Comments on: Masks and Influenza Transmission http://www.epmonthly.com/whitecoat/2009/10/masks-and-influenza-transmission/ A blog from inside the emergency department Wed, 08 Feb 2012 17:35:50 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: Chuck in MI http://www.epmonthly.com/whitecoat/2009/10/masks-and-influenza-transmission/#comment-14096 Chuck in MI Thu, 15 Oct 2009 16:50:08 +0000 http://www.epmonthly.com/whitecoat/?p=3555#comment-14096 I have used these N95 masks and the cheap masks in my woodshop. Both are absolutely useless. Air freely flows around the edges of the mask because it does not make a good seal with the face. $30 later I have myself a good mask with great rubber seals. I've had the regular flu before, I don't want it again. I have used these N95 masks and the cheap masks in my woodshop. Both are absolutely useless. Air freely flows around the edges of the mask because it does not make a good seal with the face. $30 later I have myself a good mask with great rubber seals. I’ve had the regular flu before, I don’t want it again.

]]> By: SeaSpray http://www.epmonthly.com/whitecoat/2009/10/masks-and-influenza-transmission/#comment-14086 SeaSpray Wed, 14 Oct 2009 17:50:09 +0000 http://www.epmonthly.com/whitecoat/?p=3555#comment-14086 Gee.. how could I be so insensitive?! Like Ausduck ...I am sorry you lost a co-worker, Throckmorton. :( Gee.. how could I be so insensitive?! Like Ausduck …I am sorry you lost a co-worker, Throckmorton. :(

]]> By: Ausduck http://www.epmonthly.com/whitecoat/2009/10/masks-and-influenza-transmission/#comment-14082 Ausduck Wed, 14 Oct 2009 11:53:27 +0000 http://www.epmonthly.com/whitecoat/?p=3555#comment-14082 Apologies for hogging the blog, but I'd also like to add that we don't use the fancy schmancy N95 masks in my corner of the world (rural NSW, Australia). We do use masks, but have the habit of putting them on patients with the aforementioned respiratory symptoms, and ask any visitors/relatives or any other person coming into the health care facility with said symptoms for whatever reason to don them as well. We also have a fairly robust handwashing program which has been extended to all people, not just staff, within the hospitals with the gel washes provided just about everywhere you can look. Will be interesting when the compliance audits come in! (My unit is responsible for the number crunching, among other things of a clinical governance nature) Apologies for hogging the blog, but I’d also like to add that we don’t use the fancy schmancy N95 masks in my corner of the world (rural NSW, Australia). We do use masks, but have the habit of putting them on patients with the aforementioned respiratory symptoms, and ask any visitors/relatives or any other person coming into the health care facility with said symptoms for whatever reason to don them as well. We also have a fairly robust handwashing program which has been extended to all people, not just staff, within the hospitals with the gel washes provided just about everywhere you can look.
Will be interesting when the compliance audits come in! (My unit is responsible for the number crunching, among other things of a clinical governance nature)

]]> By: Ausduck http://www.epmonthly.com/whitecoat/2009/10/masks-and-influenza-transmission/#comment-14081 Ausduck Wed, 14 Oct 2009 11:42:06 +0000 http://www.epmonthly.com/whitecoat/?p=3555#comment-14081 Sorry to hear that, throckmorton. It's never easy to lose a workmate. Sorry to hear that, throckmorton. It’s never easy to lose a workmate.

]]> By: Ausduck http://www.epmonthly.com/whitecoat/2009/10/masks-and-influenza-transmission/#comment-14079 Ausduck Wed, 14 Oct 2009 11:33:21 +0000 http://www.epmonthly.com/whitecoat/?p=3555#comment-14079 At least limitations to the study are mentioned, albeit haphazardly IMHO. What skews the meaning & confidence for me is that they didn't monitor the adherence to handwashing or other types of exposure. In fact, I got the feeling that they felt that, as droplet infection control measures included PPE (gowns, gloves & masks) handwashing probably wasn't an important variable. I submit that to conclude that it was the failure of the mask to prevent infection in the percentage of cases mentioned, correlation has been mistaken as causation as the mentioned limitations have not been monitored, evaluated and used as exclusion data. But the devil's advocate in me thinks this is a great study for the bean-counters to use as an excuse for not providing the more expensive masks. ;) At least limitations to the study are mentioned, albeit haphazardly IMHO. What skews the meaning & confidence for me is that they didn’t monitor the adherence to handwashing or other types of exposure. In fact, I got the feeling that they felt that, as droplet infection control measures included PPE (gowns, gloves & masks) handwashing probably wasn’t an important variable.
I submit that to conclude that it was the failure of the mask to prevent infection in the percentage of cases mentioned, correlation has been mistaken as causation as the mentioned limitations have not been monitored, evaluated and used as exclusion data.
But the devil’s advocate in me thinks this is a great study for the bean-counters to use as an excuse for not providing the more expensive masks.
;)

