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Contaminated instruments...at your hospital??

Discussion in 'Medical Students - MD' started by carddr, Mar 4, 2002.

  1. carddr

    carddr Senior Member

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    Just read in the paper of a contaminated instrument at Hopkins, apparently infecting pt with pseudomonas, now thats some serious stuff,128 pts so far have been affected...ever heard of this happening at your hosp.? Is this a common occurence? If so, how can the hosp. prevent this from happening? Is there a clearinghouse for this type of information so one hospital can notify everybody else when this happens? Hope so.
     
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  3. squeek

    squeek Senior Member

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    It happens a lot more than anyone would like, although the Hopkins incident was due to an equipment defect and they did not receive timely recall notification.

    Most hospitals, if not all, have hospital epidemiology staff that monitor hospital (nosocomial) infection rates. If any particular type of infection is abnormally high or clustered, they go to work tracking down the source...we actually had a lecture on this last week, and some crazy stuff happens, like surgeons carrying staph in their hair and contaminating patients, or a cat giving the owner ringworm who then gave it to 4 neonates...

    At any rate, it happens, but there are people on staff to work to solve the problems.
     
  4. ckent

    ckent Banned
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    I shadowed some pediatricians in a private practice who didn't use disposable otoscope speculums, they didn't even wipe theirs down after seeing kids with ear infections. No wonder so many kids have ear infections, they probably get them from seeing their pediatricians.
     
  5. neutropeniaboy

    neutropeniaboy Blasted ENT Attending

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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by ckent:
    <strong>I shadowed some pediatricians in a private practice who didn't use disposable otoscope speculums, they didn't even wipe theirs down after seeing kids with ear infections. No wonder so many kids have ear infections, they probably get them from seeing their pediatricians.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">The majority of children with "ear infections" have acute or chronic otitis media, whether serous, mucinous, or purulent. These are middle ear infections and come about due to the disproportionate number of URIs children have and due to anatomical differences in eustachian tube function in children when compared to adults. The organisms causing otitis media are common inhabitants of the nasopharyngeal mucosa and differ from the organisms causing otitis externa, which is what would be caused (if it at all could be) by "contaminated" specula being reused. Despite my own academic reasons for objecting to the way in which most pediatricians manage kids with OM, I'm quite sure they are not the cause of the prevalence of OM in children.

    I hope you were being facetious. That's quite a bold conclusion there.

    On the subjet of contamination, however, I wonder how many of these so-called contaminated instruments are contaminated by the decontamination process, by staff, or by physicians themselves. Furthermore, I wonder what percentage of them have the living organism on them rather than the antigens that may remain after sterilization.

    For some reason, I have a feeling that no instrument can be completely decontaminated.
     
  6. neutropeniaboy

    neutropeniaboy Blasted ENT Attending

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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by squeek:
    <strong>...like surgeons carrying staph in their hair and contaminating patients...</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Speaking of hair...

    Ever notice how the srub techs/nurses bitch and moan at you about maintaining sterility while they lean over the field with their funky/cutsie-pie scrub caps with long strands of hair falling out because they don't want to mess up their hair?
     
  7. ckent

    ckent Banned
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by neutropeniaboy:
    <strong>
    The majority of children with "ear infections" have acute or chronic otitis media, whether serous, mucinous, or purulent. These are middle ear infections and come about due to the disproportionate number of URIs children have and due to anatomical differences in eustachian tube function in children when compared to adults. The organisms causing otitis media are common inhabitants of the nasopharyngeal mucosa and differ from the organisms causing otitis externa, which is what would be caused (if it at all could be) by "contaminated" specula being reused. Despite my own academic reasons for objecting to the way in which most pediatricians manage kids with OM, I'm quite sure they are not the cause of the prevalence of OM in children.

    I hope you were being facetious. That's quite a bold conclusion there.

    On the subjet of contamination, however, I wonder how many of these so-called contaminated instruments are contaminated by the decontamination process, by staff, or by physicians themselves. Furthermore, I wonder what percentage of them have the living organism on them rather than the antigens that may remain after sterilization.

    For some reason, I have a feeling that no instrument can be completely decontaminated.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">My point was that I would not be comfortable sticking a speculum in my ear that had just been used in 10 other children, half of whom had ear infections. We only use disposable speculums in the university.
     
  8. neutropeniaboy

    neutropeniaboy Blasted ENT Attending

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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by ckent:
    <strong>My point was that I would not be comfortable sticking a speculum in my ear that had just been used in 10 other children, half of whom had ear infections.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Well, of course not! I'd feel MUCH more comfortable sticking a cerumen-coated, dripping speculum in someone ELSE'S ear! <img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" />
     
  9. droliver

    Moderator Emeritus

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    I know of a similar incident with multiple MRSA pneumonia's transmitted among ICU patients after a miscommunication led to the bronchoscopes not being cleaned. A few years before I started they had a nurse who infected a # of Neonatal ICU patients with Pseudomonas from under her artificial nails that resulted in several deaths. Most line infections are also caused by contamination during insertion, or more frequently by nurses not handling them properly
     

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