Operative Disimpaction - PPE

[jackandjill123]

Hi all -

New OR Scrub Nurse here (6 months in), we had to do an operative disimpaction via ex-lap last week on an HIV+ / Hep-C pt with a rectal cancer. The belly was extremely distended due to the build-up of 2+ weeks of stool. All efforts to avoid operative intervention were exhausted including meds (mag citrate) and even manual disimpaction bedside.

Upon opening, the release of pressure caused fecal matter to go everywhere, including over all of us. I am very diligent about PPE, but this was the first time I felt compromised, esp. given the patient's known exposures and virulent nature of the fluids in-question.

I know we all conform to "Universal Precautions", but I will be helping present at grand rounds with the chief resident about additional precautions that a surgical provider can undertake in these such circumstances.

I would love any and all input from this wonderful community of top-notch perioperative nurses!

[Rose_Queen, BSN, MSN, RN]

Following universal precautions in addition to standard surgical attire should be enough. What is different with that patient that has a diagnosis of HIV and HepC and the next patient who hasn't been diagnosed? There aren't really additional PPE needs warranted- what do you think you would add? Would you add it for every patient?

[3ringnursing, BSN]

That must have comprised the surgical site - how is the pt?

[jackandjill123]

We took patient back in 4 days later and unfortunately, he expired intraop.