A couple of recent experiences on call thanks to our tireless infection control department.
A few months ago a patient presented for surgery. A year ago she had Vancomycin Resistant Enterococcus. This was cleared and she had negative cultures. So she presents in the ER requiring emergency surgery, can't remember what, maybe a hip fracture. Whoever did her history and physical noted that she had VRE. Had can of course be present or past tense. Notwithstanding her negative cultures on goes the yellow gown and we have to go into full paranoia mode in the OR. Before the case, I ask the charge nurse, "can't we just call infection control and explain and get the isolation precautions lifted?". No of course because it is the weekend and infection control doesn't work on weekends. Silly me.
To our credit both the surgeon and I ignored the precautions which means there are probably multiple incident reports floating around.
Next a month or so ago the charge nurse informs me that the surgeon has booked a cholecystectomy. But.... the patient has been to a hospital outside of Canada and by hospital policy has to be treated as a possible antibiotic resistant carrier.
So I am trying to imagine in what third world hell-hole she found herself in hospital.
Answer:
Phoenix Arizona.
A few months ago a patient presented for surgery. A year ago she had Vancomycin Resistant Enterococcus. This was cleared and she had negative cultures. So she presents in the ER requiring emergency surgery, can't remember what, maybe a hip fracture. Whoever did her history and physical noted that she had VRE. Had can of course be present or past tense. Notwithstanding her negative cultures on goes the yellow gown and we have to go into full paranoia mode in the OR. Before the case, I ask the charge nurse, "can't we just call infection control and explain and get the isolation precautions lifted?". No of course because it is the weekend and infection control doesn't work on weekends. Silly me.
To our credit both the surgeon and I ignored the precautions which means there are probably multiple incident reports floating around.
Next a month or so ago the charge nurse informs me that the surgeon has booked a cholecystectomy. But.... the patient has been to a hospital outside of Canada and by hospital policy has to be treated as a possible antibiotic resistant carrier.
So I am trying to imagine in what third world hell-hole she found herself in hospital.
Answer:
Phoenix Arizona.
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