patients with infectious diseases part 1
Chris Horton
Description
Collection
Title:
patients with infectious diseases part 1
Creator:
Chris Horton
Date:
4/1/2008
Text:
Hi List,
I apologize for the delay in posting the responses to my question about infectious diseases. I think I have finally received the last response and I received many request to post the responses. I appreciate everyone's input. I would like to say through this situation I noticed that our field lacks knowledge and education in dealing with severe ID's, including our facility. In this particular case the hospital was very vague on the ID and gave us very little information. If it wasn't for a particular PT in the room we would have not been instructed on what precautions to use. We can not always rely on the hospital to give that information to us, so we as a practitioner need to become more educated. I encourage all facilities to come up with protocols for these types of scenarios and I would like to see more education on such topics. It only takes one little careless mistake to potential change you or your staffs health. If anyone comes up with or has a policy to deal with ID's will you please post?
Thank you,
Chris Horton, LPO
Horton's Orthotic Lab, Inc.
Horton Technology Inc.
Dear List,
>
> We had this come up recently and were wondering how other facilities handle this? How do you handle measuring and fitting patients in the hospital with infectious diseases? We recently saw a patient that was in isolation for a clam shell TLSO. The hospital wanted every tool used to be disposed of or sent to be sterilized. As you know our grinders, etc can not be thrown away, nor sterilized so how do you handle adjustments? Do you just not do them? Do you remake the brace? Do you sterilize the brace somehow before leaving the hospital and grinding it in your lab? The hospital was insistent that everything had to be sterilized in a machine not with just rubbing alcohol or wipes. Any insight that you can give would be appreciated.
>
> I will post responses if requested.
>
> Thanks,
> Chris Horton, LPO
> Horton's Orthotic Lab, Inc
> Horton Technology Inc.
We have used intuition foam for clients with open sores. It packs down over time but it can easily be replaced. It is a grey foam(closed cell). Also ideal for diabetic patients.
If it is TB do not let them breath or cough on you - they need to wear a mask. I have worked in Africa before - still very common. Is he /she HIV positive? I would gown , mask and gloves.
Good luck sounds like a tough case.
AJ
Make it out of flex foam(from Spinal Tech) which can be trimmed with
cast scissors, easy to sterilize, or take really accurate measurements
knowing that adjustments are not going to be happening. Good luck. Dan
Busch CO
What disease are you working with? I'll often trim plastic with tin snips and finish it with a file and sandpaper out of necessity. Rrr
Hi C. Horton,
If the TLSO is PE, I would bring a pair of heavy duty shears, Heat gun, Hole punch, plastic rivets for strap realignment, and edging material (i.e. self adhesive aliplast). I would cut and heat modify the edges in the hospital.
Good luck and don't skimp on universal precaution standards!
- Peter Gelinas, CPO
Dear Chris,
I am a clinical neurophysiologist in private practise in Edmonton, Canada
and I subscribe to this list out of the necessities of my patients and
personal interest. I wanted to comment on this post because I am always
ranting and raving to people about matters of hygiene and maintaining
sterility.
My response to your post is that you are allowed to say, No. Fitting a
prosthesis can wait until the patient is no longer infectious - what exactly
is the hurry? The patient can't go anywhere until s/he has recovered from
the infection anyway. And contaminating you, your staff and your equipment
is hardly a medical achievement. It's not possible to sterilize those
tools, as you point out. O&P is fundamentally a service given when the
patient has reached a certain level of medical stability. A raging,
contagious infection is not a stability!
There is a push on to multi-task patient care as if making the medical
treatment process go faster will somehow make it more cost-effective
overall. What is in the best interest of the patient cannot be a harm to
someone else. Contaminating your office is not to anyone's benefit and
makes the overall treatment cost much more expensive (you still have to
sterilize the equipment that can be sterilized!). To quote an old adage: If
there is time to do a job badly, there is time to do it well.
I hope that's helpful to you.
With best wishes,
Dr. Dragana Breberin
I have used a dremmel in the past for this and thrown the tip away, then sterilized the rest. Not a beautiful finished edge, but smooth.
Molly Cooper, CPO
SPS
chris:
I have started using 5/32 modified polyethelyene lined with aliplast liner and find that I can score the plastic with a
sharp utility knife then snap the plastic by bending it along the score line then using the knife to cut through the liner. To smooth the edge I use a deburring tool - 1 smooth pull....or use a small butane burner or heat gun if I need any further smoothing. This way, I can do all the adjustments in the hospital room and then dispose of the tools or have them sterilized. feel free to call me if you have any questions on design - I use a central fab for my TLSO's. 970-668-4455
PAM
Chris,
That is a tough and interesting question, particularly when some
materials are not conducive to sterilizing. It also poses the question
of how we protect the technicians or others working on the device.
Would you please post your responses?
