H1N1

[Arctickat]

No oxygen mask will protect against any aerosolized particles.

Sorry, I wasn't clear, I didn't mean the oxygen mask but a typical surgical mask...I'll edit my post accordingly.

[tniuqs]

Also, just this week the U.S. nurses, especially CA, have won a victory with the N95 masks and hospitals will now be held to the higher CDC standards for protection. Thus, everyone is now trying to hold onto a mask. Myself, I am now wearing a battery operated HEPA full hood mask in the ICUs. But, we do have quite a few confirmed cases on serious O2 and devices. All precautions are also being taken when doing IFT with the truck, RW and FW.

WOW someones taking things seriously thats frigging bio level 4 stuff... HEPA full mask.Yikes thats just boosted my adrenalin going big time facing the very serious possibilty that I am on a list to go back into ICU.

http://en.wikipedia.org/wiki/Biosafety_level

Now just my observation the biggest problem in dealing with any possible Pandemic is consistency, did we not learn ANYTHING FROM SARS ? I can see absolutely ZERO right now in any country. This is now surfacing as one of the biggest issues in Kanukistan, even the majority of Politics clowns have said hey point fingers later lets get or collective acts together.

IHMO some of the contentious issues welljust some:

Firstly the FEAR FACTOR media vs the experts and crackers?

The Politics ...

The proffiteers with "alternative treatments" ?

Private vs Public HC delivery in Pandemic?

Increased incidents reporting deaths vs admissions due to?

Vaccine Mandatory or Not for HCW ?

Who is the priority "at risk groups" ?

Delivery of Vaccine, clinic or appointment or home delivery?

Who is "allowed" to give the Vaccine?

Availability of Vaccine?

Reporting of IFL symptoms or NOT ?

The effects of the preservatives, short, long term +++ and all the myths?

Use of N95 vs regular masks prehospital?

Use and delivery of O2 and/or nebulizers?

Use of Bronchodialator efficacy.

ETOH vs Soap and water.

How long the virus survives on surfaces, (arcticcat best look on the Canadian website)

What is a viricidal effective agent?

The efficacy of anti-virals agents (add about 30 items ie complications alone to that list)

This it happened to me crowd and I got a bump ... If I had hit send on my response to that I would be banned

Tuna fish sandwiches.

Have I left anything out ? bet sure I have ....

What I see at this point is that H1N1 is not to kill, our collective stupidity will!

I'm speaking for myself too, I have posted some crap based on opinion or just to get a response.

cheers

Hey H1N1 is the posted topic.

Edited November 6, 2009 by tniuqs

[VentMedic]

Sorry, I wasn't clear, I didn't mean the oxygen mask but a typical surgical mask...I'll edit my post accordingly.

I just had to emphasize that since many on other forums and the EMT(P)s bringing patients to our ED are under the assumption that oxygen masks are protection. Also, some believe that the BVM via FM or ETT filters out the particles but that is only true if some type of filter is placed between the patient and the BVM. The same for ATVs and other portable ventilators. Not only has H1N1 been a problem but also meningititis. I've taken more than enough Cipro this year from exposure to patients being brought in by EMS. Be mindful where you are aiming the BVM exhaust. Thus, I now greet almost everyone with a mask. I have seen enough severe cases of PNA caused by various flus, MRSA, MSSA, Strep and whatever other alphabet the lab can find that I now consider everyone guilty until proven otherwise or deceased.

[kevkei]

No oxygen mask will protect against any aerosolized particles. In fact, almost any O2 mask will aerosolize the particle to spread t/o the immediate area.

Thoughts on this: We are carrying the NRB masks with inline HEPA filters, can also be used in conjunction with a side stream mask (without the side port openings).

[Arctickat]

All good points Vent, we've always used a filter for intubated patients but have ordered in some new ones to follow with the Health Canada guidelines.

"If high concentration oxygen and/or positive pressure ventilation are required, appropriate oxygen delivery system should be filtered with an antimicrobial, hydrophobic filter."

[VentMedic]

What I see at this point is that H1N1 is not not kill, our collective stupidity will.

I'm speaking for myself too, I have posted some crap based on opinion or just to get a response.

cheers

Hey H1N1 is the posted topic.

These are already issues that the U.S. CDC and the Canadians have been discussing just as the RT associations (AARC and CSRC) have been sharing there information.

Back in the 1980s, with HIV came TB and that is still a serious issue which is part of the reasoning for my own HEPA/battery mask. That also brought the Pentamidine txs which required special considerations. The number of R/Os and treatments we see each day in the hospital is enough to warrant quality protection. RSV season in the 80s brought the Ribavirin which required masking. Then came the HANTA virus which again brought the exposure to both the virus and the Ribavirin again. Then Avian flu, SARS and H1N1. You can also toss in the rest of the alphabet of bacteria and viruses to get blasted around with the various pieces of equipment we now have. And, in the hospital one has to consider all the gases and medications we are using that are approved and being trialed. Even all the nebulized antibiotics we run can pose some possible occupational exposure problems. For CCT/Specialty, we do have the capability to run most of them.

So, good luck with your ICU plans.

Thoughts on this: We are carrying the NRB masks with inline HEPA filters, can also be used in conjunction with a side stream mask (without the side port openings).

Where are the HEPA filters located? Do you have a link to the type of NRBM you are using?

The face mask itself does not form a good seal and without the side port openings, the gas will follow the path of least resistance.

[HERBIE1]

Have yet to see a case of even suspected H1N1, but our protocols are N95 mask, mask for PT, BSI and normal PPE. Disinfect as for any viral agent.

[kevkei]

Where are the HEPA filters located? Do you have a link to the type of NRBM you are using?

The face mask itself does not form a good seal and without the side port openings, the gas will follow the path of least resistance.

Here it is. I stand corrected, it's not specifically a 'HEPA' filter (based on info from our inservice.)

It's a FLO2MAX Isolation Oxygen Therapy Mask brom BLS Systems Ltd.

FLO2MAX

[WolfmanHarris]

Here it is. I stand corrected, it's not specifically a 'HEPA' filter (based on info from our inservice.)

It's a FLO2MAX Isolation Oxygen Therapy Mask brom BLS Systems Ltd.

FLO2MAX

Oh ya. We have those at work. Surprisingly no in-service on them and I'll have to check but I don't think we have the various sizes. I didn't pay much attention b/c I wear an N95 as a matter of course when dealing with respiratory complaints.

[kevkei]

Oh ya. We have those at work. Surprisingly no in-service on them and I'll have to check but I don't think we have the various sizes. I didn't pay much attention b/c I wear an N95 as a matter of course when dealing with respiratory complaints.

I say this with all due respect as I have never taken issue with comments before and I know it is probably a comment that wasn't really thought through but to say that you 'didn't pay much attention' is a demonstration of a lackadaisical attitude of where mistakes happen.

It's great that you are protected, but what about everyone else that could potentially be exposed to the patient? Hospital admin staff, general public in the waiting room, family members, etc. Our goal wherever possible should be to isolate the source while also protecting ourselves.

Edited November 6, 2009 by kevkei