[zerby1470]

We mask for opening rooms, and also prior to opening a total joint room (surgeon request). We are not required to wear masks on clean cases, but most do anyway. There are some things that can hit you in the face in those too, and it's good to have the barrier!

[Scrubby]

[I think the reason the patient doesn't have to wear a mask to their own surgery is because it's their own germs they'd be breathing around? Just a guess - but it makes sense to me]

Patients can still infect themselves with their own bacteria, it's called endogenous infection.

I believe the patient doesn't have to wear a mask in surgery is for several reasons. It's frightening enough for them having surgery in the first place. Making them wear a mask would not be appropriate.
In a an abdominal, lower body operation by the time the patient is having surgery and the surgical wound exposed, there are normally drapes that are put up (well in my OR anyway) which is a barrier between the head and the area which is being worked on. The head is also under the drapes as well so there is plenty of sterile layers.

At my HCF the policy is that masks are to be worn when sterile items are opened as well.

[ShariDCST]

Originally Posted by Scrubby

[I think the reason the patient doesn't have to wear a mask to their own surgery is because it's their own germs they'd be breathing around? Just a guess - but it makes sense to me]

Patients can still infect themselves with their own bacteria, it's called endogenous infection.

I believe the patient doesn't have to wear a mask in surgery is for several reasons. It's frightening enough for them having surgery in the first place. Making them wear a mask would not be appropriate.
In a an abdominal, lower body operation by the time the patient is having surgery and the surgical wound exposed, there are normally drapes that are put up (well in my OR anyway) which is a barrier between the head and the area which is being worked on. The head is also under the drapes as well so there is plenty of sterile layers.

At my HCF the policy is that masks are to be worn when sterile items are opened as well.

One thing nobody else has mentioned, and maybe because it's just too obvious to note, but a patient wearing a mask could possibly make the anesthesiologist's job of intubating that patient more of a challenge than it already is?

[maeyken]

Originally Posted by brewerpaul

Yeah, the "their own germs" explanation is what I've heard, but some of those germs might still be floating around in the room for the next case even with air filtration. This would be an interesting evidence based study.

Then the argument is why do we unmask between cases? Would our germs not be floating around the room too? So then why bother wearing masks? A definitive study would be excellent.

We only mask when sterile supplies are open too, and don't mask for "clean" cases (cystos, etc)

[Scrubby]

[the argument is why do we unmask between cases? Would our germs not be floating around the room too? So then why bother wearing masks? A definitive study would be excellent.]

Masks actually lose their effectiveness after a certain period of time, about a half hour or so they become so saturated with moisture from your breath that they stop filtering out the air you breathe out.

The real purpose of wearing a surgical masks is really to protect the scrubbed team from having blood, body fluids enter your mouth

And we don't masks between cases because the air is constantly being hepa filtered every five minutes.

[Circl8r]

Hi:

We wear masks in any room that has opened sterile supplies. In the institution that I work currently, we also wear masks in the sterile core because occasionally a scrubbed person steps in to retrieve flashed items from the sterilizer.

[Qwiigley]

Originally Posted by Circl8r

Hi:

We wear masks in any room that has opened sterile supplies. In the institution that I work currently, we also wear masks in the sterile core because occasionally a scrubbed person steps in to retrieve flashed items from the sterilizer.

A scrubbed person should never leave the room, by definition and protocol, they are no longer sterile especially if they then touch something outside the room, such as opening the sterilizer. (remind me never to go there for a procedure!)

[ShariDCST]

Originally Posted by Qwiigley

A scrubbed person should never leave the room, by definition and protocol, they are no longer sterile especially if they then touch something outside the room, such as opening the sterilizer. (remind me never to go there for a procedure!)

I have retrieved flashed instruments in the past from an autoclave located in the sterile core - but I NEVER touched the outside of it to do so. It would never be considered an option to actually open the autoclave door myself while scrubbed in. An unsterile, but masked, person always pulled the door open with the handle and stepped back for me to reach in with a sterile towel and pick up either the item or the tray. No contamination was ever experienced, and the department was designed that way. I would rather do it myself than trust that someone else retrieved it from the autoclave without contaminating it and brought it to me.
Granted, it's not an ideal circumstance, but the world is not an ideal place. We do what we can to make it work. It's been a while since I've had to do that though because that took place where we did not always have enough sterile run sets to get through a day's cases, OR because something got contaminated in some fashion during either the set up or the case.

[JustaPatient]

In the hospital I am a patient I do not know about before I get to the OR but the as soon as they are going in to the OR the staff puts their masks on. I do not wear one. lol.

It actually surprised me once. I had looked up while they were wheeling me down the hall. I looked forward while the were wheeling me through the door then looked up again and my anesthesiologist was masked. I had looked forward for maybe 10 secs and she was masked. I was kind of like wow that was fast.

[mcmike55]

At my hospital, pretty much the same as all of you. Masks when sterile fields are open, and when the case is going on. After dressings are on, masks can come down. However, I often leave mine up until after extubation, and the pt is on the cart ready for transport. Too many fluids flying at times, you know!!!!
For "clean" cases, such as ESWL, cystos, tonsillectomies, and D&C's, masks are, for the most, optional. Most of use wear them anyway, especially if you are scrubbed.
One rational I heard one time, is that droplets from you could contaminate instruments, like a uterine curette for example, which, does come in contact with open surfaces of the pt.
You know, one of these days, our kids (or kids kids) will look back on us and laugh about how we wore "masks" against our face during surgery!!

Mike