Policies for masks in the OR

[maritimegirl]

I was just wondering if some of you could give me some input on what your policies are for masks in the OR. We are required to wear masks at all times even if there is no case set up in that room, and even after hours when there are no surgeries taking place. From what I understand, this isn't the case at other hospitals. Anyone have any input?

[ShariDCST]

[i think the reason the patient doesn't have to wear a mask to their own surgery is because it's their own germs they'd be breathing around? just a guess - but it makes sense to me]

patients can still infect themselves with their own bacteria, it's called endogenous infection.

i believe the patient doesn't have to wear a mask in surgery is for several reasons. it's frightening enough for them having surgery in the first place. making them wear a mask would not be appropriate.

in a an abdominal, lower body operation by the time the patient is having surgery and the surgical wound exposed, there are normally drapes that are put up (well in my or anyway) which is a barrier between the head and the area which is being worked on. the head is also under the drapes as well so there is plenty of sterile layers.

at my hcf the policy is that masks are to be worn when sterile items are opened as well.

one thing nobody else has mentioned, and maybe because it's just too obvious to note, but a patient wearing a mask could possibly make the anesthesiologist's job of intubating that patient more of a challenge than it already is?

[maeyken]

Yeah, the "their own germs" explanation is what I've heard, but some of those germs might still be floating around in the room for the next case even with air filtration. This would be an interesting evidence based study.

Then the argument is why do we unmask between cases? Would our germs not be floating around the room too? So then why bother wearing masks? A definitive study would be excellent. :)

We only mask when sterile supplies are open too, and don't mask for "clean" cases (cystos, etc)

[Scrubby]

[the argument is why do we unmask between cases? Would our germs not be floating around the room too? So then why bother wearing masks? A definitive study would be excellent.]

Masks actually lose their effectiveness after a certain period of time, about a half hour or so they become so saturated with moisture from your breath that they stop filtering out the air you breathe out.

The real purpose of wearing a surgical masks is really to protect the scrubbed team from having blood, body fluids enter your mouth :uhoh21:

And we don't masks between cases because the air is constantly being hepa filtered every five minutes.

[Circl8r]

Hi:

We wear masks in any room that has opened sterile supplies. In the institution that I work currently, we also wear masks in the sterile core because occasionally a scrubbed person steps in to retrieve flashed items from the sterilizer.

[Qwiigley, BSN, MSN, DNP, RN, CRNA]

Hi:

We wear masks in any room that has opened sterile supplies. In the institution that I work currently, we also wear masks in the sterile core because occasionally a scrubbed person steps in to retrieve flashed items from the sterilizer.

A scrubbed person should never leave the room, by definition and protocol, they are no longer sterile especially if they then touch something outside the room, such as opening the sterilizer. (remind me never to go there for a procedure!)

[ShariDCST]

a scrubbed person should never leave the room, by definition and protocol, they are no longer sterile especially if they then touch something outside the room, such as opening the sterilizer. (remind me never to go there for a procedure!)

i have retrieved flashed instruments in the past from an autoclave located in the sterile core - but i never touched the outside of it to do so. it would never be considered an option to actually open the autoclave door myself while scrubbed in. an unsterile, but masked, person always pulled the door open with the handle and stepped back for me to reach in with a sterile towel and pick up either the item or the tray. no contamination was ever experienced, and the department was designed that way. i would rather do it myself than trust that someone else retrieved it from the autoclave without contaminating it and brought it to me.

granted, it's not an ideal circumstance, but the world is not an ideal place. we do what we can to make it work. it's been a while since i've had to do that though because that took place where we did not always have enough sterile run sets to get through a day's cases, or because something got contaminated in some fashion during either the set up or the case.

[lpnstudentin2010, LPN]

In the hospital I am a patient I do not know about before I get to the OR but the as soon as they are going in to the OR the staff puts their masks on. I do not wear one. lol.

It actually surprised me once. I had looked up while they were wheeling me down the hall. I looked forward while the were wheeling me through the door then looked up again and my anesthesiologist was masked. I had looked forward for maybe 10 secs and she was masked. I was kind of like wow that was fast.

[mcmike55]

At my hospital, pretty much the same as all of you. Masks when sterile fields are open, and when the case is going on. After dressings are on, masks can come down. However, I often leave mine up until after extubation, and the pt is on the cart ready for transport. Too many fluids flying at times, you know!!!!:wink2:

For "clean" cases, such as ESWL, cystos, tonsillectomies, and D&C's, masks are, for the most, optional. Most of use wear them anyway, especially if you are scrubbed.

One rational I heard one time, is that droplets from you could contaminate instruments, like a uterine curette for example, which, does come in contact with open surfaces of the pt.

You know, one of these days, our kids (or kids kids) will look back on us and laugh about how we wore "masks" against our face during surgery!!

Mike

[tnmtnman]

romney mg.

department of medical microbiology, faculty of medicine, university of british columbia, vancouver, bc, canada. [email protected]

in most modern hospitals, no one is allowed to enter the operating theatre without wearing a surgical face mask. the practice of wearing masks is believed to minimize the transmission of oro- and nasopharyngeal bacteria from operating theatre staff to patients' wounds, thereby decreasing the likelihood of postoperative surgical site infections. in this era of cost-restraints, shrinking hospital budgets, and evidence-based medicine, many health care professionals have begun to re-examine traditional infection control practices. over the past decade, studies challenging the accepted dogma of surgical face mask usage have been published. masks that function as protective barriers are another emerging issue. due to a greater awareness of hiv and other blood-borne viruses, masks are taking on a greater role in protecting health care workers from potentially infectious blood and body fluids. the purpose of this review is to evaluate the latest evidence for and against routine use of surgical face masks in the operating theatre. copyright 2001 the hospital infection society.

pmid: 11289767 [pubmed - indexed for medline]

[tnmtnman]

something else to think about,,,,,jepsen ob, pers c, lester a, jensen a.

centrale afdeling for sygehushygiejne, statens seruminstitut, københavn.

for more than 70 years, the surgical mask has been used under operations as part of the maintenance of aseptic conditions in the operational field. experiments with models and investigations of sources of infection carried out over the past 20 years have shown, however, that the bacterial flora of the upper respiratory tract do not contribute to airborne contamination of the surgical wound, but that persons who are situated directly beside the field may contaminate the wound directly by droplets released by speech, sneezing or coughing. over the last ten years the usefulness of the surgical mask has been disputed several times, and a few controlled clinical trials have been able to confirm any benefits associated with use of surgical masks. there is therefore no reason from the point of view of preventing infection to maintain a general requirement for the use of surgical masks by others than those persons who may be situated within an arm's length of the operational field or instrument table.

pmid: 8317057 [pubmed - indexed for medline

[JamieJCST]

I guess I'm the odd one here. I work at a level 1 trauma hospital and we have to wear masks whenever we enter an OR or the sterile core. It doesn't matter whether the room is opened or not.

[lpnstudentin2010, LPN]

As the patient I just know, I looked up while I was being wheeled down to the OR mask around neck, looked up as soon as we had entered to OR mask was miraculously on face.