BobLoblaw78]

Ah yes, I just BLUE myself!

Sad...I just looked up that actor's pic above and it looks like he is dead. If only they had someone to analyze why this happened and a therapist to console the family.

 

[Gern Blansten]

Sad...I just looked up that actor's pic above and it looks like he is dead. If only they had someone to analyze why this happened and a therapist to console the family.

I believe that David Cross is still alive and kicking and does frequent comedy projects, as well as his work as an analyst and therapist.
He did a great show with Bob Odenkirk called "Mr. Show."

 

[BobLoblaw78]

I believe that David Cross is still alive and kicking and does frequent comedy projects, as well as his work as an analyst and therapist.
He did a great show with Bob Odenkirk called "Mr. Show."

yeah....but based on his pic above he still "looks like he is dead"

 

[Gern Blansten]

yeah....but based on his pic above he still "looks like he is dead"

Ahhh. I see. I was not reading it literal enough..