Are we slowly poisoning ourselves with meds when we crush them?

[Jubei]

I took a urine test months ago and it came up positive for opiates. First of all, I don't use drugs , smoke , and I rarely drink...okay I drink with my buddies all the time :chair: .... .

Anyway, either my urine sample was contaminated or maybe it was that Fentanyl patch I had to replace (72 hours) when I carelessly forgot to use gloves when removing it (that was months before the urine test though). The hospital where I took the test told me it was possibly from sesame seeds I might have eaten or some crap like that ( I had to persuade my hospital that I wasn't a crackhead).

Maybe we should start wearing TB N95 masks when we pass out meds.

:biere:

[boulergirl, CNA]

How about having the applesauce or whatever in another cup and adding the crushed pills to that?

I used to do this when I was a med tech and we had residents in the Alzheimer's wing that had swallowing problems or spit their pills out (of course we had to have a crush order from a doctor first). Since Depakote can't be crushed and that was the one they tended to spit out, they now receive it in liquid form. They also get Risperdal in liquid form, but the med techs have to read package instructions (sometimes they don't), otherwise the poor resident will have a burning throat.

Now that I've read this thread, I'm glad I don't handle meds anymore. They don't teach this stuff in the med tech class, and God knows if we have been setting ourselves up for horrible health complications later on. (I was a med tech for four years, but the vast majority of that time was spent on the night shift, so I didn't have that many full-blown med passes, thank God). I always rinsed the pill crushers after using them, but didn't know that the pills should not come in direct contact with the crusher. My hands were clean, but I didn't always use gloves when necessary. The med techs now are so swamped with work that they usually don't give a crap about this stuff, but ALFs should really consider the safety of their med techs, as well as their workload.

[SouthernLPN2RN, MSN, RN, APRN, NP]

Ya know, I'm beginning to wonder if this isn't part of the cause of my liver being enlarged. All enzymes are fine, no hx of drug/ETOH abuse, not even on a daily med and I'm 24. The facility I use has the silent knight crushers and they do make a mess. 9 times out of ten, one of the meds punctures the bag. Giving meds to 44 pts, most of them have to be crushed. :uhoh21:

[nursetweety]

How did the doctor know the tumor was from crushing the meds?

Where I work you have to crush a lot of meds. So I am concerned about this.

[caroladybelle, BSN, RN]

There are a number of PO meds that are considered chemotherapy, that should not be crushed, except under a biohood. They should always be handled with gloves.

I have had problems w/staff that crush THALIDOMIDE on the floor, and excuse it by saying that they have had a tubal ligation.....it's not a problem to them but effectively aerosolizes the drug in the area. Given the amount of paperwork and regulations that the manufacturer places on proper administration of Thalidomide (the extremely high risk of liability, if mishandling results in birth defects), if the facility gets caught not abiding by those rules, the drug will get pulled.

There are also antivirals such as gangcyclovir that should be handled with chemo precautions, yet in many hospitals are handled like any other IV med.

But also think about it. Many nurses prime antibiotic tubing all the time, without wearing gloves. As we are aerosolizing and inhaling the byproducts, we are setting ourselves up for developing resistant infections.

[caroladybelle, BSN, RN]

I know a patient who gets thalidamide. And of course, it's to be crushed. Perhaps the nurses can babysit each others' "flipper babies".

Thalidomide is NEVER to be crushed on the unit. If needed it can be crushed in pharmacy under the biohood.

Though some places have actually have it in liquified form.

[Nieuport]

Hi April, we use the Silent Knight at my facility as well. I really like it. Ditto on making a habit of cleaning the pill cutter, though.

[achot chavi]

I think that different people are sensitive and more vulnerable than others- how else do you explain that some non smokers develop lung cancer (through 2nd hand exposure) and others puff away for 100 years.

I always instruct my nurses to wear gloves when applying ointments and creams, wipe off the pill crusher between uses, and turn your head away when crushing to avoid inhaling the powder.

That doesnt make it fool-proof and I love the Silent Knight!!

Re: defending yourself- don't they have to take a repeat and give you the benefit of the doubt (this is America not the Tour De France)

And why are you taking a urine test anyway? I thought that was illegal?

[LeahJet, ASN, RN]

Interesting thread...but the Op'er has long been banned.