Does anyone find pediatrics more contagious than other specialties???

[premed101]

Do you find yourself getting sick more often because of the patients who are contagious? What do you do to prevent catching something?

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[oldbearprofessor]

What do you do to prevent catching something?

I do Neonatology. Prematurity is not "catching."

 

[drbetty]

What do you do to prevent catching something?

1. wash hands with soap and water
2. get flu shot
3. wash hands with soap and water
4. use antibacterial gel
5. wash hands with soap and water
6. use antibacterial foam
6. wash hands with soap and water
7. liberally apply lotion to my chapped hands

 

[premed101]

I do Neonatology. Prematurity is not "catching."

What about when the mother had something contagious or even bloodborne like HIV(neonatology is procedural)

Also, Dr betty: aren't most contagious illnesses caught through the mouth/nose?(patient coughs in doctor's face, doctor gets the contagious illness only to pass it on to other kids. Yikes!!!)

 

[DO Sigma Nu guy]

1. wash hands with soap and water
2. get flu shot
3. wash hands with soap and water
4. use antibacterial gel
5. wash hands with soap and water
6. use antibacterial foam
6. wash hands with soap and water
7. liberally apply lotion to my chapped hands

 

[drbetty]

What about when the mother had something contagious or even bloodborne like HIV(neonatology is procedural)

Unless you sleep with the mother, share needles with her, or have an accidental needle stick, this is not really a huge concern. You can get an accidental needle stick with adult patients, and fields like surgery are far more procedural than neonatology. Plus the amount of blood from a teenie premie is likely to have less viral load than someone who has been HIV viruses swimming in them for years. Regardless of patient and their risk factors, you need to use caution with needles.

Aren't most contagious illnesses caught through the mouth/nose?(patient coughs in doctor's face, doctor gets the contagious illness only to pass it on to other kids. Yikes!!!)

Sure, if patient coughs a loogie in doctor's face, doctor wipes his/her face, forgets to wash hands, then touches next patient. Close quarters are probably the easiest ways infection is spread i.e., living in a college dorm, sick person on train/airplane sneezing all over you. It's not just in the pediatrician's office.

http://www.mayoclinic.com/health/infectious-disease/ID00004

Prevent the spread of infectious diseases

Decrease your risk of infecting yourself or others:

• Wash your hands often. This is especially important before and after preparing food, before eating and after using the toilet.
• Get vaccinated. Immunization can drastically reduce your chances of contracting many diseases. Make sure to keep your recommended vaccinations, as well as your children's, up-to-date.
• Use antibiotics sensibly. Only take antibiotics when necessary. And if they're prescribed, take them exactly as directed — don't stop taking them early because your symptoms have gone away.
• Stay at home if you have signs and symptoms of an infection. Don't go to work if you are vomiting, have diarrhea or are running a fever. Don't send your child to school if he or she has these signs and symptoms, either.
• Be smart about food preparation. Keep counters and other kitchen surfaces clean when preparing meals. In addition, promptly refrigerate leftovers — don't let cooked foods remain at room temperature for extended periods of time.
• Pay special attention to cleaning the 'hot zones' in your home. These include the kitchen and bathroom — two rooms that can have high concentrations of bacteria and other infectious agents.
• Practice safe sex. Use condoms if you or your partner has a history of sexually transmitted diseases or high-risk behavior — or abstain altogether.
• Don't share personal items. Use your own toothbrush, comb and razor blade. Avoid sharing drinking glasses or dining utensils.
• Travel wisely. Don't fly when you're ill. With so many people confined to a small area, you may infect other passengers on the plane. And your trip won't be comfortable, either. Depending on where your travels take you, talk to your doctor about any special immunizations you may need.
• Keep your pets healthy. Bring your pet to a veterinarian for regular care and vaccinations. Keep your pet's living area clean.

With a little common sense and the proper precautions, you can avoid infectious diseases and keep from spreading them.

