Breath tubes spread SARS

Canoe.com ^ | Rob Granatstein

[Judith Anne]

Breath tubes spread SARS

By ROB GRANATSTEIN - Toronto Sun

SARS spread slowing in Asia

Toronto doctors have admitted SARS is being spread to health-care workers when tubes are put down patients' throats to help them breathe -- and the physicians don't know how to stop it. Dr. Don Low, chief microbiologist at Mount Sinai hospital, said Toronto's two newest SARS cases that will be reported today are a result of procedures, called intubations, that infected health-care workers last Wednesday.

"Intubation is a major issue with SARS patients," Low said. "Why? I don't know why. It's not easily explainable.

"We're scratching our heads why should this be such a high-risk procedure."

The patient in the North York General Hospital intubation died despite having the procedure done.

SARS is being spread to the health-care workers even though everyone in the room is taking full gowning, gloving and masking precautions.

That's led Low to rethink forcing medics to wear space-like gear, called Stryker suits, while doing an intubation.

"Seeing what's happening here, it suggests this is what you need -- that kind of protection," Low said.

"If what we're seeing is the rule, there has to be new guidelines for everybody in the world to deal with these patients," Low said.

There have been other intubations, including at Scarborough Grace and Sunnybrook, that have seen other health-care workers infected.

"You have to do a risk assessment," he said. "If this is somebody who you feel that you can do something for, then you're going to take the risk for that person's life.

"This is what these health-care workers are doing every day," Low said. "People don't understand the kind of risks these people are taking."

[Judith Anne]

Getting into mask, gown, gloves (2 pair) face shield, haircover, isn't the fastest thing in the world, and when intubation is done in the ER, it's usually urgent...

Then, maybe the patient dies. At that moment, you aren't going to be thinking "How do I get out of all this gear without potentially exposing myself or anyone else to SARS?" you're going to be discouraged, saddened, upset...

[Judith Anne]

ping

[Dog Gone]

Maybe it's not happening during the intubation, but when they are changing clothes afterwards.

[Judith Anne]

One thing I've noticed is that a lot of HCWs 'snap' their latex gloves when they take them off...imho it spreads stuff all over the room...at my hospitals, we carefully remove them so they're inside out...snapping is verboten.

The paper gowns can get wet, too, and then they aren't much protection...

[Judith Anne]

Thank you for the link.

[TEXASPROUD]

This is the first time I've heard an endotracheal tube referred to as a "breath tube".

[Judith Anne]

Ah, well, reporters...;-D

[freedomcrusader]

Me too, and it was my first clue that the article was going to be completely uninformative.

Why do they suspect ET tubes? How many people have gotten sick after intubating a SARS patient? How long after intubation? What about others that cared for the patient, but did not perform intubation on a SARS patient? What is their rate of acquiring SARS versus those who intubated a SARS patient? And on and on...

[harpseal]

If the medical facts not stated in this article do support the conclusion that intubation with an endotrachial tube is actually endangering health care workers the clearly the protocols need to be adjusted. Protocols were adjusted for AIDS even for non HIV positive people has the need to don gloves for a lot more procedures meant greater time is taken in getting ready to treat patients? Yes, even emergency room patients. I can not prove it but it may well be the case that some patients die from having to wait for those precautions to be put into place but we as a society can not ask health care workers to expose themselves to disease when measures exist that do allow for protection. Such is the the unmeasured toll of some diseases.

Unfortunately this article only hints at what the data actually shos so further comment is almost pointless.

[Judith Anne]

I agree, the article doesn't tell much. I'd like to see some other articles posted...

[4mycountry]

Talk about a case of bad breath.

[Future Useless Eater]

a lot of HCWs 'snap' their latex gloves when they take them off...imho it spreads stuff all over the room...at my hospitals, we carefully remove them so they're inside out...snapping is verboten.

I'm sure you are right, I've seen that several times in movies and medical tv shows. The actor stretches the glove he just took off, and 'shoots' it across the room into a waste bin.

It looks cool, so I'm sure some HCW's copycat that practice, and spread some deadly germs at times also.

(thanks for all your recent pings as well)

[Judith Anne]

Haha! The actors are copying the HCWs, in this instance...;-D.

Incidently, for the growing number of people allergic to latex, this is a poor practice also--spreads latex particles in the air, sometimes causes breathing problems.

[IvanT]

This is the first time I've heard an endotracheal tube referred to as a "breath tube"

Hey, it's the Toronto Sun, they're not exactly renowned for being particularly articulate. Although their politics are conservative at least.