Single glove during surgery

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SpringDO

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Hey guys I'm a bit paranoid. During surgery rotation I singled gloved instead of double gloving. Then glove didn't rip or tear but when I held the patients organ with my glove on it felt like the blood was soaking through the gloves and my hands felt wet. Is it possible that his blood soaked through my glove? I didn't visibly see blood on my hands after the surgery but wondering If microscopic particles may have soaked through??
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Hey guys I'm a bit paranoid. During surgery rotation I singled gloved instead of double gloving. Then glove didn't rip or tear but when I held the patients organ with my glove on it felt like the blood was soaking through the gloves and my hands felt wet. Is it possible that his blood soaked through my glove? I didn't visibly see blood on my hands after the surgery but wondering If microscopic particles may have soaked through??
 
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My guess would be it felt wet from your own perspiration and your brain associated the organ/blood with the sensation. Everything is fine.
 
SpringDO said:
Hey guys I'm a bit paranoid. During surgery rotation I singled gloved instead of double gloving. Then glove didn't rip or tear but when I held the patients organ with my glove on it felt like the blood was soaking through the gloves and my hands felt wet. Is it possible that his blood soaked through my glove? I didn't visibly see blood on my hands after the surgery but wondering If microscopic particles may have soaked through??
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Why are you freaking out? you washed your hands didn't you?
 
Why did you single glove? Good now, you'll always double glove now. There's no reason why medical students should single glove, protect yourself before you start your medical career.

If you didn't have a wound, HIV/HCV/HBV other blood borne diseases don't diffuse through your skin. Hopefully you did wash your hands for 10 seconds before you touched your eyes, eat, who knows where-ever you touched.

If you are really worried, please report to occupational medicine. Doesn't this count as medical advice posting on here?
 
I single gloved bc it was so hectic in OR and I just forgot. I have eczema so I may have some cuts in my skin. The glove was not torn or anything, it was intact.

My hands just felt wet after I reached inside the body and touched the organs. I just hope the blood didnt soak through the gloves.

the surgeon also single gloved and after he removed his glove he had some blood on his dorsum of his hand but he also didnt have cuts or tears in his glove. But my hands were not bloody after I took of glove.
 
I dunno, I bet you contracted ebola or some **** from those organs. Better say good-bye to your loved ones..
 
Rendar5 said:
I dunno, I bet you contracted ebola or some **** from those organs. Better say good-bye to your loved ones..
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hahah you are so funny! Cant help it i'm just a paranoid student!!
 
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SpringDO said:
I single gloved bc it was so hectic in OR and I just forgot. I have eczema so I may have some cuts in my skin. The glove was not torn or anything, it was intact.

My hands just felt wet after I reached inside the body and touched the organs. I just hope the blood didnt soak through the gloves.

the surgeon also single gloved and after he removed his glove he had some blood on his dorsum of his hand but he also didnt have cuts or tears in his glove. But my hands were not bloody after I took of glove.
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You're fine.
 
I always single gloved when I was on surgery. I didn't do enough to warrant a need for a second pair of gloves, and I felt like it was a waste of materials to double glove to cut sutures and close skin. I also never did anything substantial on cases where there was contamination (open bowel, C-sections) that would warrant having a pair that could quickly be pulled off and continue surgery.
 
evilbooyaa said:
I always single gloved when I was on surgery. I didn't do enough to warrant a need for a second pair of gloves, and I felt like it was a waste of materials to double glove to cut sutures and close skin. I also never did anything substantial on cases where there was contamination (open bowel, C-sections) that would warrant having a pair that could quickly be pulled off and continue surgery.
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It's more about protection than it is about quickly pulling off the top layer. Our attendings get upset if they find out that we (or the residents) single glove.

Funny enough, closing is probably one of the times that it's advantageous to have double gloves. Most people get stuck with suture needles.
 
tco said:
It's more about protection than it is about quickly pulling off the top layer. Our attendings get upset if they find out that we (or the residents) single glove.

Funny enough, closing is probably one of the times that it's advantageous to have double gloves. Most people get stuck with suture needles.
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How would another layer of thin glove help prevent a needlestick?
 
