Disclaimer
- We are not sponsored in any shape or form from any companies
- Below are just personal opinions and experiences
- The cost can vary on the volume purchased and the contracts of each health system, and is just an estimate/guide only
Manufacturer’s recommendation?
Interesting point about the manufacturer’s recommendation (of number of uses).
It is worth noting that’s what they were tested for, but does not necessarily mean they are no longer functional after the number of reuse is reached.
For example, there was a study looking at the reusability of classic and proseal LMAs.
Now while 40 uses are the manufacturer’s recommendation, there is a study that looked at the actual reuses (tested 6x classic, 6x Proseal), and the range for reuses were
- Classic 133 +/- 35 (76-176)
- Proseal 82 +/- 23 (45-109)
Ref: https://pubmed.ncbi.nlm.nih.gov/15673899/
You can see that the number of reuses possible is much higher than the recommended number. Planned obsolescence is never a good thing.
Perhaps we should reuse things until they are no longer reusable?
Food for thought… 🤔
Tourniquets
Infection control is generally not happy about people reusing fabric tourniquets due to the porous nature of the tourniquet which makes it much harder to clean.
They are however happy with silicone tourniquets! They are already in use in many hospitals in Australia (and world wide)
Key points about silicone tourniquets
- Number of uses
- Validated for 10,000 uses but really as long as they last. Mine is still going after 2 years of use with no signs of wear
- Cleaning
- Spray with chlorhexidine/alcohol and wipe it down. Moving the buckle up and down will get chlorhexidine within it clean its insides
- Can use Clinell wipes but I personally prefer chlorhex spray as there is less waste 🙂
- After a while the silicone can feel sticky due to chemical residue – if this happens wash it with water and it will feel nice and smooth again
- Spray with chlorhexidine/alcohol and wipe it down. Moving the buckle up and down will get chlorhexidine within it clean its insides
- Pinching
- One thing to be mindful of is because of the silicone its more likely to pinch the skin, so have a finger in when you tighten the tourniquet
- Tightness
- It can feel less tighter than the fabric tourniquets due to the material, but the pressure generated is similar and works just as well
There are two brands on the market currently.
I have both and I use both quite regularly – haven’t used a disposable one for over 2 years now!
Note disposable tourniquets are ~$1 each so these will pay themselves off very quickly.
Biggest issue is again, EDUCATION!
Notify/educate people to NOT THROW AWAY the reusable tourniquets when seen.
Brands
Daisygrip
Cost
- ~$40 each
The OG reusable tourniquets (even though they aren’t that old).
Daisygrip is made by an European company, with Tristel being the distributor.
They currently only come in green in Australia but in the future they may be available in different colours ( I have a blue one that I got while I was in UK and there are pictures of pink ones).
The silicone band is quite large and the clip is a magnetic one.
Advantages
- The magnetic clip system removes the need for crevices/clip on and this allows easy cleaning of all parts of this tourniquet.
DisadvantagesBe wary of the magnet. Don’t take this tourniquet into MRI 😯
- Magnetic clip while easy to apply and take off require a bit of ‘teaching’ on how to use. You simply push the tourniquet clip side ways and it will come off
- There’s no label of ‘reusable’ which means they run the higher risk of being thrown out if left alone
- Upfront cost is a bit more ‘substantial’
https://tristel.com/au-en/product/daisygrip
Haines
Cost
- ~$16 each
New player to enter the scene.
Same size and mechanism as the disposable ones in Australia. Also labelled reusable!
I have a soft spot for daisygrip as I have been using it for a while, but this is also a very good product. Probably easier for widespread appeal given the same mechanism as our disposable ones.
Advantages
- No magnet inside – MRI compatible
- Cheaper than daisygrip
- More familiar mechanism – no teaching required
- Labelled reusable! Bigger deal than people realise
Disadvantages
- Can be harder to clean due to the clip and the crevices within it.
Airway
LMA
There aren’t too many options available in this space (manufacturer’s intent on equipment being reusable anyway).
An anaesthetist from Hungary told me that back home they used to wipe down i-gels and used them again.
Low-resource environments can achieve so much with so little, often with little difference in patient outcomes (Now I am not suggesting we do that, but food for thought…).
For reference, disposable LMAs (i-gel, supreme, ambu etc) cost about ~$15-30 each depending on the brand.
Anyhow, lets get into the reusable ones.
Brands
1st Gen – Classic
Manufacturer’s recommended uses
- 40 times*
Cost
- ~$200
The OG of OG LMAs. The classic, going all the way back to 1987.
Slightly cheaper than the Proseal. Some people will argue why put a 1st gen when you have a 2nd gen (and I tend to agree).
Still, good to have as backup (and it’s always good to have multiple supply chain in times of shortages).
2nd Gen – Proseal
The OG of 2nd gen reusable LMAs, from 1999.
Manufacturer’s recommendation
- 40 uses*
Cost
- ~$300 each
They are floppy in the middle part, so often a finger is used to help guide it in.
Reusable introducers are also available to help with this ‘problem.’
I personally prefer to insert them without an introducer as the introducer gives the proseal quite a sharp angle (also not using them = one less thing to process after).
These are the main LMA of choice at Royal Darwin Hospital and most people use them without an introducer so it’s definitely not a necessity.
The one disadvantage of it is in the rare case you need to intubate through the LMA, a size 5 Proseal can only fit a size 6 ETT (while i-gel for example will be able to accommodate a 8 ETT). Not usually a problem because I can count on one hand the number of times I had to intubate through the LMA, but something to be mindful of.
2nd Gen – Baska Ballum
New kid on the bloc, from an Australian company!
Manufacturer’s recommendation
- 60 uses (20 more than proseal)
Cost
- ~$150 each
Cheaper than proseal and classic lma, and more reuses, and from an Australian company?? Sounds great!
These are also more like the i-gel, with a little tab that can be used to curve the LMA more.
The gastric reflux drainage port is interesting.
[Attach photo]
I am yet to trial these at Darwin (it’s a bit of a pain trying to get equipment approved with CSSD) but I am very keen to trial these.
https://baskamask.com/product/baska-mask-baska-balum
Reusable scrub hats
As far as I am aware, there is only 1 hospital in Australia where the hospital has funded reusable hats as part of theatre attire (not individual scrub hats, but general scrub hats that people can grab in the morning and put into the laundry basket).
Some hospitals don’t even allow reusable scrub hats as part of their policy (crazy stuff in 2026), so that’s the first thing you can work on if that is the hospital policy.