quietmedic Posted April 17, 2016 Share Posted April 17, 2016 hey all. So perhaps this is a little OCD but hey. so I was doing a pelvic exam on a patient with genital herpes. I was in gloves, with one of those thin yellow gowns just for safety, but of course in my OCD mind, I was afraid that maybe while I was pulling off all the personal protective gear, maybe a drop of liquid from my glove got onto my arm. Now normally I wouldn't worry, but genital herpes is like super super contagious, at least in my headgenital it seems thatwayfrom all I've read. I of course wash my hands right away and everything, but still in the back of my head I'm worried, like what if that drop got into my skin, or there's some residue left on my shirt, or since I wasn't wearing a mask what if a tiny bit got on to my face or mouth (mucous membrane!) ... there was no splash or spray of any kind, I'm just super paranoid about these things...just looking to be reassured.do I have to change my clothes, and wash my face? Or am I okay to go out and hug and kiss? Can genital herpes survive on my arm or face skin? Link to comment Share on other sites More sharing options...
Timon Posted April 17, 2016 Share Posted April 17, 2016 This instantly came to my mind after reading your post.. Link to comment Share on other sites More sharing options...
quietmedic Posted April 17, 2016 Author Share Posted April 17, 2016 funny, but really didn't address my question Link to comment Share on other sites More sharing options...
Febrifuge Posted April 17, 2016 Share Posted April 17, 2016 ...I was in gloves, with one of those thin yellow gowns just for safety, but of course in my OCD mind, I was afraid that maybe while I was pulling off all the personal protective gear, maybe a drop of liquid from my glove got onto my arm. Now normally I wouldn't worry, but genital herpes is like super super contagious, at least in my headgenital it seems thatwayfrom all I've read. I of course wash my hands right away and everything, but still in the back of my head I'm worried, like what if that drop got into my skin, or there's some residue left on my shirt, or since I wasn't wearing a mask what if a tiny bit got on to my face or mouth (mucous membrane!) ... there was no splash or spray of any kind, I'm just super paranoid about these things...just looking to be reassured.do I have to change my clothes, and wash my face? Or am I okay to go out and hug and kiss? Can genital herpes survive on my arm or face skin? So, so paranoid. Residue on your shirt? How the heck do you do your pelvic exams? From Medscape: "HSV is transmitted by close personal contact, and infection occurs via inoculation of virus into susceptible mucosal surfaces (eg, oropharynx, cervix, conjunctiva) or through small cracks in the skin. The virus is readily inactivated at room temperature and by drying; hence, aerosol and fomitic spread are rare." Also, here: back to school with you. http://web.biosci.utexas.edu/field/mic361a/herpes.htm You're worried about possible contact with your intact skin, maybe in the process of removing your PPE, when there was no fluid contact with that in the first place? Dude. You could go home at the end of the day, and rub your shirt all over your eyes and not worry about herpesvirus. Inactivated at room temperature and with drying. I don't want to be mean, but again: dude. How can you reassure your patients if you don't have a good store of resources you can draw on to find good information? EDIT because having re-read, you also mention mucous membranes. I talk pretty much constantly during pelvics, explaining everything before I do it, and I have never been concerned about this. Again, there really isn't any spray or droplets or the transmission of any fluids through space. I'm sorry that this question strikes me as so weird, but... dude. Link to comment Share on other sites More sharing options...
cinntsp Posted April 17, 2016 Share Posted April 17, 2016 lol, this is the best thread on here lately. Sent from my SHIELD Tablet using Tapatalk Link to comment Share on other sites More sharing options...
ndpa09 Posted April 17, 2016 Share Posted April 17, 2016 hey all. So perhaps this is a little OCD but hey. so I was doing a pelvic exam on a patient with genital herpes. I was in gloves, with one of those thin yellow gowns just for safety, but of course in my OCD mind, I was afraid that maybe while I was pulling off all the personal protective gear, maybe a drop of liquid from my glove got onto my arm. Now normally I wouldn't worry, but genital herpes is like super super contagious, at least in my headgenital it seems thatwayfrom all I've read. I of course wash my hands right away and everything, but still in the back of my head I'm worried, like what if that drop got into my skin, or there's some residue left on my shirt, or since I wasn't wearing a mask what if a tiny bit got on to my face or mouth (mucous membrane!) ... there was no splash or spray of any kind, I'm just super paranoid about these things...just looking to be reassured.do I have to change my clothes, and wash my face? Or am I okay to go out and hug and kiss? Can genital herpes survive on my arm or face skin? ...are you a practicing PA? Link to comment Share on other sites More sharing options...
Z PA-C Posted April 17, 2016 Share Posted April 17, 2016 What did I just read? Link to comment Share on other sites More sharing options...