1) You're absolutely fine

2) surgical gloves are engineered to provide enhanced tactile feel (more than what you'd expect for gloves of the thickness they are). Part of that tactile feel is associated with change in temperature/convection when "wet", which is probably what you felt. Various glove types have different properties changing the feel, stretch and grip. That's why OR's stock so many different brands/types of gloves (I'm not a surgeon, but was always a fan of BioGel's)

3) The double gloving thing is NOT a universal expectation. If your attendings want students to double glove, just do it. But I've been in lots of different OR's where the surgeons and students only single gloved.
 
DO Fo Sho said:
How would another layer of thin glove help prevent a needlestick?
Click to expand...

It just gives you an extra layer that the needle has to go through before it hits your skin. That's all...
 
DO Fo Sho said:
How would another layer of thin glove help prevent a needlestick?
Click to expand...

There have been a number of review articles showing that when surgeons double glove, the most common event is that the outer glove gets perforated while the inner glove is left intact. Thus double gloving as compared to single gloving reduces the overall risk of you getting contaminated with something.

Now if you stab yourself in the hand with a 14 gauge needle, no it's not like the second glove will be a magical barrier. But that's not the most common event. There are many times when gloves will develop a small tear from traction, or you just barely scrape it with a needle or instrument. In these cases the inner glove does keep you from getting exposed.


As a surgery resident, I would say that EVERY student should double glove EVERY time.

The only reason not to double glove is if you really think you need some extra tactile feedback for a technically complex case (such as sewing a vascular anastomosis), and even then I think it's a stupid decision. I always double glove. I always make my students double glove.

The argument that its "wasteful" to use a second glove when you aren't really doing much is stupid. The amount of waste in hospitals is already absurd and adding one pair of gloves to the mix is hardly making a difference. And it's never a waste in my mind to do everything you can to ensure your personal safety.

And just because you aren't really doing much doesn't mean you arent at risk. Surgeons may set a needle down right in front of you without noticing where your hands are. Things get dropped/tossed/thrown. I've seen students have needle sticks before, and personally had one as an M3, and it is never a fun thing to deal with.
 
SpringDO said:
Hey guys I'm a bit paranoid. During surgery rotation I singled gloved instead of double gloving. Then glove didn't rip or tear but when I held the patients organ with my glove on it felt like the blood was soaking through the gloves and my hands felt wet. Is it possible that his blood soaked through my glove? I didn't visibly see blood on my hands after the surgery but wondering If microscopic particles may have soaked through??
Click to expand...

You'll be fine. I personally hate double gloving, it makes me feel like I have big mickey mouse hands. I have been single gloving for years and still don't have AIDS (despite needle sticks, holes from traction or god knows what).
 
You're fine, I'm sure it was just the difference in the temperature of the organ. If you are really concerned get tested. As far as double gloving- just do it, at the very least it will save you having to re-glove if your outer glove rips. If you where properly sized gloves it should not make a significant difference in your dexterity. One thing that often surprises people is that you should wear the bigger glove on the inside. For instance, I wear a 7.5 under glove and a 7.0 on top. Comfy, dexterous!

Survivor DO
 
mimelim said:
In contrast, I never double glove. I did at one point and stopped after experiencing working with only a single set. I have found that it makes a measurable difference in my work.
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Anastamosing vessels with suture so small you can't even see it is a different situation than most will encounter.
 
southernIM said:
There have been a number of review articles showing that when surgeons double glove, the most common event is that the outer glove gets perforated while the inner glove is left intact. Thus double gloving as compared to single gloving reduces the overall risk of you getting contaminated with something.

Now if you stab yourself in the hand with a 14 gauge needle, no it's not like the second glove will be a magical barrier. But that's not the most common event. There are many times when gloves will develop a small tear from traction, or you just barely scrape it with a needle or instrument. In these cases the inner glove does keep you from getting exposed.


As a surgery resident, I would say that EVERY student should double glove EVERY time.

The only reason not to double glove is if you really think you need some extra tactile feedback for a technically complex case (such as sewing a vascular anastomosis), and even then I think it's a stupid decision. I always double glove. I always make my students double glove.

The argument that its "wasteful" to use a second glove when you aren't really doing much is stupid. The amount of waste in hospitals is already absurd and adding one pair of gloves to the mix is hardly making a difference. And it's never a waste in my mind to do everything you can to ensure your personal safety.

