MRSA in sputum with trach?

[kc1985]

I was wondering if anyone could answer this question for me. I am a nursing student and was assigned to a patient to care for the other day with MRSA in their sputum. The person was on a closed system trach I believe is what the RN called it. I am super paranoid and asked her if I need to wear a mask while in the room because I had seen 5 people *yes I counted* go in the room without one. They all did wear gloves and gown however. She said that it was not necessary because all of the sputum was being sucked into a closed container. The patient was not coughing while I was there. I am curious if this happens again should I wear a mask to be safe. I don't want to be overly paranoid but at the same time I want to be safe!!!

[zacarias, ASN, RN]

I would wear a mask. Just say, "I'd prefer to wear a mask" and that's it.

MRSA in the sputum is an automatic mask requirement if you get within three feet of patient. While the closed suction system is great and means you're less exposed to their sputum, you should still wear a mask.

That closed system surely is changed out occasionally by respiratory therapy and when that happens, there is a period when it's not closed, so I would wear a mask.

[Whispera, MSN, RN]

Why would gloves and a gown be needed and a mask not needed? Do people just not want the MRSA on their clothes and hands? They are being illogical. If it's there, it's THERE!

[kc1985]

I am correct though that it is droplet not air born? In that case the sputum would actually have to get on me to cause me to get infected right?

[travel50]

Well, I assume you can breate in droplets in the air, and if the patient coughs hard enough...if any comes out of their mouth (and it can), or as someone noted, during the system change out, then it can be in the air in droplets. Or am I wrong here? I agree that a mask is appropriate. Furthermore, even if it were not necessary, they should provide you with one if you ask.

[kc1985]

Now I am worried. I did pt care for about 4 hours without a mask. Its my mistake I assumed that the RN would know and would give adequate advice to a newbie. I will def. wear a mask next time. The pt was not coughing and I did not see resp therapy in the room during the time I was there however I did get close to the patient doing the assessment and such I guess all I can hope is that I haven't caught anything due to that mistake.

[Whispera, MSN, RN]

Over the course of years, caring for patients, it's pretty likely you'll pick up MRSA. Lots of times people have it and we don't even know it... Having the germ in you doesn't mean you'll become ill from it.

[morte, LPN, LVN]

Well, I assume you can breate in droplets in the air, and if the patient coughs hard enough...if any comes out of their mouth (and it can), or as someone noted, during the system change out, then it can be in the air in droplets. Or am I wrong here? I agree that a mask is appropriate. Furthermore, even if it were not necessary, they should provide you with one if you ask.

i am thinking the dif between "droplet" and "airbornn" is that the droplets are too heavy and are deposited within that 3' circumference mention in a prior post? which would mean that, unless the pt is positive in oral secretions, no mask would be nec in this situation excepting when the system is opened, ie daily change of equipment/changing of receptical....

[patrick1rn, MSN, RN, NP]

Now I am worried. I did pt care for about 4 hours without a mask. Its my mistake I assumed that the RN would know and would give adequate advice to a newbie. I will def. wear a mask next time. The pt was not coughing and I did not see resp therapy in the room during the time I was there however I did get close to the patient doing the assessment and such I guess all I can hope is that I haven't caught anything due to that mistake.

Your a RN student right ?

Then look up what MRSA is

[Balder_LPN, LPN]

Over the course of years, caring for patients, it's pretty likely you'll pick up MRSA. Lots of times people have it and we don't even know it... Having the germ in you doesn't mean you'll become ill from it.

Yes, the OP used the term infected. But you would not likely get infected, but rather might be colonized (have the bacterium on your skin or even in your respiratory tract, less likely) and not have any s&sx of infection. MRSA is Staph that is not responsive to penicillin. a significant portion of the population is colonized w/ staph at any time. It is actually beneficial as your body has many defenses against it, and it can out compete other, more harmfull bacteria.

All that said though, since you are working with many compromised (ill, old) patients it is important for you to make sure you're NOT colonized with MRSA. I thought a mask was considered best practice for respiratory MRSA. But I will take another look.

[kc1985]

I was there again today with the same patient. This time I did wear a mask. It still amazes me though that none of the other nurses, aides, or guest wear them while in the room.

[Christie RN2006]

Where I work, if the pt is diagnosed with MRSA of the sputum, they are automatically placed in droplet isolation which means gown, gloves and mask. It does not matter if they are on the vent or not, there is still a risk of possibly being exposed. What if the closed system accidentally comes apart? Better to be safe than sorry!