 

[drbon]

1. wash hands with soap and water
2. get flu shot
3. wash hands with soap and water
4. use antibacterial gel
5. wash hands with soap and water
6. use antibacterial foam
6. wash hands with soap and water
7. liberally apply lotion to my chapped hands

seriously, OCD washing of hands works wonders. and try not to let the kids cough in your face, although sometimes that's unavoidable

 

[premed101]

Sure, if patient coughs a loogie in doctor's face, doctor wipes his/her face, forgets to wash hands, then touches next patient. Close quarters are probably the easiest ways infection is spread i.e., living in a college dorm, sick person on train/airplane sneezing all over you. It's not just in the pediatrician's office.

True, but in a pediatrician's office, you have a lot more contagious people coming in than living in a dorm where someone may be sick once or twice in a year and knows better than to cough all over you, hopefully. Also, in a pediatric office, you are going right in the patient's face to do the physical examination(ie. looking in the eyes,etc.)

 

[drbetty]

True, but in a pediatrician's office, you have a lot more contagious people coming in than living in a dorm where someone may be sick once or twice in a year and knows better than to cough all over you, hopefully. Also, in a pediatric office, you are going right in the patient's face to do the physical examination(ie. looking in the eyes,etc.)

First of all, dorms are notorious for breeding germs in the winter - when your roommate is sick, the whole floor becomes sick. Plus, this is why we get meningitis shots prior to living in the dorm - we live and breathe each others germs.

The fact is that you are looking right into the patient's face in almost all specialties, including pediatrics. Generally, kids are pretty healthy, and most primary care clinic is comprised of "well child" exams. Have you had your clinical rotations yet? People of all ages are sick all year round. I've had 5 year-olds cough in my face as well as 55 year-olds. Just yesterday, a nearly brain-dead adult coughed up a loogie on my forehead. Bulls eye. Welcome to medicine.

I'm not sure why you are adamant that pediatrics is an especially dirty field. If this is a large concern to you, then consider a field like radiology or pathology or a non-medical desk job at home or in a bubble where you don't have to touch things that other sick people are touching. Exposure to contagious ailments is a risk that most physicians make, and it is a risk that anybody that anybody takes when working with people in general. This is why the president uses hand sanitizer between shaking hands with multiple people.

 

[Stitch]

When I started in the ED I was sick every two weeks, but now I've got the strongest immune system around.

People are vectors, no matter what their age, but I must admit that children seem to resemble petri dishes, growing whatever bug is around and sharing generously.

 

[BigNavyPedsGuy]

Do you find yourself getting sick more often because of the patients who are contagious? What do you do to prevent catching something?

True story: 36 hours ago when I was sitting on the toilet and throwing up in a trash can I was wondering the same thing.

I wish I was kidding.

 

[TexasRose]

True story: 36 hours ago when I was sitting on the toilet and throwing up in a trash can I was wondering the same thing.

I wish I was kidding.

Ouch. Sorry!

I haven't been sick once this year. (don't know how I lucked into this ridiculously good immune system, but I surely appreciate it!)

 

[Stitch]

Ouch. Sorry!

I haven't been sick once this year. (don't know how I lucked into this ridiculously good immune system, but I surely appreciate it!)

It's just a matter of time, TR. Just a matter of time.
They'll find you.

 

[Sweet Tea]

True story: 36 hours ago when I was sitting on the toilet and throwing up in a trash can I was wondering the same thing.

I wish I was kidding.

Oh I had that earlier this year. Lost 8 lbs in less than 24 hours. Good times.

 

[Sweet Tea]

I've been sick 3 times this year. The first time I was on heme/onc and a GI bug was systematically taking down the residents. I managed to not catch cancer or sickle cell from my kids, but my fellow interns made me miserable. The other 2 times I was sick were both outpatient community months. Saw a bunch of sick kids, and while I'm crazy about washing my hands and stethoscope, many vectors haven't learned the whole "don't cough in the doctor's face while she's looking at your throat" trick. It was unfortunate. I also had my first case of pink eye since I was oh, 4. Folks, pink eye hurts.

But to be honest, I was sick much more often last year when I was a surgery intern. The difference was that I couldn't take a sick day and instead would leave the OR to puke every 30 mins or so. Good times. I'll take the vectors.

