4 ms·

Now, like all pieces of medical equipment, it would probably good to culture some swabs off them to see what's growing, and how hard they are to clean.

by Fomite 13y ago

jebus989 13y ago
Huh, why would that be good? Why is the sterility of a doctor's eye-wear a concern? Tabloid scare-stories of "X species of bacteria found living on Y" just feed on the public's ignorance of microbiology; i.e. "wow that many on the average toothbrush!"... well, how many are found in your mouth? In the intestines? How do we define a bacterial species?
- DougWebb 13y ago
  Because they touch their eye-wear, and they touch patients and themselves before and after touching their eye-wear. This probably is the same problem for regular glasses, so it's not a new concern unless the Google Glass gets touched more often.
  - jebus989 13y ago
    For sure, that's why hospitals are jam-packed with hand anti-bacterial (fungal etc.) stations. They don't try to sterilise the doctor.
    - Fomite 13y ago
      First, those stations are ineffective against some major pathogens (C. difficile and Norovirus come to mind), and alcohol gels aren't particularly well suited for cleaning equipment - they're meant for hands. We do talk about sterilizing equipment doctors carry - lab coats, ties, stethoscopes, phones, etc. all the time. There's just not a good solution yet, which is one of the reasons one might need to assess: 1. How much of a problem this is for Google Glass in particular? 2. How amenable are the devices to cleaning? You know, exactly what I said in my first post.
  - Fomite 13y ago
    My thought is that if they're using Google Glass as a routine tool, they've increased the number of people wearing eye-wear, and those who are not used to wearing glasses will probably be fiddling with them more.
- nooron 13y ago
  Carrying pathogens room to room, even when the object doesn't directly touch the patient, is a serious concern: http://www.nysenate.gov/files/pdfs/DirtyTieFINAL_1.pdf http://www.nysenate.gov/files/pdfs/DirtyTieFINAL_1.pdf
- bigchewy 13y ago
  It's incredibly important. the place you are most likely to acquire an infection / disease and die is the hospital, after adjusting for the fact that you're there because you're already sick. Forgive me for not linking to a source on this
- tomwalker 13y ago
  I am a doc and my partner is a medical microbiologist. Its just about simple bacteria spread - would you want your immunocompromised relative in contact with a doctor that has just been in contact with a contagious infection source without at least trying to minimise the chance of cross infection? The stethoscope is a similar concern - rarely cleaned properly, often present.
- Fomite 13y ago
  The sterility of a doctor's eye-wear is a concern because of the following simple scenario: A doctor has been seeing patients all day, and visits one with an active C. difficile infection. They touch the patient's bed (which has been shown to be as contaminated with organism as the skin), and then, before they change their gloves, adjust their glasses - transferring the pathogen to a surface it can likely persist on for some span of time. Later that day, they adjust their glasses again (seriously, I do this like 20 times a day), and recontaminate their hands before examining another patient. Glasses - along with shoes, ties, lab coats, cell phones, etc. represent potential sources of cross contamination between patients, and are an active area of scientific and medical research.
  - jebus989 13y ago
    I get this I really do, you can invent just-so stories about transmission with anything regardless of whether he's wearing Glass. Doctor visits patient with <highly transmissable pathogen> touches x, washes hands and but then (!) retouches x and treats an immune-deficient patient etc. My point is x can be forehead, hair, pocket, watch, any variable you can think of and we can't control for any of them. You seem to think every item a doctor carries needs to be autoclaved at clocking out time, when really the only viable solution is to wash your hands, change gloves etc. — sterilise your contact points, not your person and everything on it.
    - Fomite 13y ago
      > we can't control for any of them Yes, we can. Infection control procedure is exactly that, and we have begin looking at how we can minimize as many of those items as possible. Things like the universal gowning and gloving studies, examining how to clean surfaces and keep them clean, what to do about cell phone and clothing contamination, etc. There are a massive number of studies showing contamination of things doctors carry, and studies showing heavy correlations between the level of contamination and patient outcomes. It's an active area of research, and commercial development. Your idea that somehow "Wash your hands and change gloves" is fine, but "Find out if you can use clorhexidine wipes on Google Glass, and if we need to" is somehow Infection Control Gone Mad! really puzzles me.
skue 13y ago
Wow, I just noticed your nick and wish I could give you more upvotes for that alone! It looks like you have a background in epidemiology, so not sure if you are seriously concerned or posting for the pure perfection of deploying your nick. But it is an interesting question and assumedly one they thought through. The alternative inputs they mentioned (head tilts) may have been designed to minimize needing to touch Glass. Certainly touching glass after having ones hands on some patients would be a concern -- and for the health provider given that it's rather close to the eyes. Providers do touch smartphones, tablets, pens, etc. when they are with patients. I wonder whether Glass can be chem wiped. Many of the chemicals used in the wipes are reportedly weak carcinogens as well (at least where I trained), so personally I would be concerned about putting something on my face that had been wiped repeatedly during a 16 hour shift. However, if it's not touched, then it's no worse than eyeglasses and likely to be less of a fomite than a white coat or a necktie.[1] [1] http://online.wsj.com/news/articles/SB125859205137154753?mg=reno64-wsj&url=http%3A%2F%2Fonline.wsj.com%2Farticle%2FSB125859205137154753.html http://online.wsj.com/news/articles/SB125859205137154753?mg=... (Plenty of peer reviewed studies, but this is publicly accessible.)
- Fomite 13y ago
  grins It was a perfect use of my nick, but more importantly I'm a computational epidemiologist who works on hospital acquired infections. It's mostly a curiosity, to see if the gesture and command based Glass system results in less carriage than some other tools. It likely cuts down on some things, but I touch my own glasses all the damned time to adjust them, and I'm used to them - I've been wearing them all my life.
  - skue 13y ago
    As someone who trained recently (after hand washing became a widespread practice), I can say that I developed a consciousness I didn't have previously. Though I don't practice now, I still get this strong sense that my hands are unclean and need to be washed when I blow my nose, touch something dirty, am around someone who is ill, etc. But not touching my face (or glasses) was a much harder habit to break and something I still do subconsciously. So I'd also be curious how often docs using Glass do this. Also, hospitals already sterilize surgical instruments, but I did a quick search and it looks like some manufacturers are designing devices meant to be deployed in nursing stations in response to mobile.[1] So maybe more use of these devices will actually drive increased use of rapid sanitizers within the clinic, as a secondary benefit. http://www.infectioncontroltoday.com/news/2013/09/steridesign-introduces-new-sterilization-devices-for-high-touch-electronic-devices.aspxhttp://www.infectioncontroltoday.com/news/2013/09/steridesign-introduces-new-sterilization-devices-for-high-touch-electronic-devices.aspx http://www.infectioncontroltoday.com/news/2013/09/steridesig...

