A reusable laryngoscope is only as safe as its reprocessing. This overview is for sterile services teams and procurement staff. It describes common practice, not a protocol: national guidance, local policy and the manufacturer’s instructions for use (IFU) decide what is done in a particular hospital.
How laryngoscopes are classified
Infection-prevention guidance commonly uses the Spaulding classification, which sorts reusable items by the tissue they contact:
- Critical items enter sterile tissue or the bloodstream and must be sterile.
- Semi-critical items contact mucous membranes or non-intact skin. They need at least high-level disinfection, and sterilisation is often used where the device allows it.
- Non-critical items touch only intact skin and need cleaning and low- or intermediate-level disinfection.
Laryngoscope blades contact the mucous membranes of the mouth and throat, so they are usually treated as semi-critical; the US CDC guideline on disinfection and sterilisation in healthcare facilities lists them in that group.
Guidance for handles varies. Some sources classify the handle as non-critical. Others point out that handles are held with contaminated gloves during airway management, and some organisations require handles to be cleaned and disinfected, or packaged, between patients. Follow national guidance and local policy, and check that the IFU supports the method chosen.
The basic cycle
Point-of-use care
Separate the blade from the handle straight after use. Remove gross soil as the IFU directs, do not let secretions dry on the blade, and send it for reprocessing in a closed, labelled container. A used blade should never go back on the trolley or into a drawer.
Cleaning
Cleaning removes the organic material that would otherwise shield microorganisms from disinfection or sterilisation, so every later step depends on it. It may be manual, with a suitable detergent and soft brushes, or automated in a washer-disinfector, as the IFU allows. Pay attention to the hook-on fitting, the ends of the light guide and any joints, then rinse and dry thoroughly.
Inspection
Inspect every blade after cleaning, in good light and preferably under magnification. The main checks are listed below.
Disinfection or sterilisation
Blades then undergo high-level disinfection, thermal or chemical, or sterilisation, by a method the IFU validates for that model. Steam sterilisation is common for blades designed to withstand it. Handles are usually wiped with a compatible disinfectant; some designs allow the batteries and light source to be removed so that the handle body can be processed further.
Storage
Store processed blades clean, dry and protected from recontamination, for example packaged or in a closed container, and labelled so that staff can tell processed equipment from used. Where the hospital tracks instruments, record which blade was used on which patient.
Why fiber-optic blades suit repeated reprocessing
A conventional blade carries a lamp near the tip, a lamp socket and an electrical contact at the fitting. These are places where moisture and soil can collect, and the IFU may require the lamp to be removed before processing.
A green-system fiber-optic blade has no lamp, wiring or electrical contact; the light source stays in the handle and the blade carries only a light guide. With no electrical parts to protect, the blade is simpler to clean and better suited to repeated washing, disinfection and sterilisation, within the methods its IFU validates. Our article on fiber-optic green system and conventional laryngoscopes covers the other differences.
What to inspect
- Light guide. Both ends should be clean, clear and undamaged. Chips, scratches, cloudiness, yellowing or dark spots in a fiber bundle, which indicate broken fibers, all reduce the light. On a test handle, the light should be bright and even.
- Hook-on fitting and hinge. The blade should hook on smoothly, click firmly into the working position, switch the light on and hold without play. Wear or a weak click is a reason to withdraw it.
- Surfaces. Look for residual soil, stains, corrosion, pitting, cracks, burrs, bending and rough edges, especially at the tip and flange. Damaged surfaces are harder to clean and can injure tissue.
- Handles. Check the grip and end cap for retained soil, the battery compartment for moisture or corrosion, and the light for reliable switching.
Withdraw anything that fails. Have it repaired only where the manufacturer allows, or replace it.
Validated parameters come from the IFU
Temperatures, contact times, detergents, disinfectants and any limit on the number of cycles are not general values. They belong to a specific device and are validated by its manufacturer. The IFU should state them, together with any restrictions, such as maximum temperatures or chemicals to avoid.
ISO 17664-1 sets out the information manufacturers should provide for processing critical and semi-critical devices, and procurement teams can use it as a checklist when reviewing an IFU. If the IFU and local practice differ, resolve the difference with the manufacturer before the device goes into service.
Single-use blades must never be reprocessed: they are designed and validated for use on one patient only. Our article on reusable and single-use blades compares the two options.
For questions about reprocessing a particular blade or handle, ask our export team.