Re: Another question for Nurses (or anybody)
I'm an RN and have worked in Pediatric Intensive Care for over 25 yrs. If a child has swine flu or bird flu they will be intubated and vented if they are in my unit.
Here's my question. Should the incidence and morbidity of the swine flu increase but we are still allowed to travel to and from work and home. What would be the best way to protect our families.
Should I not go home. Should I change into scrubs at the hospital and shower before changing again to go home. Should I have a decontamination area at home in the garage maybe for me to change before going in to shower.
Over the years I've taken care of alot of infectious diseases. Never brought any unwelcome '"guests" home. Am I just reacting to the term pandemic? Seems only prudent to have a plan. What do you all think?
I've worked in infection control for several decades, but the answer to your question is not straightforward.
Unless you family is in protective self-isolation, that is, isolating themselves at home without any contact with the outside world, family members will be at risk from many sources. This is a novel virus, to which very few have immunity. As Dr. Fukuda pointed out at the WHO briefing on 5/14/09, half the people who have become infected so far are relatively young, the median age is around 20. Among those people who have died, half have no known predisposing factors. At present, young people appear to have a higher risk of infection, including severe infection.
However, hospitals, doctors offices, clinics, pharmacies and the like will have higher levels of the virus present. If I were working in a high risk environment, and then going home to my family, I would do the following:
First, whenever personal protective equipment is used, it must be removed with great care. Several studies have shown high levels of self-contamination during removal of PPE.
Second, I would wear a protective gown over my uniform at all times, even when not in an isolation room.
Third, wipe down all shared items (keyboards, phones,) and don't share pens. Remember the influenza virus can survive on paper, cloth, hands, smooth and rough surfaces. It will be everywhere.
Fourth, clean your hands frequently and avoid touching your face except immediately after hand hygiene. Be sure to turn off faucets and open rest room doors with a paper towel. Keep alcohol based hand sanitizer in yoru pocket and use it often throughout the day.
So the first order of business is to reduce your own risk of infection so that you don't infect family members directly through your own illness. Then, concern about indirect transmission comes to the fore.
Fifth, if possible, change into cleans scrubs at the hospital before leaving for the day. I would change my shoes before getting into my car, leaving the pair worn in the hospital in a plastic bag in the trunk. I would use the hand sanitizer before going into the house.
Sixth, I would shower at home before having contact with my family. It's also a good idea to wipe down surfaces and floors daily., including the bathroom. The flu virus is easily killled with detergents and household cleaners..
Seventh, teach family members to wash their hands frequently, avoid touching their feyes, nose and mouth, consider all public touched surfaces and items contaminated, do not share pens, drinking glasses, utensils, food, drinks, plates, avoid hand shakes, hugs, kissing, and try to keep a reasonable distance from others. Avoid public transportation and enclosed places with many people.
Eighth, teach family members to cover their coughs and sneezes, preferably with the crook of their elbow, so they don't contaminate their hands; dispose of tissues directly into waste receptacles, and wear a medical mask, stay home and away from other family members if they are symptomatic
Ninth, optimize health. Eat well. Get plenty of sleep. Take vitamins and supplements. Get needed medical, and dental care incluing immunizations.
Tenth, if you haven't made preparations at home for a severe disaster, start now, it will lessen anxiety. In particular, be certain to have at least a months supply of medications, medical supplies, food and water on hand.
Eleventh, if I had a small baby at home, I would not allow anyone in the house with shoes. I would use a clean cloth between the baby and my clothing whenever the baby is held. I would consider wearing a mask when close to the baby.
The influenza virus lives on cloth, paper, objects, surfaces, hands, in the respiratory tract and probably the GI tract. There will be particularly heavy levels of contamination whereever infected persons are present.
