medic417
The Truth Provider
- 5,104
- 3
- 38
Congrats on the the 3 millionth post about stethoscopes on this site alone. Tell him what he's won admin. <_<
is an orange stethoscope professional?
- Thread starter haywood415
- Start date
Scout
Para-Noid
- 576
- 2
- 18
Calm down at least its a novel fair question. However I do like the idea of prizes.
Can I get piglet?
Sasha
Forum Chief
- 7,667
- 11
- 0
I have a very bad pug I am giving away to a semi-good home, she's got a squished nose and a curly tail, she's kind of a pig wannabe, occasionally she snorts, particularly while you are trying to sleep, would that do?
Scout
Para-Noid
- 576
- 2
- 18
Will my stet fit comfortably through her?
Sasha
Forum Chief
- 7,667
- 11
- 0
Uhm I have never tried.. I'm sure you could thread it through with enough effort, but you probably wouldn't want it anymore afterwards.
usafmedic45
Forum Deputy Chief
- 3,796
- 5
- 0
We don't have time between every patient to wipe down anything more than the bell and diaphraghm. That's the difference between prehospital and in-hospital.
The whole stethoscope gets wiped down at the end of rounds (7:30 pm, 9 pm, 10 pm, 1 am, and 5am) or when going from one unit to another (ICU to med/surg, med/surg to ER, etc).TornWingedAngel1
Forum Crew Member
- 93
- 0
- 6
heh...I don't think the color of it matters...
Sasha
Forum Chief
- 7,667
- 11
- 0
Wiping down the tubing is not a timely task. You already have the wipe.
We don't have time between every patient to wipe down anything more than the bell and diaphraghm. That's the difference between prehospital and in-hospital.
Sasha
Forum Chief
- 7,667
- 11
- 0
She already has a boston terrier and would not forgive me if I brought in another sibling for her.
usafmedic45
Forum Deputy Chief
- 3,796
- 5
- 0
Yes, yes...what you are forgetting is that it takes several alcohol preps to thoroughly clean the entire stethoscope and most (nearly all of it according to most studies I have seen) of the contamination is at the parts I mentioned cleaning between patients, namely the bell and the diaphragm.
The contamination is most prevalent around the seams and such, which are not easy to clean quickly with a simple "once over" with a alcohol wipe. Therefore wiping down the entire tubing is not going to add any significant benefit to the process. Using a larger wipe (like they use for decontaminating equipment and counters and such) at the end of each round is simply a way of making sure I did not miss anything and actually is done more to prevent the buildup of skin oils from my neck resulting in the degradation of the tubing than anything else. Anything more is overkill. Of course, I also break down my stethoscope at the end of each shift and clean all the parts individually because of the tendency for contamination between them. THAT is going to do more for the control of infection than wiping down the entire tubing, a large part of which never touches the patient.
Anything less thorough, such as wiping down the entire stethoscope briefly with an insufficient amount of cleaning agent like you'd get from a rapidly drying alcohol prep pad, is going to give a false sense of security. You said it yourself that you're OCD about this which implies that you realize you're engaging in overkill. Also keep in mind that we have the benefit of most of our MRSA/VRE patients being identified (everyone is screened for it on admission to the hospital and whenever they enter a high-risk category while in the facility) and our personal stethoscopes are not taken into those rooms, which is something prehospital care distinctly lacks.
The contamination is most prevalent around the seams and such, which are not easy to clean quickly with a simple "once over" with a alcohol wipe. Therefore wiping down the entire tubing is not going to add any significant benefit to the process. Using a larger wipe (like they use for decontaminating equipment and counters and such) at the end of each round is simply a way of making sure I did not miss anything and actually is done more to prevent the buildup of skin oils from my neck resulting in the degradation of the tubing than anything else. Anything more is overkill. Of course, I also break down my stethoscope at the end of each shift and clean all the parts individually because of the tendency for contamination between them. THAT is going to do more for the control of infection than wiping down the entire tubing, a large part of which never touches the patient.
Anything less thorough, such as wiping down the entire stethoscope briefly with an insufficient amount of cleaning agent like you'd get from a rapidly drying alcohol prep pad, is going to give a false sense of security. You said it yourself that you're OCD about this which implies that you realize you're engaging in overkill. Also keep in mind that we have the benefit of most of our MRSA/VRE patients being identified (everyone is screened for it on admission to the hospital and whenever they enter a high-risk category while in the facility) and our personal stethoscopes are not taken into those rooms, which is something prehospital care distinctly lacks.
