To the Editor
We wanted to share our experience in preparing for an inspection by internal Infection Control personnel. We conducted a requisite inventory of several of our anesthesia equipment carts. Figure 1 shows, on the left, a sampling of items for which there was an expiration date (according to their packaging), while those on the right are selected items without an expiration date. Of interest is the apparent lack of logic dictating expiration versus no expiration. For example, a nasal cannula has an expiration date, while a disposable facemask does not; a 30-mL syringe has an expiration date, but a 10-mL syringe (from the same manufacturer) does not; an IV tubing of one type has an expiration date, while another type does not, although their purpose is exactly the same.
Another question is why certain nonsterile items have an expiration date at all? Is there truly an effective life span for a tongue depressor or an intubation stylet? Or, for that matter, for a tube of lubricating jelly and a flexible connector for breathing circuit (both of which were found in our survey, but not pictured, and had expiration dates)? If so, it is likely longer than the average 2- to 3-year expiration period listed on the packages.
Attempts to address these conundrums were ultimately fruitless. We contacted the Occupational Health and Safety Administration, our state Medical Board, as well as hospital infection control personnel, and none was able to provide any guiding rationale, beyond “if it is expired, it should be discarded.” Several medical device manufacturers were also contacted, and none could explain why some of their products had expiration dates and others did not. An internal hospital policy document regarding sterilization did state that “sterile items do not have expiration dates,” and that “these items may be used as long as the integrity of the package is not compromised.”
As a practical matter, though a tedious endeavor, it seems worthwhile to do a thorough inspection of all anesthetic equipment, given that one apparently cannot logically anticipate what will expire and what will not. Rotation of items soon to exceed their expiration dates to the “front of the line” minimizes waste, while removal of those already past their expiration date avoids possible regulatory citation(s).
Zachary B. Deutch, MD
Shashank S. Shettar, MD
Department of Anesthesiology
University of Florida Health
Valerie M. Aquino, BSN, SRNA
School of Nursing
University of North Florida