And just because you aren't really doing much doesn't mean you arent at risk. Surgeons may set a needle down right in front of you without noticing where your hands are. Things get dropped/tossed/thrown. I've seen students have needle sticks before, and personally had one as an M3, and it is never a fun thing to deal with.
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Great logic here! I agree for the most part for sure. I think it's sad when cost becomes a factor over safety. If you feel more comfortable double gloving - def. do it.

I'll just chime in that the only surgeries I've been involved with that required double gloving were enteric resections and anastamosis, removal of contaminated/infected tissue, and when the uterus was cut into (cesarean). The purpose being to not cross contaminate with bacteria in the sense of enteric resections once closed the outter glove was removed before closure of the remaining tissues. Similar with the uterus; once the incision was closed - the outer gloves were removed to prevent uterine blood from potential seeding the abdomen (endometriosis) while closing the remaining tissues.

If one has open wounds on their hands - double gloving sounds like a good idea. Gloves arent always perfect and they do on occasion have weak spots etc that tear easy. Otherwise, your hands are sterile going into the glove - if it tears during surgery - simply have assistance removing it and replacing the glove. Of course wash your hands after surgery regardless if you know of a glove tear or not; it's just the common sense thing to do.

double gloving wont protect you from needle sticks, the pointed end of a hartman-mosquito, gelpi, scalpel etc. So unless you have cuts on your hand where double gloving can protect a possible exposure due to one glove failing - that's the main argument for double gloving imo. You will lose dexterity for surgeries like vascular surgeries double gloving.
 
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SpringDO said:
Hey guys I'm a bit paranoid. During surgery rotation I singled gloved instead of double gloving. Then glove didn't rip or tear but when I held the patients organ with my glove on it felt like the blood was soaking through the gloves and my hands felt wet. Is it possible that his blood soaked through my glove? I didn't visibly see blood on my hands after the surgery but wondering If microscopic particles may have soaked through??
Click to expand...
YOU ARE FINE. Blood does not soak through an impenetrable layer of latex/nitrile, or else we wouldn't bother wearing gloves. Go put on a pair of gloves and put them under cold running water. They'll feel "wet."

tco said:
Anastamosing vessels with suture so small you can't even see it is a different situation than most will encounter.
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Most surgery residents will do vascular anastomoses. I don't think that tactile feedback really plays any role in doing an anastomosis, since you're holding instruments the entire time.

DO Fo Sho said:
How would another layer of thin glove help prevent a needlestick?
Click to expand...
The needle usually catches on your glove. You don't usually get straight-up impaled by it. An extra glove does make a difference. I've had the outer glove get perforated without the inner glove breaking.

mimelim said:
+1

I'm not saying it is right or wrong. I simply strongly prefer to single glove.
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I did too, until I got tired of filling out the paperwork from needlesticks 😉

Now it feels weird not to double glove, and I did a recent perc trach on a Hep B/C patient, and I'd forgotten about that fact when I did it, and I'm sitting here wondering if I double gloved, even though I didn't stick myself...

You just have to find the right combo of gloves to double glove with, and it will feel fine. I wear the same size of blue undergloves and white outer gloves, and it feels pretty good.
 
TheProwler said:
I did too, until I got tired of filling out the paperwork from needlesticks 😉

Now it feels weird not to double glove, and I did a recent perc trach on a Hep B/C patient, and I'd forgotten about that fact when I did it, and I'm sitting here wondering if I double gloved, even though I didn't stick myself...

You just have to find the right combo of gloves to double glove with, and it will feel fine. I wear the same size of blue undergloves and white outer gloves, and it feels pretty good.
Click to expand...

I had one needlestick this year, three of us closing after fem-pop with GSV harvest. Three needles going and one of my senior residents caught my thumb 🙁. The paperwork was bad, plus getting the tubes sent for testing + my own testing was a pain. I'll try playing with the different gloves. I was originally doing 8 inside, 7.5 outside, now I just wear 7 outside. Will try 7/7 tomorrow and see. I only have 8 cases tomorrow (all AVF vs. AVG), so I can do some experimenting 🙂.
 
mimelim said:
I had one needlestick this year, three of us closing after fem-pop with GSV harvest. Three needles going and one of my senior residents caught my thumb 🙁. The paperwork was bad, plus getting the tubes sent for testing + my own testing was a pain. I'll try playing with the different gloves. I was originally doing 8 inside, 7.5 outside, now I just wear 7 outside. Will try 7/7 tomorrow and see. I only have 8 cases tomorrow (all AVF vs. AVG), so I can do some experimenting 🙂.
Click to expand...