Now, like all pieces of medical equipment, it would probably good to culture some swabs off them to see what's growing, and how hard they are to clean.

by Fomite 13y ago

Now, like all pieces of medical equipment, it would probably good to culture some swabs off them to see what's growing, and how hard they are to clean.

jebus989 13y ago

Huh, why would that be good? Why is the sterility of a doctor's eye-wear a concern? Tabloid scare-stories of "X species of bacteria found living on Y" just feed on the public's ignorance of microbiology; i.e. "wow that many on the average toothbrush!"... well, how many are found in your mouth? In the intestines? How do we define a bacterial species?

DougWebb 13y ago
Because they touch their eye-wear, and they touch patients and themselves before and after touching their eye-wear. This probably is the same problem for regular glasses, so it's not a new concern unless the Google Glass gets touched more often.
- jebus989 13y ago
  For sure, that's why hospitals are jam-packed with hand anti-bacterial (fungal etc.) stations. They don't try to sterilise the doctor.
  - Fomite 13y ago
    First, those stations are ineffective against some major pathogens (C. difficile and Norovirus come to mind), and alcohol gels aren't particularly well suited for cleaning equipment - they're meant for hands. We do talk about sterilizing equipment doctors carry - lab coats, ties, stethoscopes, phones, etc. all the time. There's just not a good solution yet, which is one of the reasons one might need to assess: 1. How much of a problem this is for Google Glass in particular? 2. How amenable are the devices to cleaning? You know, exactly what I said in my first post.
- Fomite 13y ago
  My thought is that if they're using Google Glass as a routine tool, they've increased the number of people wearing eye-wear, and those who are not used to wearing glasses will probably be fiddling with them more.
nooron 13y ago
Carrying pathogens room to room, even when the object doesn't directly touch the patient, is a serious concern: http://www.nysenate.gov/files/pdfs/DirtyTieFINAL_1.pdf http://www.nysenate.gov/files/pdfs/DirtyTieFINAL_1.pdf
bigchewy 13y ago
It's incredibly important. the place you are most likely to acquire an infection / disease and die is the hospital, after adjusting for the fact that you're there because you're already sick. Forgive me for not linking to a source on this
tomwalker 13y ago
I am a doc and my partner is a medical microbiologist. Its just about simple bacteria spread - would you want your immunocompromised relative in contact with a doctor that has just been in contact with a contagious infection source without at least trying to minimise the chance of cross infection? The stethoscope is a similar concern - rarely cleaned properly, often present.
Fomite 13y ago
The sterility of a doctor's eye-wear is a concern because of the following simple scenario: A doctor has been seeing patients all day, and visits one with an active C. difficile infection. They touch the patient's bed (which has been shown to be as contaminated with organism as the skin), and then, before they change their gloves, adjust their glasses - transferring the pathogen to a surface it can likely persist on for some span of time. Later that day, they adjust their glasses again (seriously, I do this like 20 times a day), and recontaminate their hands before examining another patient. Glasses - along with shoes, ties, lab coats, cell phones, etc. represent potential sources of cross contamination between patients, and are an active area of scientific and medical research.
- jebus989 13y ago
  I get this I really do, you can invent just-so stories about transmission with anything regardless of whether he's wearing Glass. Doctor visits patient with <highly transmissable pathogen> touches x, washes hands and but then (!) retouches x and treats an immune-deficient patient etc. My point is x can be forehead, hair, pocket, watch, any variable you can think of and we can't control for any of them. You seem to think every item a doctor carries needs to be autoclaved at clocking out time, when really the only viable solution is to wash your hands, change gloves etc. — sterilise your contact points, not your person and everything on it.
