Based on world estimates for general anaesthetics annually (see here) could we be discarding more than 200 million unnecessary plastic Clausen Harness Hooks every year at massive environmental expense?
Since the advent of the laryngeal masks (more than 20 years ago) the hooks and the harness are no longer in use in most European countries. A short survey in four hospitals in the West Midlands, UK, showed that the hooks on the anaesthetic face masks were removed by the anaesthetic team and discarded unused straight from the packaging (see here). A similar survey by Dr Will Rattenberry was published in Anaesthesia News February 2018:
The NHS Supply Chain is extremely supportive of removing anaesthetic masks with Clausen Hooks from procurement. Led by Karen Hudson they are after your help to guide future procurement decisions – if you are a member of NHS staff please take a moment to complete this brief survey: (clickhere)
Clausen Hooks are very rarely used in the US – this appears to be in some cases a hangover of traditional practice amongst few and primarily not for airway support but respiratory support using the Boussignac CPAP system – in this system mask, hooks, straps and CPAP device can be purchased together (see here). All staff we’ve spoken to who still use a Clausen Hook in US are happy for it to be provided with the straps on the rare occasions it’s used.
I was shown a Clausen Harness in action 20 years ago for ‘historical reasons’.
Years later we still have these hooks on most of our anaesthetic masks. Many anaesthetic trainees have no idea what they are other than an annoying feature which digs into their hands when trying to hold the mask. They may even present a patient risk – occasionally masks with hooks are left next to the patients face and risk facial trauma (see here).
Another excuse for the hooks is to colour code mask sizes however many mask brands have colour coding without the need for the hooks or additional plastic.
Perhaps, in reality, it would be costly for companies manufacturing the hooks with the mask to change their manufacturing process. Further it doesn’t make much difference to their ability to sell them if we keep buying them as they are.
Often staff in hospital procurement have little feedback of what happens on the front line. Masks with Clausen Harness hooks continue to be ordered. We can change this.
If your hospital purchases anaesthetic masks with a Clausen Hook please forward this post to your anaesthetic department and hospital procurement. Ask if they might purchase a variety of mask without a Clausen Hook.
If your hospital purchases a brand of mask without a Clausen Hook please send us a picture and let us know the manufacturer & supplier details and we’ll add to the list below. If you’re an anaesthetist and would like to provide your independent feedback regarding the masks listed please do get in touch.
Please click on this image and check out this series of slides from Dr Will Rattenberry who is driving the removal of Clausen Hooks internationally – great work Will:
Thank you 😃
Below is a gallery of Hook-Free Anaesthetic Masks – please let us know if you are aware of others. Click on each image for more details:
Disposable Masks:
Reusable Masks:
| # | NAME | RATING | DESCRIPTION | PRICE | Statistics | LINK |
|---|---|---|---|---|---|---|
| 1 |
MDevices
|
Read review | Very good seal & can add additional air. Colour coding in syringe connection. |
AUD 1.75 |
Usability
Eco-Friendly
|
MDevices |
| 2 |
BesMed Reusble Silicone Facemask
|
Read review | Reusable, autoclavable mask. Doesn't have air cuff which might impair seal. |
AUD 22.20 (Reusable) |
Usability
Eco-Friendly
|
BesMed |
| 3 |
Draeger
|
Read review | Good seal, obvious colour coding. Unable to add additional air to cuff. |
AUD 1.13 |
Usability
Eco-Friendly
|
Draeger |
For those working in New South Wales public hospital the MDevices, Draeger and Silicone Reusable anaesthetic masks are available for purchasing order through Oracle. Perhaps ask your department and procurement staff to trial and order those masks (in image below) above the red line (MDevices disposable or Silicone Reusable) as opposed to the 3 varieties below the red line which come with the unnecessary Clausen Hook:
The Anaesthesia masks listed with Clausen Hooks are no cheaper than those without.
WellLead – AUD 1.75
Ambu King (scented) – AUD 3.00
Ultraseal II – AUD 1.90
Merry Christmas – let’s improve lines of communication between front line staff and hospital procurement and make 2019 a very happy new year.
We have started to contact relevant manufacturers from this link: https://www.made-in-china.com/products-search/hot-china-products/Anesthesia_Mask.html
We will display their responses below:
Thank you very much for your good suggestion, the clip, if need or not, is up to the buyer’s demand, we can do as per the customers’ requirement.
If you have any good project or any good idea on it, feel free to talk with us by any way.
Happy new year, wish you have a prosperous business in 2019.
RGDS.
Yours,
Roye Qiu
Sales Manager
—————————————-
Hangzhou Cuanz Medical Device Co.,Ltd
Address:Room 101, Building 17, #488-1 East lake North Road, East lake Sub-district, Yuhang District, Hangzhou City, Zhejiang Province, China.311100
Tel: 0086-571-86123676
Fax: 0086-571-86123005
Mob.: 0086-159-68815095 (also for Wechat & What’s APP)
Email : qly@hzcuanz.com qiulongyun@gmail.com
Website: www.hzcuanz.com
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