I'd say if you were wearing 8/7.5's and now are just wearing 7s, it may have been as much a problem of fit as anything.

But to some degree it's a matter of preference. If you were my student you'd be double gloving while under my supervision...but you're a grown up and can decide for yourself what you need to do.
 
southernIM said:
I'd say if you were wearing 8/7.5's and now are just wearing 7s, it may have been as much a problem of fit as anything.

But to some degree it's a matter of preference. If you were my student you'd be double gloving while under my supervision...but you're a grown up and can decide for yourself what you need to do.
Click to expand...

When you double glove, which glove should be the "correct size?"

Meaning...if I wear a 7, should I have a 7 under a 6.5, or should I have a 7.5 under a 7?
 
southernIM said:
I'd say if you were wearing 8/7.5's and now are just wearing 7s, it may have been as much a problem of fit as anything.

But to some degree it's a matter of preference. If you were my student you'd be double gloving while under my supervision...but you're a grown up and can decide for yourself what you need to do.
Click to expand...

Sorry, I should have expanded, I tried smaller double gloving and would always get annoyed because of how constrictive it felt. I could never balance 'feel' and 'constriction'. Maybe I need to try non-biogel gloves? But I'll try 7/7 or 7/7.5 tomorrow.
 
BigRedBeta said:
3) The double gloving thing is NOT a universal expectation. If your residents/attendings want students to double glove, just do it. But I've been in lots of different OR's where the surgeons and students only single gloved.
Click to expand...

I agree with this. For me, personally, I'm fine with wearing one set of gloves. I wore 2 sets once, and my hands got considerably more sweaty and uncomfortable even in a relatively short case.
 
evilbooyaa said:
I agree with this. For me, personally, I'm fine with wearing one set of gloves. I wore 2 sets once, and my hands got considerably more sweaty and uncomfortable even in a relatively short case.
Click to expand...
The undergloves we have make my hands sweat less, even though I have a second pair of gloves over them. I don't think they're powdered, but they kind of feel like they are.

mimelim said:
I had one needlestick this year, three of us closing after fem-pop with GSV harvest. Three needles going and one of my senior residents caught my thumb 🙁. The paperwork was bad, plus getting the tubes sent for testing + my own testing was a pain. I'll try playing with the different gloves. I was originally doing 8 inside, 7.5 outside, now I just wear 7 outside. Will try 7/7 tomorrow and see. I only have 8 cases tomorrow (all AVF vs. AVG), so I can do some experimenting 🙂.
Click to expand...
that's it? pick up the pace, man.
 
Not to beat a dead horse, but...I don't think students should ever NOT double glove. There's nothing you are doing as a student that will ever necessitate that kind of tactile feedback; especially considering the risks - few, but completely unnecessary for a student.
I double glove all open operations still, single glove for laparoscopic cases.
 
Not that I've ever seen anything come of it, or that I single glove every time. I've heard there is actually leakage rates through gloves depending on glove type and wear.
 
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TheProwler said:
that's it? pick up the pace, man.
Click to expand...

We typically do 2-3 marathon days of HD access a week of between 8-12 AVF/AVG. Too bad the cases don't count toward our numbers as vascular residents...


So I played around with double gloving, the best was 7.5/7, but it still felt like crap 🙁. I should have never single gloved in the first place. I just got called from employee health about blood results from a needle stick this weekend =/. I don't think double gloving would have helped in that case, but meh made me think about this afterward =/.
 
mimelim said:
We typically do 2-3 marathon days of HD access a week of between 8-12 AVF/AVG. Too bad the cases don't count toward our numbers as vascular residents...


So I played around with double gloving, the best was 7.5/7, but it still felt like crap 🙁. I should have never single gloved in the first place. I just got called from employee health about blood results from a needle stick this weekend =/. I don't think double gloving would have helped in that case, but meh made me think about this afterward =/.
Click to expand...

Do you have da hep now?
 
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