UpRegulated Posted April 17, 2016 Share Posted April 17, 2016 Now I am concerned. I read this thread on a touch screen. If a poster on this forum has herpes, and I touch their post on my screen, can I get herpes? Link to comment Share on other sites More sharing options...
cop to pa Posted April 17, 2016 Share Posted April 17, 2016 Wear latex gloves as an effective barrier to tactile transmission... Link to comment Share on other sites More sharing options...
Marinejiujitsu Posted April 17, 2016 Share Posted April 17, 2016 That's why you are not supposed to date your patients. Gosh, don't they teach that in school. Sent from my SAMSUNG-SM-N920A using Tapatalk Link to comment Share on other sites More sharing options...
gcox87 Posted April 18, 2016 Share Posted April 18, 2016 lol, this is the best thread on here lately. Sent from my SHIELD Tablet using Tapatalk Link to comment Share on other sites More sharing options...
Cideous Posted April 18, 2016 Share Posted April 18, 2016 lol Link to comment Share on other sites More sharing options...
Boatswain2PA Posted April 18, 2016 Share Posted April 18, 2016 hey all. So perhaps this is a little OCD but hey. so I was doing a pelvic exam on a patient with genital herpes. I was in gloves, with one of those thin yellow gowns just for safety, but of course in my OCD mind, I was afraid that maybe while I was pulling off all the personal protective gear, maybe a drop of liquid from my glove got onto my arm. Now normally I wouldn't worry, but genital herpes is like super super contagious, at least in my headgenital it seems thatwayfrom all I've read. I of course wash my hands right away and everything, but still in the back of my head I'm worried, like what if that drop got into my skin, or there's some residue left on my shirt, or since I wasn't wearing a mask what if a tiny bit got on to my face or mouth (mucous membrane!) ... there was no splash or spray of any kind, I'm just super paranoid about these things...just looking to be reassured.do I have to change my clothes, and wash my face? Or am I okay to go out and hug and kiss? Can genital herpes survive on my arm or face skin? Quiet - You posted a while back about having difficulties in the ED, and got some good advice. Making some observations from that post and from this post, I have some advice for you. Please don't take it as any sort of personal insult because that is certainly not my intention, just some observations and advice, take it or leave it. Your language is unprofessional, and very passive. Instead of "I was gloved and gowned", you wrote "I was in gloves, with one of those thin yellow gowns just for safety." "genital herpes is like super contagious" "it seems that way from all that I have read" "maybe", "maybe", "what if", "seems", Your OCD/paranoia is alarming. We all probably need to wash our hands more often, and some of us likely get fluids on us more than we should so I'm not suggesting you dip your finger in blood to note the time on your patient's forehead (like we used to be taught to do for tournequets).....but your OCD/paranoia about "catching something icky" is alarming. If I worked with you, and you got into full gown attire for every pelvic exam, I would think you were ridiculous. Add to that your unprofessional language, and your apparent lack of knowledge, and I think I can see why you are struggling in the ED. My suggestions (take them or leave them): You made it through PA school and passed the PANCE, so your head IS full of knowledge. Maybe your OCD/paranoia is just blocking access to it. If so, then get help with your OCD/paranoia so your cognitive side can shine through. Work on your professionalism. Dress professional, TALK professional, and BE professional. Lose ALL SEMBLANCE of the juvenile "Valley talk" that you have used in this post (never, ever again use the term "like" as an adjective, as in "it's, like, super contagious"). Use the medical language that you know. And perhaps EM isn't your calling. If you get OCD about doing a pelvic, what are you going to do when EMS brings in the multi-trauma that's still pumping blood all over the floor, or the diabetic homeless guy with maggots literally crawling under his skin. These are the times when YOU HAVE TO PERFORM and get your team to perform. Again, just some observations and suggestions based on just a couple of posts. I may be wayyyyyy of base, and if so, then just ignore them. Link to comment Share on other sites More sharing options...
Febrifuge Posted April 18, 2016 Share Posted April 18, 2016 I feel like one of the good things about this board is the ability to let our hair down (so to speak, this is funny if you've met me) so I'm not necessarily worried about the "likes" and "I means" and "maybes." Seems to me that QM is trying to verbally acknowledge the idea that this is all probably silly, but he/she is worried anyway. And fair enough. But really, when you do that, please understand that if you pitch a question in terms of "I know this might be dumb, but..." then responses may follow your lead and mostly be "yep, you're being dumb." I agree 100% with Boats, and I also had thought back to that previous thread from a couple of months ago. Remember what I said in that one, about my own horrible first job after school, and how it made me feel totally unprepared and vulnerable to mistakes? Don't let the environment do that to you, QM. Like Boats said, you have the knowledge and probably the skill, now it's your mission in life to put it all together. And not for the sake of some employer who isn't being fair with you; for yourself. And for your patients. My god, the patients. I don't know how someone would feel if she came in, likely already feeling embarrassed about having a herpes outbreak, and the provider gowned up and did all this isolation stuff for a routine pelvic exam. Please, do whatever you need, talk to whomever you need to talk to, to get your mind a little more at ease. And don't forget to think about how your patients are likely to feel about this skittishness you display. This is a safe place to let it out, but make sure it's not also a vibe you're giving off all day every day. Link to comment Share on other sites More sharing options...
