Another way to get MRSA

Severe infections can occur in about 20 percent of all cases, the researchers state, and are caused by Pasteurella, Streptococcus, Fusobacterium, and Capnocytophaga bacteria from the animal's mouth, plus possibly other pathogens from the human's skin.
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Humans probably gave it to the cats and dogs. These poor animals were probaby not told by their mothers not to lick the humans because they may carry lots of harmful bacteria on their skin.

Staphylococcus aureus has become part of the normal human flora with 30 - 40% of the general population that may be colonized with it.

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I know this isn't particularly related, but a few weeks ago we were working with a patient, perfectly healthly aside from the CC, and when we were filling out the PCR, across the top of the screen read, in huge red letters, MRSA. I was a bit taken aback, because I was expecting... i don't know, something else I guess, like a sign. It kind of put me in my place to remember that these well known infectous diseases are everywhere, and they don't present with a big sign taped to their forehead :wacko:
 
Katie Elaine said:
I know this isn't particularly related, but a few weeks ago we were working with a patient, perfectly healthly aside from the CC, and when we were filling out the PCR, across the top of the screen read, in huge red letters, MRSA. I was a bit taken aback, because I was expecting... i don't know, something else I guess, like a sign. It kind of put me in my place to remember that these well known infectous diseases are everywhere, and they don't present with a big sign taped to their forehead :wacko:
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I think everyone has that moment when you realize that despite stereotypes you can't tell what a patient has by looking at them. That moment came for me when I had this sweetest little old lady who looked clean and healthy with HIV, Hep C, MRSA, hx of substance abuse and a bunch of other stuff. Kind of shocking and very humbling.
 
I have been to many nursing homes. I always stop at the nurses station to get info. Sometimes I do and sometimes I don't get any info. I have on numerous occasions been in the room with a patient when staff walks in in full precautions. And that is the 1st time I am informed the Pt has MRSA or C-Diff.
Even when they give me the info prior to entering the patient's room, they seem to neglect to inform us of the MRSA or C-Diff.:glare:
 
djmedic913 said:
Even when they give me the info prior to entering the patient's room, they seem to neglect to inform us of the MRSA or C-Diff.:glare:
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For known C-Diff, there will be an isolation sign and gowns nearby as well as a bleach based cleaner. Chances are the C-Diff will do nothing to you unless you are taking antibiotics for an infection. It can however be easily acquired by another patient whose immune system is weakened or they have been taking antibiotics. Clean you equipment well with THE PROPER CLEANER and WASH your hands well. The alcohol gel will do very little to C-Diff.

For MRSA, there may not be any precautions depending on the location. If it is wound, it will be contact. If the patient is colonized in the respiratory system, there may be not precautions unless it is an open trach. You just use universal precautions along with good handwashing and you should be fine. Clean any equipment including you stethoscope and stetcher very well.

How many of you know if you are colonized with MRSA? Have you had you equipment or nares swabbed? I would bet a good number of EMS providers are carrying MRSA and it may not have been acquired from a NH patient. If you get an active infection, you may have been colonized for awhile and didn't just acquire it from a patient yesterday.

BTW, this is good reason why Neonatal and some Specialty transport teams use their own staff, their own equipment and their own trucks. They will have control over the cleaning and can also test the staff periodically.
 
VentMedic said:
For known C-Diff, there will be an isolation sign and gowns nearby as well as a bleach based cleaner. Chances are the C-Diff will do nothing to you unless you are taking antibiotics for an infection. It can however be easily acquired by another patient whose immune system is weakened or they have been taking antibiotics. Clean you equipment well with THE PROPER CLEANER and WASH your hands well. The alcohol gel will do very little to C-Diff.

For MRSA, there may not be any precautions depending on the location. If it is wound, it will be contact. If the patient is colonized in the respiratory system, there may be not precautions unless it is an open trach. You just use universal precautions along with good handwashing and you should be fine. Clean any equipment including you stethoscope and stetcher very well.

How many of you know if you are colonized with MRSA? Have you had you equipment or nares swabbed? I would bet a good number of EMS providers are carrying MRSA and it may not have been acquired from a NH patient. If you get an active infection, you may have been colonized for awhile and didn't just acquire it from a patient yesterday.

BTW, this is good reason why Neonatal and some Specialty transport teams use their own staff, their own equipment and their own trucks. They will have control over the cleaning and can also test the staff periodically.
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If there were an isolation sign or gowns near by would have been a good clue, but that would have been noticed prior to entering the room.
It would have been noticed under the scene size up...still very important even in a nursing home. But there was NO indication there was a precaution issue until the staff came in gowned, masked, and gloved up. I understand that both are not truly a big deal to me, but to other patients I come into contact with, but it would have been nice to be informed before entering...instead I get the surprise and ask "why are you gowned?" just to hear they have XYZ.
 
Then just get into the habit of asking if the patient has C-Diff or open wounds.

I may see over 50 patients in a 12 hour shift if working in a hospital, many in the ED with unknowns, and don't always have time to check labs or specifics. I just make sure my uniform is covered if I have any close contact and I wash my hands over and over. If the patient is getting O2 at a flow of 6L or greater or a nebulizer, I mask. If the patient is coughing, I mask. If the patient is on a single limb CPAP in an ambulance or helicopter, I mask. I wear gloves for unknowns, oozy things and procedures.

I also do not wear my uniform/shoes, either Flight or scrubs, in my car and definitely not in my home. They are either exchanged at the hospital where the water is hotter or professionally cleaned by the company. If I must take uniforms home, they are in a plastic bag that goes straight to the wash. I also allow not children or even other adults to play with my stethoscope.
 
So, we aren't to lick our pets anymore? :unsure:
 
I'm more concerned about getting MRSA at the gym than from the NH PT with MRSA.
 
mikeN said:
I'm more concerned about getting MRSA at the gym than from the NH PT with MRSA.
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I absolutely agree. I actually had a kid die at my university from a MRSA infection that was believed to have been acquired at our school gym.
 
MRSA is basically in the community now and you need to be conscious of that fact. Although I cannot totally blame spiders, I wouldnt be surprised if the reason they get blamed is when someone scratches at any "bite" or ingrown hair, whatever; they innoculate a break in the skin with whatever culture is growing under their nails. Now the "bite" turns red and shows the signs of infection. It is human nature to blame something else when the problem lies with our own poor hygiene.
 
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