3 ms·

PPE is hard... Every time you take it off is an opportunity for infection. It's very easy to get complacent and not be as careful as you should be (yes, even wh

PPE is hard... Every time you take it off is an opportunity for infection. It's very easy to get complacent and not be as careful as you should be (yes, even when dealing with something like Ebola). When you're donning and doffing dozens of times a day, mistakes happen. It's very likely she wasn't the only one to be exposed, but hopefully she's the only one that was infected.

konstruktor 12y ago
The prevalent culture in medicine still assumes that people can do things correctly all the time. Contrast that to aviation where every interaction has been designed around the fallibility of human beings for decades. You can't change a culture on a moment's notice, just because the threat is more significant.
toomuchtodo 12y ago
Do they do a decontamination shower before you remove your PPE?
- JshWright 12y ago
  Maybe? I'm a firefighter/paramedic (with training and experience in hazmat operations). I don't know anything about the specific procedures used in this case. I doubt they do in this case though. Probably at the end of the shift, but when you are in and out of a patient's room a dozen times a day, it's not likely they do a full decon each time. EDIT: Just reread your post after seeing frankydp's reply. I thought you were asking about decon showers _after_ removing PPE. frankydp is absolutely correct that showering while wearing most styles of PPE is a bad idea.
- frankydp 12y ago
  Showers can actually do more harm than good if the equipment is permeable, or the individual did not follow protocol when donning. Meaning even little things like not cuffing your gloves. The can cause overconfidence in regards to contamination.
- ChuckMcM 12y ago
  I was wondering the same. Clearly this wouldn't work with permeable cloths as that would just rinse possible virus into the suit (assuming water). UV exposure perhaps, there are a lot of these (http://www.sott.net/article/287166-Ultraviolet-light-robot-kills-Ebola-in-two-minutes-on-surfaces http://www.sott.net/article/287166-Ultraviolet-light-robot-k...) things going around.
frankydp 12y ago
PPE is very hard. Military contamination rates for Decon are considered to be 25%. That number is just the projection for unit effectiveness after an event, but it is rooted in the fact that even the most well trained people will still cut corners in decon. Mostly due to heat and fatigue. Overconfidence and repetition weariness can also be issues for those that decon too much.
- look_lookatme 12y ago
  > Military contamination rates for Decon are considered to be 25%. Just curious, do you have any citations for this?
  - frankydp 12y ago
    There are no public citations that I could dig up. That number is the number used for planning with persistent agents. It varies quite a lot by agent. For further context look up the health worker mortality in West Africa due to Ebola. Even if those people are not all highly trained they are trained. The reality is that people simply cut corners, even when they know the risk, and the margin for error is obnoxiously low.
- oskarth 12y ago
  This is interesting. Are there any protocols or alternatives that you are aware of which push this % down to <<1%?
  - JshWright 12y ago
    Remove humans from the equation? Humans make mistakes. Humans working in high stress situations are at a greater risk for making mistakes. Humans working in high stress situations, while wearing PPE that traps heat and moisture are at a tremendous risk for making mistakes.
    - PeterisP 12y ago
      This seems to be a viable target - for people in quarantine, if we can replace x% of actions that need to be done by humans with devices that can be sterilized, then that's a x% decrease in number of infections. We don't need any AI for this - remote control would work just as well. Can't we get a pair of robotic hands on wheels + Oculus Rift and controller gloves for a small fraction of what an MRI device costs?

konstruktor 12y ago

The prevalent culture in medicine still assumes that people can do things correctly all the time. Contrast that to aviation where every interaction has been designed around the fallibility of human beings for decades. You can't change a culture on a moment's notice, just because the threat is more significant.

toomuchtodo 12y ago

Do they do a decontamination shower before you remove your PPE?

JshWright 12y ago
Maybe? I'm a firefighter/paramedic (with training and experience in hazmat operations). I don't know anything about the specific procedures used in this case. I doubt they do in this case though. Probably at the end of the shift, but when you are in and out of a patient's room a dozen times a day, it's not likely they do a full decon each time. EDIT: Just reread your post after seeing frankydp's reply. I thought you were asking about decon showers _after_ removing PPE. frankydp is absolutely correct that showering while wearing most styles of PPE is a bad idea.
frankydp 12y ago
Showers can actually do more harm than good if the equipment is permeable, or the individual did not follow protocol when donning. Meaning even little things like not cuffing your gloves. The can cause overconfidence in regards to contamination.
ChuckMcM 12y ago
I was wondering the same. Clearly this wouldn't work with permeable cloths as that would just rinse possible virus into the suit (assuming water). UV exposure perhaps, there are a lot of these (http://www.sott.net/article/287166-Ultraviolet-light-robot-kills-Ebola-in-two-minutes-on-surfaces http://www.sott.net/article/287166-Ultraviolet-light-robot-k...) things going around.

frankydp 12y ago

PPE is very hard. Military contamination rates for Decon are considered to be 25%. That number is just the projection for unit effectiveness after an event, but it is rooted in the fact that even the most well trained people will still cut corners in decon. Mostly due to heat and fatigue. Overconfidence and repetition weariness can also be issues for those that decon too much.

look_lookatme 12y ago
> Military contamination rates for Decon are considered to be 25%. Just curious, do you have any citations for this?
- frankydp 12y ago
  There are no public citations that I could dig up. That number is the number used for planning with persistent agents. It varies quite a lot by agent. For further context look up the health worker mortality in West Africa due to Ebola. Even if those people are not all highly trained they are trained. The reality is that people simply cut corners, even when they know the risk, and the margin for error is obnoxiously low.
oskarth 12y ago
This is interesting. Are there any protocols or alternatives that you are aware of which push this % down to <<1%?
- JshWright 12y ago
  Remove humans from the equation? Humans make mistakes. Humans working in high stress situations are at a greater risk for making mistakes. Humans working in high stress situations, while wearing PPE that traps heat and moisture are at a tremendous risk for making mistakes.
  - PeterisP 12y ago
    This seems to be a viable target - for people in quarantine, if we can replace x% of actions that need to be done by humans with devices that can be sterilized, then that's a x% decrease in number of infections. We don't need any AI for this - remote control would work just as well. Can't we get a pair of robotic hands on wheels + Oculus Rift and controller gloves for a small fraction of what an MRI device costs?