 

[BigNavyPedsGuy]

I've been sick 3 times this year. The first time I was on heme/onc and a GI bug was systematically taking down the residents. I managed to not catch cancer or sickle cell from my kids, but my fellow interns made me miserable. The other 2 times I was sick were both outpatient community months. Saw a bunch of sick kids, and while I'm crazy about washing my hands and stethoscope, many vectors haven't learned the whole "don't cough in the doctor's face while she's looking at your throat" trick. It was unfortunate.

Believe it or not, you'll get even better at dodging the cough as time goes on. Not to say you won't get sick, but you'll learn a poke your head in view right when they gag/cough and get the heck out.

 

[TexasRose]

It's just a matter of time, TR. Just a matter of time.
They'll find you.

Meh. I've got kids and I used to teach elementary. I've been immunized.

 

[BigNavyPedsGuy]

Meh. I've got kids and I used to teach elementary. I've been immunized.

You will regret those words . . . . . . tick . . . . . tock

 

[TexasRose]

You will regret those words . . . . . . tick . . . . . tock

Man, you guys have really got it in for me!

A kid who was flu immunized and got Flu B coughed directly in my face while I was about 6inches away trying to see his tonsils. I didn't get sick.

(I know, I know, I'm really asking for it...)

 

[premed101]

would it be bad to wear a mask? Or is that simply not allowed on peds

 

[Stitch]

would it be bad to wear a mask? Or is that simply not allowed on peds

Medicine is no better with the 90 year old GOMERs drooling all over. And just remember that their diapers are bigger...

Seriously if you're that frightened of sick people you might seriously consider a different line of work.

 

[BigNavyPedsGuy]

would it be bad to wear a mask? Or is that simply not allowed on peds

Whenever we (the residents and staff) have colds and are working around really sick/vulnerable kids like Heme/Oncers or in the NICU we wear masks. It's sort of expected.

But that's for the kids' protection, not ours. We are but pawns in the germ producing machine . . . .

 

[KidDr]

while wearing a mask in the NICU and on heme/onc when you're sick is expected, people are going to think you're seriously weird if you walk around with a mask on 24/7. and you'll probably scare some kids. and given that many of the things that kids get are spread by contact, and not by droplet (i.e. by getting coughed on), just wearing a mask isn't going to keep you healthy anyways. wash your hands a lot, try not to get coughed/barfed on, and get on with your life. everyone gets sick sometimes---even if they're not in medicine.

 

[premed101]

I was trying to find out if being sick is a regular occurrence for peds specialists. But after reading these posts, it doesn't seem as frequent as thought.
It's a little surprising that a kid can have strep, doctor does strep test, kid coughs almost instinctually, and doctor doesn't catch it. Counterintuitive I guess

To kiddr, Isn't a cough droplet contacting your skin?

 

[Stitch]

while wearing a mask in the NICU and on heme/onc when you're sick is expected, people are going to think you're seriously weird if you walk around with a mask on 24/7. and you'll probably scare some kids. and given that many of the things that kids get are spread by contact, and not by droplet (i.e. by getting coughed on), just wearing a mask isn't going to keep you healthy anyways. wash your hands a lot, try not to get coughed/barfed on, and get on with your life. everyone gets sick sometimes---even if they're not in medicine.

And in addition, remember to clean your stethoscope. That's a huge germ carrier. Wipe it down after each patient.

 

[oldbearprofessor]

while wearing a mask in the NICU and on heme/onc when you're sick is expected

We really prefer folks stay out of the NICU if they are so sick they need to wear a mask. This includes family members, doctors, nurses, dietitians, therapists and the 250 random folks that seem to come through...

In the old days (like a few years ago...) residents wearing masks in the NICU when they had a URI was done sometimes. Currently we invite them to call in their backup and enjoy hacking away at home.

We also currently invite you to leave your stethoscope somewhere else at all times when going to the NICU. We'll provide you with one for each baby. They may not work well, but who's really hearing that split S2 when the HR is 180?

 

[KidDr]

We really prefer folks stay out of the NICU if they are so sick they need to wear a mask. This includes family members, doctors, nurses, dietitians, therapists and the 250 random folks that seem to come through...

In the old days (like a few years ago...) residents wearing masks in the NICU when they had a URI was done sometimes. Currently we invite them to call in their backup and enjoy hacking away at home.

