Re: Learning Thread: Med/Surg Originally Posted by ranaazha 
We are expected to do so no matter what and no matter where the infection is. If it's in a wound that is covered, and I'm going in just to pass meds, I am expected to wear full PPE. I actually had a CNA tell on me the other day for not doing so!
Of course I wear full PPE when coming in close contact with any "contact" isolation patient, but I still fail to see the point when passing meds and NOT coming in close proximity with the patient. I love this idea that the door-way is some sort of magical barrier...
I used to think this way too, and still occasionally go into a contact iso room w/o PPE, but it's become the exception--like the night my guy was choking while I was still getting report & I almost had to do the Heimlich. I didn't think he'd appreciate me taking 30+ seconds to glove & gown while his eyes were bulging & his face was turning purple. We gown & glove, not to protect ourselves, but to protect our other patients who may have compromised immune systems. Studies have been done on the thoroughness of cleaning ISO rooms after the patients are d/c'd, and VRE and MRSA have been found on door knobs, bed rails, IV poles & pumps (there goes my excuse that I'm just going to hang a new bag of fluid, 3 feet away from the patient), thermostats, chairs, walls, computer keyboards, you name it. If it's a surface, it's been infected. Think about the patient w/ MRSA in his nares. He sneezes or simply blows his nose, doesn't wash his hands, can't reach the trash, so he leaves the tissue on his tray table & then steadies himself on the bedside rail to get out of bed. He then grabs his IV pole by the pump, walks with it to the bathroom & opens the door, flushes the toilet, (hopefully) turns on the faucet to wash his hands, but then doesn't use a towel but his bare hand to turn off the faucet. Grabs the same door handle & bed rail on his way back to bed. I come in the room to hang a new bag of fluid and accidentally brush up against the pole & the bathroom doorknob (our rooms are small). I'm gloved, so my hands don't come in contact with his equipment, but my scrubs do. So even though I wash my hands thoroughly before heading in to see my next patient, I've still got MRSA on me. And for some people, that's all it takes.
I do often wonder if the cloth gowns are totally effective, especially after being washed a million times & getting thing, but at least they have some protection. If someone has an oozing wound or has VRE in their urine & they're incontinent, I order the paper gowns, which are thicker and offer more barrier between the germs and me.
What really grosses me out is when the all the various doctors come and go from these rooms, touch the patient and their wounds, and then use a little alcohol foam before sitting down at a computer to type up their notes.
I always wipe down the keyboards and mice before using them! Call me a germophobe, but I have kids at home and my own health to think of. And if I'm ever hospitalized, you can bet I'll be there with my own bottle of Quat to have someone wipe down my bedrails & call light!
you are correct! When carbon monoxide attaches to the Hgb molecule the pulse ox still pics it up as if the oxygen molecules are the ones attached to the Hgh molecule. Do you have a question to post?
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