Sasha
Forum Chief
- 7,667
- 11
- 0
I use a cancer wipe which is large enough to clean a scope with just one.
Yes I'm a little vigilant with infection control I also get sick often. Don't need MRSA around my neck.
Yes I'm a little vigilant with infection control I also get sick often. Don't need MRSA around my neck.
usafmedic45
Forum Deputy Chief
- 3,796
- 5
- 0
"Cancer wipe"? You mean one of the large disinfectant wipes? Never heard them called that before.
We don't exactly carry them around in our pockets (the big disinfectant wipes come in dispenser jugs in hospitals for the most part) and many people, myself included, are sensitive to the chemicals in them and cleaning/disinfecting products as a class are one of the leading causes of chemical contact dermatitis. If you'll note most of those wipes carry a warning about "do not apply to skin" or "avoid prolonged contact with skin". What do you think you're doing by putting it on your scope every time and then tossing the scope around your neck?
The chances of you getting a dermatitis from overzealous use of disinfectants in an unapproved way is a lot higher than your chances of actually becoming ill (assuming you're not immunosuppressed) from any resistant bug in the hospital, let alone on the street. There is a reason why I limit their use to only as much as necessary (based on actual evidence and not fear, superstition, rumor, innuendo, etc) and then rinse the stethoscope with water afterwards to remove the residue.
JPINFV
Gadfly
- 12,681
- 197
- 63
I think you're over estimating the actual amount of skin contact with stethoscopes around the neck. First off, the Sani-Wipe (tm) ("cancer wipes") solution dry pretty quickly when applied. Unlike the actual sheet, equipment cleaned is generally dry in less than a minute after a superficial wipe (which is important because outside of AIDS, which is 10 minutes, what you're cleaning is supposed to be wet for at least a minute for it to work as advertised. A quick wipe off generally doesn't work as well as most believe). Additionally, the vast, vast majority of EMS uniforms are collared, be it button down shirts or polo shirts. That collar, in most cases, will prevent contact between the stethoscope and skin. Also, at least with how I practice, when I wipe my stethoscope off after a call, it goes on the back bench seat, not around my neck. Additionally, in the hospital providers have the option of using a holster (I don't see holsters practical for prehospital work), which eliminates the need to sling the stethoscope.
Of course I get a dorky little short coat that has tons of pocket space.
DrParasite
The fire extinguisher is not just for show
- 6,289
- 2,162
- 113
It is grossly unprofessional, unless you are going to be using the scope in Syracuse New York or Princeton NJ
Sasha
Forum Chief
- 7,667
- 11
- 0
Sani-Wipes.. Cancer Wipes because the supposbly can cause liver cancer or liver damage or something.
one hospital I worked in had them in little packets, which was really awesome, and every other hospital I have functioned in had them in or right outside patient rooms on the wall. Which was very convienent. My scope rests against my collar, and I have never had a problem with inflammation or irritation. The chemical is allowed to dry before putting it back on.
TransportJockey
Forum Chief
- 8,623
- 1,675
- 113
Cavi-wipe = cancer wipes. When I worked on a truck we had tubs of them in each rig. At the hospital each room had them
usafmedic45
Forum Deputy Chief
- 3,796
- 5
- 0
Then the point Sasha was making is even more of a moot one about infection risk.
And you're comfortable having skin contact with that (wet or dry)? One of my buddies who is an infection control specialist (MPH and PhD in public health and a second PhD in microbiology) gave me the following advice: "If you wouldn't wipe it directly on your skin, don't wipe your stethoscope with it even if it will dry quick."
It can still cause problems. Bleach for example is well documented to still cause irritation and other issues even after it has been dried. Lysol and several other common disinfectants is similarly reported to produce such issues.
Well, I was speaking to the flight suit I wear as a flight RT (which technically has a collar but it's not making any really difference) and the scrubs I wear in hospital. Most of the time the scope is in my lab coat pocket or in leg pocket of my flight suit. About the only time it actually spends a lot of time around my neck is when I am in the ER and don't have my lab coat on.
Sasha
Forum Chief
- 7,667
- 11
- 0
You can have a quick wipe down while adequately soaking it to stay wet for over a minute. It doesn't require you stand there and wipe vigorously for five minutes.
Again, my scope rests against my collar and does not come in contact with my skin. And, I have touched the cancer wipes with my bare skin, and have not had irritation issues.
These are the same wipes I wipe the entire stretcher, including arm rails, handles, and O2 bottles with, places that it will come in contact with skin, mine and/or patient's and I have NEVER had a problem or have heard of a problem.