]]> By: SeaSpray http://www.epmonthly.com/whitecoat/2009/10/masks-and-influenza-transmission/#comment-14074 SeaSpray Wed, 14 Oct 2009 05:06:23 +0000 http://www.epmonthly.com/whitecoat/?p=3555#comment-14074 Yikes! So much for this non-medical mind to sift through...but what I glean from the counter point article to http://www.bmj.com/cgi/content/abstract/339/oct06_2/b3928, is that the study was skewed because of how the controls were conducted and is not an accurate representation to be relied upon. ?? Also.. they mention 2008-2009 vaccine. Is that the current standard flu vaccine for now ... or are we on the 2009-2010 vaccine? Because what I am wondering is if the study were accurate... couldn't we just get the regular vaccine because isn't one of the concerns that this H1N1 vaccine was made to quickly and hasn't been tested long enough? Yikes! So much for this non-medical mind to sift through…but what I glean from the counter point article to http://www.bmj.com/cgi/content/abstract/339/oct06_2/b3928, is that the study was skewed because of how the controls were conducted and is not an accurate representation to be relied upon. ??

Also.. they mention 2008-2009 vaccine. Is that the current standard flu vaccine for now … or are we on the 2009-2010 vaccine?

Because what I am wondering is if the study were accurate… couldn’t we just get the regular vaccine because isn’t one of the concerns that this H1N1 vaccine was made to quickly and hasn’t been tested long enough?

]]> By: SeaSpray http://www.epmonthly.com/whitecoat/2009/10/masks-and-influenza-transmission/#comment-14073 SeaSpray Wed, 14 Oct 2009 04:47:00 +0000 http://www.epmonthly.com/whitecoat/?p=3555#comment-14073 It is unnerving to read about these cases where people die.. that would not be expected to. I admittedly.. yet guardedly have a wait and see attitude. Guess that's playing a bit of Russian roulette. It is unnerving to read about these cases where people die.. that would not be expected to.

I admittedly.. yet guardedly have a wait and see attitude.

Guess that’s playing a bit of Russian roulette.

]]> By: SeaSpray http://www.epmonthly.com/whitecoat/2009/10/masks-and-influenza-transmission/#comment-14072 SeaSpray Wed, 14 Oct 2009 04:14:21 +0000 http://www.epmonthly.com/whitecoat/?p=3555#comment-14072 Thank you Pharmosochist. :) Still just not sure. I heard president Obama's daughters haven't gotten the shots and wonder why? Thank you Pharmosochist. :)

Still just not sure.

I heard president Obama’s daughters haven’t gotten the shots and wonder why?

]]> By: BK http://www.epmonthly.com/whitecoat/2009/10/masks-and-influenza-transmission/#comment-14071 BK Wed, 14 Oct 2009 03:14:28 +0000 http://www.epmonthly.com/whitecoat/?p=3555#comment-14071 "when caring for febrile patients with respiratory illnesses" this strikes me as the most problematic aspect of the study. what about other types of exposure? say from walking through a busy ER triage area? or before you realize that the patient has a fever and respiratory symptoms? “when caring for febrile patients with respiratory illnesses”

this strikes me as the most problematic aspect of the study. what about other types of exposure? say from walking through a busy ER triage area? or before you realize that the patient has a fever and respiratory symptoms?

]]> By: throckmorton http://www.epmonthly.com/whitecoat/2009/10/masks-and-influenza-transmission/#comment-14068 throckmorton Tue, 13 Oct 2009 16:46:41 +0000 http://www.epmonthly.com/whitecoat/?p=3555#comment-14068 We just had a critical care nurse pass away from H1N1. We dont know how she contracted it but she was taking care of patients with it. We just had a critical care nurse pass away from H1N1. We dont know how she contracted it but she was taking care of patients with it.

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