DizzyJ Posted April 19, 2016 Share Posted April 19, 2016 I spent most of my time in the ED afraid of getting a herpetic whitlow....I'm also afraid of spiders. They are about equal to me.....maybe the spiders a little more Link to comment Share on other sites More sharing options...
sk732 Posted April 19, 2016 Share Posted April 19, 2016 First I've heard of needing a full body condom for a pelvic exam...gloves, yes, maybe protective eye wear IF there are bad active lesions, but dude, I think you were going overboard. I agree with Bos'n - you need to get a grip on your professionalism, trust your training, trust yourself, and if necessary, take a long step backwards, a couple even longer breaths , and think things through a bit. Barring that, CBT or full on psychotherapy might be in your cards if you're not engaged already, not to mention a less touchy feely specialty. Even medical people need help sometimes. $0.02 Cdn. SK Link to comment Share on other sites More sharing options...
Reality Check 2 Posted April 19, 2016 Share Posted April 19, 2016 Over 50% of the US population has HSV I and 1 in 6 people aged 14-49 have genital herpes which can be HSV I or HSV II. 25 yrs in --- My exposure has been to: Tuberculosis - up to 1 in every 4 patients walking through doors of urban hospital HIV - everywhere Hep A, B, and C MRSA Gonorrhea Chlamydia Strep everything Trichomonas Bacterial meningitis - intubated the guy stat on arrival Lice Scabies Crabs - the yucky not edible kind Maggots Open bowels in surgery Gunshot wounds Stab wounds Crazy drug fueled patients with weapons Bleeding head wounds Barfing and pooping kids Ruptured pregnancy membranes Missing limbs And everything else I cannot remember at this point Somehow - I don't have any of the diseases and have tested negative by my insurance company for everything under the sun And, I am a complete nonresponder to Hep B after 7 injections - zero titer - zilch So, I think you are over-worried and perhaps not exuding an air of confidence to your patients by treating them like Typhoid Mary Wash your hands, wash your hands, wash your hands. Change clothes if shat upon or barfed upon. Wash ER clothes in nice hot water and hot dryer. Wash your hands. Just my thoughts Link to comment Share on other sites More sharing options...
DizzyJ Posted April 20, 2016 Share Posted April 20, 2016 wearing a "thin yellow gown" or any for that matter can certainly be smart for pelvics. Not that you will generally need it, but if there is any bleeding, abscess, or the occasional baby (she claims not to be pregnant with) then it is smart. Link to comment Share on other sites More sharing options...
UpRegulated Posted April 21, 2016 Share Posted April 21, 2016 Wear latex gloves as an effective barrier to tactile transmission... Mmm...uhh...heh...heh...heh...... You said tactile... Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted April 21, 2016 Moderator Share Posted April 21, 2016 I spent most of my time in the ED afraid of getting a herpetic whitlow....I'm also afraid of spiders. They are about equal to me.....maybe the spiders a little more what about herpetic spiders? Link to comment Share on other sites More sharing options...
Reality Check 2 Posted April 21, 2016 Share Posted April 21, 2016 live cockroaches in ears were plenty for me. seeing antennae magnified and wiggling at me gave me the willies. not a huge bug fan Link to comment Share on other sites More sharing options...
Febrifuge Posted April 21, 2016 Share Posted April 21, 2016 what about herpetic spiders? Herpetic Spiders? I saw them open for the Replacements in 1987. Good show. (For real, Minneapolis band names are the best. Dumpster Juice, Gramma's Boyfriend, Boiled In Lead, Communist Daughter, it goes on and on. And they're good bands, is the thing.) Link to comment Share on other sites More sharing options...
Reality Check 2 Posted April 21, 2016 Share Posted April 21, 2016 Cottage Cheese From the Lips of Death - Texas band in the 80s/90s Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted April 21, 2016 Moderator Share Posted April 21, 2016 Herpetic Spiders? I saw them open for the Replacements in 1987. Good show. (For real, Minneapolis band names are the best. Dumpster Juice, Gramma's Boyfriend, Boiled In Lead, Communist Daughter, it goes on and on. And they're good bands, is the thing.) trampled by turtles. great name. http://trampledbyturtles.com/ I feel like that some days.... Link to comment Share on other sites More sharing options...
sk732 Posted April 23, 2016 Share Posted April 23, 2016 live cockroaches in ears were plenty for me. seeing antennae magnified and wiggling at me gave me the willies. not a huge bug fan So not a huge fan of herpetic cockroaches then? What sort of PPE do you need for those - full body condom or targeted one? Fruit flavoured or not? SK Link to comment Share on other sites More sharing options...
Recommended Posts
Archived
This topic is now archived and is closed to further replies.