avoiding getting gastro and other URIs from your patients

[LadyJubilee8_18]

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So I'm an aspiring pediatrician on my pedi core rotation, and I'm quickly learning that kids are awesome, but kinda gross. I had a patient today who was spitting up through out the history. When I went to do a fundoscopic exam, I was concentrating so my mouth was hanging open a bit. The kid started to smile, and all of a sudden, he stuck his spitty, vomity hand in my mouth I'm sure I'll be throwing up in due time despite all the air born I've been taking, but I'd really like some advice on how to avoid this in the future (besides the obvious: keeping my mouth closed). Any little secrets on how to keep your health while working with children?

 

[primadonna22274]

Yup, kids are awesome, albeit little bug factories.
1. I always turn my head when auscultating a chest (away from the kid's mouth/nose).
2. I wash my hands before/after touching every patient. (Sanitizer helps here.)
3. I stand back a fair bit and to the side when looking in a throat/etc.
4. I disinfect my stethoscope a few times a day with germicidal wipes (the kind we wipe down beds and other stuff in the room with).
And still, sometimes I get sick, but far less often than I used to. I was sick (bad URIs) 7-8 times my first year in practice and steadily less frequently since, maybe once or twice a year now. Sometimes it's just inevitable. I work with about 2/3 adults and 1/3 kids in family practice and it still irks me that people will come in to the office/ED with every single viral infection thinking I can magically make it disappear, all the while exposing the rest of the waiting room and clinical staff. Job security I guess.
Of course the usual stuff like eat right, exercise, get enough sleep (ha).
Enjoy!
Lisa PA-C

 

[oldbearprofessor]

The kid started to smile, and all of a sudden, he stuck his spitty, vomity hand in my mouth

okay, I laughed at the story. Sorry, I don't usually laugh at other's misfortunes (?) but I laughed.

The long-term solution here is to do neonatology. Short-term, you'll get bugs no matter what. Worst time is internship. But, by your PL-3 year, you should have your immunity pretty high!

 

[TexasRose]

You could teach elementary school &/or have several of your own kids prior to starting your residency. That'll build up your immune system! 😉

Several interns told me that they wear gloves when examining patients, no matter the CC.

 

[Freibi]

O-o, I hope you don't get sick! If that ever happens again (read: when...), excuse yourself and wash out the affected area with plenty of water. At least you won't be feeling as gross. When you ask a child to say ahh, never demonstrate it with your own mouth open at the same time, as they may cough/sputter right at you (there was at least one time where I knew exactly how I got the new bug)!
There are 2 options to stay healthy - either stay out of the risk zone (go into neonatology) or become immune against everything (go into general peds or EM) 🙄

 

[bluebirdie]

The long-term solution here is to do neonatology.!

this makes no sense....

 

[LadyJubilee8_18]

okay, I laughed at the story. Sorry, I don't usually laugh at other's misfortunes (?) but I laughed.

The long-term solution here is to do neonatology. Short-term, you'll get bugs no matter what. Worst time is internship. But, by your PL-3 year, you should have your immunity pretty high!

Thanks for laughing at my misfortune 🙁 (just joking). Well, I'm sick, but not in the way I thought I was going to be. I have some tummy pain, but mostly I had a fever for a day, I've been really tired, I have lymphadenopathy of the cervical, axillary, and inguinal nodes, and my muscles ache--especially my back. I don't have much in the way of a URI except for some enlarged tonsils. Pretty weird, I'd expect to feel more URIy than this, or to have gastro. Mostly my back really hurts. What causes these symptoms?

 

[oldbearprofessor]

I have some tummy pain, but mostly I had a fever for a day, I've been really tired, I have lymphadenopathy of the cervical, axillary, and inguinal nodes, and my muscles ache--especially my back. I don't have much in the way of a URI except for some enlarged tonsils. Pretty weird, I'd expect to feel more URIy than this, or to have gastro. Mostly my back really hurts. What causes these symptoms?

Kiddie crud is the technical term. It can take lots of forms depending on the virus, especially in adults. But, as you know, SDN is not for having your kiddie crud diagnosed!😉

Treatment of choice is Kosher Chicken Soup and rest.

 

[LadyJubilee8_18]

Kiddie crud is the technical term. It can take lots of forms depending on the virus, especially in adults. But, as you know, SDN is not for having your kiddie crud diagnosed!😉

Treatment of choice is Kosher Chicken Soup and rest.

true, well I'm just gonna sleep and drink lots of tea. Hopefully I'll feel better by tomorrow since I'm working the ben taub pedi ec tomorrow 👍 I'm headed to the TCH NICU in about a week 😀

 

[kristing]

Isn't it amazing how what looks like meere puking in a kid can cause a full-blown flu like illness in you? It's like how a stomach ache can really mean anything, from strep throat to pneumonia to gastro.