  - Fomite 13y ago
    > we can't control for any of them Yes, we can. Infection control procedure is exactly that, and we have begin looking at how we can minimize as many of those items as possible. Things like the universal gowning and gloving studies, examining how to clean surfaces and keep them clean, what to do about cell phone and clothing contamination, etc. There are a massive number of studies showing contamination of things doctors carry, and studies showing heavy correlations between the level of contamination and patient outcomes. It's an active area of research, and commercial development. Your idea that somehow "Wash your hands and change gloves" is fine, but "Find out if you can use clorhexidine wipes on Google Glass, and if we need to" is somehow Infection Control Gone Mad! really puzzles me.

skue 13y ago

Wow, I just noticed your nick and wish I could give you more upvotes for that alone! It looks like you have a background in epidemiology, so not sure if you are seriously concerned or posting for the pure perfection of deploying your nick. But it is an interesting question and assumedly one they thought through. The alternative inputs they mentioned (head tilts) may have been designed to minimize needing to touch Glass. Certainly touching glass after having ones hands on some patients would be a concern -- and for the health provider given that it's rather close to the eyes. Providers do touch smartphones, tablets, pens, etc. when they are with patients. I wonder whether Glass can be chem wiped. Many of the chemicals used in the wipes are reportedly weak carcinogens as well (at least where I trained), so personally I would be concerned about putting something on my face that had been wiped repeatedly during a 16 hour shift. However, if it's not touched, then it's no worse than eyeglasses and likely to be less of a fomite than a white coat or a necktie.[1] [1] http://online.wsj.com/news/articles/SB125859205137154753?mg=reno64-wsj&url=http%3A%2F%2Fonline.wsj.com%2Farticle%2FSB125859205137154753.html http://online.wsj.com/news/articles/SB125859205137154753?mg=... (Plenty of peer reviewed studies, but this is publicly accessible.)

Fomite 13y ago
grins It was a perfect use of my nick, but more importantly I'm a computational epidemiologist who works on hospital acquired infections. It's mostly a curiosity, to see if the gesture and command based Glass system results in less carriage than some other tools. It likely cuts down on some things, but I touch my own glasses all the damned time to adjust them, and I'm used to them - I've been wearing them all my life.
- skue 13y ago
  As someone who trained recently (after hand washing became a widespread practice), I can say that I developed a consciousness I didn't have previously. Though I don't practice now, I still get this strong sense that my hands are unclean and need to be washed when I blow my nose, touch something dirty, am around someone who is ill, etc. But not touching my face (or glasses) was a much harder habit to break and something I still do subconsciously. So I'd also be curious how often docs using Glass do this. Also, hospitals already sterilize surgical instruments, but I did a quick search and it looks like some manufacturers are designing devices meant to be deployed in nursing stations in response to mobile.[1] So maybe more use of these devices will actually drive increased use of rapid sanitizers within the clinic, as a secondary benefit. http://www.infectioncontroltoday.com/news/2013/09/steridesign-introduces-new-sterilization-devices-for-high-touch-electronic-devices.aspxhttp://www.infectioncontroltoday.com/news/2013/09/steridesign-introduces-new-sterilization-devices-for-high-touch-electronic-devices.aspx http://www.infectioncontroltoday.com/news/2013/09/steridesig...