scabies

[nrsbetrn]

Could someone share your policy/procedure on scabies? Every now and then we will have a resident that is suspected to have scabies. The rash and itching are there but the skin scrape is negative. No one is really sure if the case is scabies or not. Also, if there is a case of scabies how do other facilities treat the room and the roommate? Do you treat the roommate also or wait for S/S. I know the tx can be very toxic for the elderly population.

[suebird3]

We had a "rash" of non scabie rashes, and still used Eurax, etc. The stuff does work on other sorts of rashes. And yes, we treat the roommate, too.

Suebird

[CapeCodMermaid, RN]

Before we use the dreaded "S" word, we make darned sure it really is scabies which usually means a trip to the dermatologist and a skin scraping. If it comes back positive, then EVERYONE gets treated...all the residents and all the staff. I worked at one place where all new admits got treated whether they needed it or not....nasty business.

[Megsd, BSN, RN]

We had a scabies outbreak last fall. 7 residents had confirmed cases, but all residents and staff were treated. All washable items were sent to laundry (the poor people had no clothes for days), anything unable to be washed (stuffed animals, pillows) had to be put in a sealed plastic bag for 3 months. The staff was given a tube of Elimite and we had to shower, apply the scream, then shower in 12 hours. All 50 residents on the unit got the same treatment: 1st shift showered everybody, everybody got creamed, then 2nd shift showered everybody again.

It was pure and utter chaos and I hope to never encounter scabies ever ever again.

[snowfreeze, BSN, RN]

One facility where I work uses ivermectin for many patients. All clothing and belongings are placed in dark trash bags for 3 days then washed. A recliner was placed in dark plastic for 3 days in a non-patient area. Patient is isolated for one week then is given a second dose of ivermectin and allowed out of isolation. We did have a few cases of norwegian scabies which was not identified by scraping, we had to arrange a skin biopsy to identify that. The first patient had been to a dermatologist a few times prior to the skin biopsy. Treatment was with prescription cream and ivermectin over a 4 week period.

Ivermectin is a weight based oral treatment.

[Jedi_Iatros]

We usually got our scabies outbreak from homeless patients.

Elimite's supposed to be carcinogenic (atleast with mice) if used longterm.