My patient had HIV and the flu but wore mask incorrectly

arbldj1234 · Dec 24, 2013

Did you just ask if you could get HIV through droplets??

I am not entirely sure why anyone would feel comfortable asking questions when people are treated like this. You can't be expected to know EVERYTHING! Did you seriously have to be that rude?

KelRN215, BSN, RN · Dec 24, 2013

Blood, seceretions but was told if they cough you can't get it through that way.

Not "secretions". There are plenty of "secretions" and bodily fluids that you CAN'T get HIV from. HIV is blood-borne or sexually transmitted. You cannot get it through droplet. If you could, every HIV+ patient would be on droplet precautions. I think you need to review a little more on HIV transmission.

MOST bodily fluids do not transmit HIV. You cannot get HIV from tears, sweat, saliva, urine, feces, vomit, CSF. You CAN get it from blood, semen, pre-semen, lady partsl fluid and breast milk.

KelRN215, BSN, RN · Dec 24, 2013

I thought we put them in isolation for their own protection

When someone has the flu, no. You are thinking of reverse precautions which is for immunocompromised patients. When someone has the flu, why would they need precautions for their own protection? For the most part, you're protecting other patients.

BuckyBadgerRN, ASN, RN · Dec 24, 2013

An n95 mask (if I'm not mistaken), requires each wearer to be fit-tested. Your facility should not be tossing a mask or directing you to a pile of them and saying "wear one".

LocaW8ta · Dec 24, 2013

I am not entirely sure why anyone would feel comfortable asking questions when people are treated like this. You can't be expected to know EVERYTHING! Did you seriously have to be that rude?

If I came across as rude, I apologize. I posted without thinking which was wrong of me. I do agree that some homework is in order though.

Caffeine_IV · Dec 24, 2013

No you cannot get HIV through droplets.

akulahawkRN, ADN, RN, EMT-P · Dec 24, 2013

So the other day I had a patient with hiv who was there for the flu. He was on droplet precautions but for some reason I was told to wear an n95 mask. He has no history of tb. Why would I need an n95 mask? Another concern is I realized I was wearing the mask wrong the first time I went into see him to do his assessment. The mask didn't cover over my mouth...stupid me but i hadn't wore one before. I can't get hiv through droplets from him having the flu can I? I know I could be at risk for the flu for not wearing the mask right. Any advice would be greatly appreciated as I'm very paranoid about this now...thank you!

Of the two issues your patient has, only one of them is droplet transmissible. Remember, droplet transmission is different from airborne precautions in distance the pathogen travels through the air and also what type of respirators/equipment you need to wear. Using an N95 mask is overkill though, and you'd have to be properly fit-tested to ensure that the mask will adequately protect you. I've been fit-tested before and I've also been the person doing the fit-testing as well. I know what size, brand, model N95 masks will protect me. However, since I'm still a student and not an employee of any particular facility, I haven't been fit-tested to their standards, therefore I'm not authorized to care for patients that are on airborne precautions, not that I don't know how to safely do it.

sapphire18 · Dec 24, 2013

How were you wearing the mask if it wasn't covering your mouth?

As others have stated, N95 is for airborne precautions and the flu requires droplet precautions- a standard surgical mask is used for this. So yes, you are at risk for contracting the flu since your mouth wasn't covered. HIV, no. I look forward to the day that how HIV is transmitted is common knowledge. Ignorance on this topic only perpetuates the stigma associated with HIV and AIDS.

schnookimz · Dec 24, 2013

If I came across as rude I apologize. I posted without thinking which was wrong of me. I do agree that some homework is in order though.[/quote']
I thought your response was hilarious.

jadelpn, LPN, EMT-B · Dec 24, 2013

I would take the time to familiarize yourself with how to put on any and all protective masks, etc. The time to figure that out is NOT when you have a positive flu you need to care for.

This has nothing to do with the patient's HIV status. I would go to your local state's website and become familiar with HIV. It does perpetuate the myth that patients can somehow "spew HIV germs".....and this is really, really misinformation.

Finally, educate this patient on the importance of a flu vaccine every year. Your patient needs to be educated on the importance of protecting themselves from flu, pneumonia, whooping cough.....

madwife2002, BSN, RN · Dec 24, 2013

Be kind everybody-not everybody knows everything about nursing and this should be a safe environment where nurses can come to learn from more experienced and not feel threatened!

Esme12, ASN, BSN, RN · Dec 24, 2013

I thought we put them in isolation for their own protection

I am not sure of your role in bedside care but you need some education about isolation and the care of patients.

Not all patients are placed in isolation for their own protection. TB patients are placed in isolation because they are infectious to everyone else and you need to protect yourself from becoming infected.

I think the nursing staff needed to ensure that you were educated on why this patient needed an N95 mask and then made sure you knew how to wear one. Many, if not all, of these masks need to be fit tested to the individual for best protection of the worker involved in their care.

We cannot give medical advice. I suggest that you call your employee health and ask about fit testing and that you didn't wear the PPE correctly. You are probably just fine but you need to let them know.