itchy residents

Atarax for geriatric patients is not a good idea, you're going to start having falls.

Is this a recent thing? Did your facility recently change soap products or laundry detergents? Could this be an allergy? You could recommend using a lotion like lac-hydrin or unimol which may reduce the itching. Where are the lesions located?

Did dietary make a change in vendors?

Did the docs order some new drug for these people? You probably already checked that one out.

Did the pharmacy make some kind of change?

I work in a 310 bed nursing home so 7 patients itching isn't a large number.

It is the start of winter with dry heat, this could just be dry skin. Are you using a new lotion on the dry skin?

Was there a medication change, possibly brand drug now generic---have seen skin rashes from dyes too---need to rule out.

Found this skin lesions/rashes websites with pics for you to view.
Sounds like dermatologist consult is indicated .

http://www.healthcentral.com/mhc/top/003220.cfm
http://www.pennhealth.com/ency/article/003220.htm
http://health.discovery.com/diseases...edia/3241.html
http://www.aafp.org/afp/980915ap/rose.html

Scabies scrapings have a very HIGH rate of false negative-especially when performed by the nursing staff...The derm does several sites on one slide and never an actual burrow that has been scratched=he goes for the places that are known to harbor the little devils frequently like the webbing of the fingers and the wrists.....Sounds like your admin is in denial-they'll become VERY concerned when someone calls the board of health(it can be done anonymously) That will push them into acting.If you really feel that they are stonewalling then go in there tomorrow with as much info printed from good websites as you can find...And if you have to don't hesitate to make that anonymous report yourself....Treatment failure with topical meds is common-we had to resort to the po Ivermectin to stop our infestation.........

Huge issue for everyone -- not just residents. Scabies is often the first thing that comes to mind without ruling out other culprits or extensive troubleshooting.

As others have already warned -- going forward the elimite + atarax puts them at even greater risk. No room for guesswork.

Residents (as well as staffers that treat out of fear without warnings for their particular vulnerabilities such as ?pregnant
?asthma, s/p chemo? ) -- become prime candidates for adverse events when all this is followed with more heavy artillery. Say no to lindane or Ivermectin either of which is bad bad news.

Bacterial stuff might be picked up by doing some cultures from the skin.

Itching is one thing. Anybody complaining of biting or crawling? In addition to questions already posted....Any water leaks in the place? Sewage backup/problem? Mold? Monthy exteriminator services? Visiting pets? Window sills loaded with leaves or...bird nests?

Have an update for us,Nancy? I think that if you have ruled out everything but scabies then you have to get the facility to jump on that...Our dermatologist will now see any one with a suspicious rash within a day or so.....We had such a rough time and now they really take it seriously....

I think you hit the nail on the head, stressed, especially with there being no evidence so far of it being anything else. The question, Nancy, is are you using any lotion at all on the patients. It's cold. It's Michigan. The heaters are cranked. Sounds like a simple case of dry skin. I itch like a fein when the heaters start up this time of year. What I forgot I live in Florida ooops. Nancy rule out the simpliest of things first. Hope you find a cure soon.