And who doesn't understand why going into neonatology would mean no infections? thinnnnnnnk about it.....

All I can say is WASH YOUR HANDS A LOT!!!

Don't wear gloves all the time. That's so lame. It makes you seem unapproachable and a germaphobe.

My favorite combination when starting to feel sick is echinacea tincture (the nasty liquid, not the pills) - 1 dropperfull every 4 hours (apple juice masks the flavor best) along with zicam every 4 hours while awake. I swear when I do this my illnesses are much shorter and less hairy.

 

[doctawife]

In peds, you're gonna get sick. No way around it. Washing your hands, cleaning the stethoscope, using your hands to block the nasty bronchiolitic cough may help... but until your system has seen every viral pathogen, you are destined to be sick every viral season.

Even as an attending, I've gotten viral pneumonia and sinusitis in the last year. I haven't gotten gastro since I've been an intern, and most flu like syndromes pass me by. Given enough time, you'll be immune as well.

 

[LadyJubilee8_18]

Isn't it amazing how what looks like meere puking in a kid can cause a full-blown flu like illness in you? It's like how a stomach ache can really mean anything, from strep throat to pneumonia to gastro.

And who doesn't understand why going into neonatology would mean no infections? thinnnnnnnk about it.....

All I can say is WASH YOUR HANDS A LOT!!!

Don't wear gloves all the time. That's so lame. It makes you seem unapproachable and a germaphobe.

My favorite combination when starting to feel sick is echinacea tincture (the nasty liquid, not the pills) - 1 dropperfull every 4 hours (apple juice masks the flavor best) along with zicam every 4 hours while awake. I swear when I do this my illnesses are much shorter and less hairy.

Well, I certainly have a broader differential for kids who show up vomitting. I still feel terrible by the way; the I found the URI symptoms. I wonder if I got the flu. Even though I got a flu shot, I heard it didn't cover the major strains this year (anyone know the percentage?). I actually swear by airborne because of the echinacea, but I ran out about a month ago, and my fiance made fun of me so bad I was too embarrassed to get more. Now look at me! maybe I'll try your method.

In peds, you're gonna get sick. No way around it. Washing your hands, cleaning the stethoscope, using your hands to block the nasty bronchiolitic cough may help... but until your system has seen every viral pathogen, you are destined to be sick every viral season.

Even as an attending, I've gotten viral pneumonia and sinusitis in the last year. I haven't gotten gastro since I've been an intern, and most flu like syndromes pass me by. Given enough time, you'll be immune as well.

I kinda figured this. I've been washing my hands like mad, and ducking and dodging all sneezes, coughs and hands since last week. Now I've got a cold, dry skin, and a stiff neck 🙁

 

[MaddieMay]

Airborne and echinacea have not been proven to do anything, but take advantage of that placebo effect! I do!

 

[LadyJubilee8_18]

Airborne and echinacea have not been proven to do anything, but take advantage of that placebo effect! I do!

Pretty much what I do 👍 It makes me feel better

 

[1viking]

Several interns told me that they wear gloves when examining patients, no matter the CC.

That is unreal! I wonder how the 12-18 monthers deal with that. I wash my hands before and after every visit. The white coat stays in the car, and I shower the moment I get home for the day.

Lucky for me, I have three kids under age 4, so I anecdotally have a heightened immune system.

 

[LadyJubilee8_18]

You could teach elementary school &/or have several of your own kids prior to starting your residency. That'll build up your immune system! 😉

Several interns told me that they wear gloves when examining patients, no matter the CC.

I just noticed this. Really? I would think this would be intimidating to kids. I can barely get a good physical from a toddler when I'm wearing my white coat, can't imagine trying to get one with gloves on. Though I once had a patient who turned out to have head lice. They put her on contact isolation right after I did my physical and presented it to the resident. Kinda wished I had gloves on for that one. I made my fiance check me for lice every day for about a week before I could stop freaking out.

 

[TexasRose]

That is unreal! I wonder how the 12-18 monthers deal with that. I wash my hands before and after every visit. The white coat stays in the car, and I shower the moment I get home for the day.

Lucky for me, I have three kids under age 4, so I anecdotally have a heightened immune system.

I just noticed this. Really? I would think this would be intimidating to kids. I can barely get a good physical from a toddler when I'm wearing my white coat, can't imagine trying to get one with gloves on. Though I once had a patient who turned out to have head lice. They put her on contact isolation right after I did my physical and presented it to the resident. Kinda wished I had gloves on for that one. I made my fiance check me for lice every day for about a week before I could stop freaking out.

I thought it was odd, too. I don't feel like I get the best exam with gloves on. Also, I feel like (right or wrong) it's telling the parents "I think your child is germy and gross!"

I put gloves on in the NICU to protect the patients from me since their immune systems aren't working so well yet.