Thank god things have changed since I was a resident (at least at some places...). The risk to the babies is NOT worth it. And anyone who argues otherwise hasn't seen what happens when a micropreemie gets RSV.

 

[Saluki]

I've had a few different attendings tell me that the pediatric interns are the sickest group in the entire hospital, but after that, they've gotten everything and never get sick again...

It's probably an urban legend, but it's a comforting one

 

[BigNavyPedsGuy]

We really prefer folks stay out of the NICU if they are so sick they need to wear a mask. This includes family members, doctors, nurses, dietitians, therapists and the 250 random folks that seem to come through...

In the old days (like a few years ago...) residents wearing masks in the NICU when they had a URI was done sometimes. Currently we invite them to call in their backup and enjoy hacking away at home.

I just can't see this flying. Your average URI last 2-3days. Residents get colds pretty often. We get (an ACGME mandated) 4 days a month off, and staff all criticize it "back when I was a resident I didn't have a day off for 4 months." I just can't see them letting every resident with a cold stay home and not having punitive consequences.

I'm not saying that's not how it goes in your hospital. I just know that I would fail and repeat an entire month in the NICU if I skipped 3 or 4 days with a cold. Not to mention the lack of resident coverage.

 

[oldbearprofessor]

I just can't see this flying. Your average URI last 2-3days. Residents get colds pretty often. We get (an ACGME mandated) 4 days a month off, and staff all criticize it "back when I was a resident I didn't have a day off for 4 months." I just can't see them letting every resident with a cold stay home and not having punitive consequences.

I'm not saying that's not how it goes in your hospital. I just know that I would fail and repeat an entire month in the NICU if I skipped 3 or 4 days with a cold. Not to mention the lack of resident coverage.

Bottom line is to do what is best for the babies and it's not in the best-interests of the babies to have a hacking really sick resident or attending (or nurse, etc) taking care of them. There are alternatives for a day or two during the worst of a bad URI. No one is irreplaceable. The key is that the system has to recognize that the resident is doing everyone a favor by taking a day or two off at the worst of a URI if they are in the NICU. Obviously, this is an evolving recognition pattern that may not yet be in place.

 

[BigNavyPedsGuy]

Bottom line is to do what is best for the babies and it's not in the best-interests of the babies to have a hacking really sick resident or attending (or nurse, etc) taking care of them. There are alternatives for a day or two during the worst of a bad URI. No one is irreplaceable. The key is that the system has to recognize that the resident is doing everyone a favor by taking a day or two off at the worst of a URI if they are in the NICU. Obviously, this is an evolving recognition pattern that may not yet be in place.

Will you please come run our NICU?

I do see waht you mean. There are staff that feel the way you do. They tend to be the younger more progressive staff that have finished fellowship (at another place) more recently.

 

[oldbearprofessor]

Will you please come run our NICU?

I do see what you mean. There are staff that feel the way you do. They tend to be the younger more progressive staff that have finished fellowship (at another place) more recently.

Run an NICU? R U nuts? Talk about the worst job anyone could have - it would be running a large NICU, IMHO. NO thx. k? . I shudder to think of having to spend about 80 hours a week in meetings about stuff like what brand of NG tubes to buy.

Also, watch the ageism there! I'm a very oldbear and I like to think I'm progressive, even though I still wonder what happened to all my old "Baby Birds"

 

[BigNavyPedsGuy]

Run an NICU? R U nuts? Talk about the worst job anyone could have - it would be running a large NICU, IMHO. NO thx. k? . I shudder to think of having to spend about 80 hours a week in meetings about stuff like what brand of NG tubes to buy.

Also, watch the ageism there! I'm a very oldbear and I like to think I'm progressive, even though I still wonder what happened to all my old "Baby Birds"

It wasn't ageism. I was complimenting you on being "progressive" and youthful.

 

[J-Rad]

We also currently invite you to leave your stethoscope somewhere else at all times when going to the NICU. We'll provide you with one for each baby. They may not work well, but who's really hearing that split S2 when the HR is 180?

He he...me!

 

[Marigold]

I got sick about 3 times during the 1st half of intern year...2 viral URI's, one bout of strep throat. Only ended up needing to call in once, so the colds were annoying, but certainly not debilitating.