Thank you,
Judy Wagner, CP
hi,
I have never had such strict regulations put on me...........if it is of any use ..i would take as many measurements as possible so the trim lines are as close as possible in a single hit...i.e to get the under arm and thigh shapes as close as possible and then wait for the patient to get out of isolation before doing any more changes and explain that this one hit was a compromise and the patient would have to bear with it until you were in a position to modify it closer in the future,
interested to see the other replies on this one...Ta
Laurence Hughes
S/R P&O UK
I apologize for the delay in posting the responses to my question about infectious diseases. I think I have finally received the last response and I received many request to post the responses. I appreciate everyone's input. I would like to say through this situation I noticed that our field lacks knowledge and education in dealing with severe ID's, including our facility. In this particular case the hospital was very vague on the ID and gave us very little information. If it wasn't for a particular PT in the room we would have not been instructed on what precautions to use. We can not always rely on the hospital to give that information to us, so we as a practitioner need to become more educated. I encourage all facilities to come up with protocols for these types of scenarios and I would like to see more education on such topics. It only takes one little careless mistake to potential change you or your staffs health. If anyone comes up with or has a policy to deal with ID's will you please post?
Thank you,
Chris Horton, LPO
Horton's Orthotic Lab, Inc.
Horton Technology Inc.
Dear List,
>
> We had this come up recently and were wondering how other facilities handle this? How do you handle measuring and fitting patients in the hospital with infectious diseases? We recently saw a patient that was in isolation for a clam shell TLSO. The hospital wanted every tool used to be disposed of or sent to be sterilized. As you know our grinders, etc can not be thrown away, nor sterilized so how do you handle adjustments? Do you just not do them? Do you remake the brace? Do you sterilize the brace somehow before leaving the hospital and grinding it in your lab? The hospital was insistent that everything had to be sterilized in a machine not with just rubbing alcohol or wipes. Any insight that you can give would be appreciated.
>
> I will post responses if requested.
>
> Thanks,
> Chris Horton, LPO
> Horton's Orthotic Lab, Inc
> Horton Technology Inc.
We have used intuition foam for clients with open sores. It packs down over time but it can easily be replaced. It is a grey foam(closed cell). Also ideal for diabetic patients.
If it is TB do not let them breath or cough on you - they need to wear a mask. I have worked in Africa before - still very common. Is he /she HIV positive? I would gown , mask and gloves.
Good luck sounds like a tough case.
AJ
Make it out of flex foam(from Spinal Tech) which can be trimmed with
cast scissors, easy to sterilize, or take really accurate measurements
knowing that adjustments are not going to be happening. Good luck. Dan
Busch CO
What disease are you working with? I'll often trim plastic with tin snips and finish it with a file and sandpaper out of necessity. Rrr
Hi C. Horton,
If the TLSO is PE, I would bring a pair of heavy duty shears, Heat gun, Hole punch, plastic rivets for strap realignment, and edging material (i.e. self adhesive aliplast). I would cut and heat modify the edges in the hospital.
Good luck and don't skimp on universal precaution standards!
- Peter Gelinas, CPO
Dear Chris,
I am a clinical neurophysiologist in private practise in Edmonton, Canada
and I subscribe to this list out of the necessities of my patients and
personal interest. I wanted to comment on this post because I am always
ranting and raving to people about matters of hygiene and maintaining
sterility.
My response to your post is that you are allowed to say, No. Fitting a
prosthesis can wait until the patient is no longer infectious - what exactly
is the hurry? The patient can't go anywhere until s/he has recovered from
the infection anyway. And contaminating you, your staff and your equipment
is hardly a medical achievement. It's not possible to sterilize those
tools, as you point out. O&P is fundamentally a service given when the
patient has reached a certain level of medical stability. A raging,
contagious infection is not a stability!
There is a push on to multi-task patient care as if making the medical
treatment process go faster will somehow make it more cost-effective
overall. What is in the best interest of the patient cannot be a harm to
someone else. Contaminating your office is not to anyone's benefit and
makes the overall treatment cost much more expensive (you still have to
sterilize the equipment that can be sterilized!). To quote an old adage: If
there is time to do a job badly, there is time to do it well.
I hope that's helpful to you.
With best wishes,
Dr. Dragana Breberin
I have used a dremmel in the past for this and thrown the tip away, then sterilized the rest. Not a beautiful finished edge, but smooth.
Molly Cooper, CPO
SPS
chris:
I have started using 5/32 modified polyethelyene lined with aliplast liner and find that I can score the plastic with a
sharp utility knife then snap the plastic by bending it along the score line then using the knife to cut through the liner. To smooth the edge I use a deburring tool - 1 smooth pull....or use a small butane burner or heat gun if I need any further smoothing. This way, I can do all the adjustments in the hospital room and then dispose of the tools or have them sterilized. feel free to call me if you have any questions on design - I use a central fab for my TLSO's. 970-668-4455
PAM
Chris,
That is a tough and interesting question, particularly when some
materials are not conducive to sterilizing. It also poses the question
of how we protect the technicians or others working on the device.
Would you please post your responses?
Thank you,
Judy Wagner, CP
hi,
I have never had such strict regulations put on me...........if it is of any use ..i would take as many measurements as possible so the trim lines are as close as possible in a single hit...i.e to get the under arm and thigh shapes as close as possible and then wait for the patient to get out of isolation before doing any more changes and explain that this one hit was a compromise and the patient would have to bear with it until you were in a position to modify it closer in the future,
interested to see the other replies on this one...Ta
Laurence Hughes
S/R P&O UK
Citation
Chris Horton, “patients with infectious diseases part 1,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/229220.