 

[oldbearprofessor]

He he...me!

and at a HR of 180 and RR of 60 and the baby on the vent you can appreciate the change of the S2 splitting with inspiration?

Dang, you're good. Who needs an ECHO machine!

j/k - I love it when the cardiology attendings "school" the residents in the NICU on what "sounds" they are hearing in a baby with heterotaxy, a shunt, and about 3 cardiac defects! and all that off of a $1.50 bedside plastic stethoscope!

 

[CrazyPeds527]

The only times i have been sick this year have been the 2 URIs I have gotten from my fiancee. No child has gotten me ill, and its all because I wash my hands like Michael J Fox's OCD character on Scrubs!!

Seriously though...if you are scared of getting ill, time for a new line of work.

 

[premed101]

I've always thought that the reason you wash your hands is so that you don't touch your eyes, mouth, etc where germs can be transfered through the opening.
But if I understand, you're all saying that being coughed in the face (germs directly on your face) doesn't matter much? I'd like if someone can explain that with regard to science,logic,etc.

By the way, I'm not afraid of getting sick. I just don't want to be sick!
(if I knew the chances were low of transmission(which I'm picking up on reading the posts), I'd care less about getting coughed on)

 

[Freibi]

I've always thought that the reason you wash your hands is so that you don't touch your eyes, mouth, etc where germs can be transfered through the opening.
But if I understand, you're all saying that being coughed in the face (germs directly on your face) doesn't matter much? I'd like if someone can explain that with regard to science,logic,etc.

The reason you wash your hands is 1. to protect patients from whatever germs are sitting on your hands (maybe from the patient next door, or the ones that live in your own nose), and 2. to protect yourself from getting the germs in your eyes/mouth/etc as you mentioned.
If you're being coughed in the face, the result may be equivalent to touching your face before you can wash your hands after touching a patient. Most likely, you won't get sick right away, unless you're immunocompromised. But maybe you will.
I'm pretty sure that chances of catching all the colds around are much greater if you're a preschool teacher than if you're a physician working with children who uses hand sanitizer after each patient encounter and follows isolation precautions etc.

 

[BigNavyPedsGuy]

I'm pretty sure that chances of catching all the colds around are much greater if you're a preschool teacher than if you're a physician working with children who uses hand sanitizer after each patient encounter and follows isolation precautions etc.

Interesting comparison. However, I would argue that the physician skews the sample so s/he spends a much greater percent of time with the sick ones where the preschool teacher is around all the kids - healthy and sick.

 

[BigRedBeta]

But if I understand, you're all saying that being coughed in the face (germs directly on your face) doesn't matter much? I'd like if someone can explain that with regard to science,logic,etc

1) Your immune system is a pretty impressive piece of work. Exposure to a pathogen absolutely doesn't mean infection.

2) Different disease pathogens are transmitted in different ways. There are a limited number that are transmitted through respiratory secretions. So in some cases, whatever is making them hack isn't necessarily causing them to erupt with pathogens. To further add to the nuance, the size of a pathogen also effects the size of droplets it can subsist in - and particle size is inversely proportional to the distance it can travel in the air. This is why TB patients get put in negative pressure rooms and all the other precautions they have to put up with.

http://en.wikipedia.org/wiki/Transmission_(medicine)

3) The use of hand washing, alcohol gels, contact/droplet/total precautions, etc in a hospital/clinic setting is to prevent the physician from being a carrier of disease to the next patient - not to prevent the physician from getting sick (though that's a nice benefit to us).

4) There's a lot more nuance that goes into all this, but if you find it interesting, there are positions at all major hospitals in infection control for health care professionals of all types.

I hope this helps answer at least some of your questions.

 

[medsurg2010]

I have no evidence to back this up beside my own anecdotal experience, but I always got sick working in the ER in college until one of the ER attendings told me to go buy a pair of glasses-- her reasoning was that viruses can enter the body through the conjunctiva and even if you wash your hands a million times you can still be infected through your exposed conjunctiva.

Well, since getting glasses I have gotten sick once in two years and its been from my own daughter not from any of my patients (but then again I'm just a med student). Anyway, you can find cheap glasses at walmart/target.

BTW, my wife thinks it makes me look way smarter, too which improves my home life, too.