Prep PPE

Prep PPE

Response to covid 19 and a question from a friend– as a nurse have you ever seen anything like this virus?

kinda have, yes…. given the REPORTED speed of spread there only really 2 conclusions … neither path matters to most of us….[[ how so?? our response on a personal or even local level has to be the same]] IF they can pin point when/where the disease started [this fast] is if it is a bioweapon that escaped or was released….you nor I can DO anything about that, RIGHT? —–OR—— it is totally natural thing in which case it has been around for some time, spreading UNIDENTIFIED … which is actually most likely, in which case, well we just have to deal with it as is…. the ONLY way to know if someone has it is to do the testing….

JUST like the common flu—you may have ALL the signs of the flu, BUT the actual diagnosis is dependent on lab tests. Ultimately it does NOT matter [effectively] because you still just treat the symptoms and provide supportive care. In cases where the illness is “mild” people self treat at home and therefore do not come to medical attention. A side effect of that is even IF they have true flu, they are not counted. SAME with the covid 19, unless or until the test comes back NOBODY ACTUALLY KNOWS how many have it. There is no effective specific treatment YET. So all that can actually be done is treat the symptoms and use standard precautions just like the flu.

TB was rampant years ago and there was an effective treatment available that sometimes took a full year. One thing I always found sadly funny was how many people were nonchalant around the patient UNTIL the tests came back and the patient was diagnosed as having TB….. THEN the staff would “run around with their hair on fire soiling themselves” figuratively speaking and put the patient in isolation. This was sad because the staff had already been exposed. See standard precautions below.

How do the above disease spread? All 3 mostly are air bourne and surface contact. If someone coughs or sneezes, droplets go into the air [some bigger and some smaller] the bigger droplets fall sooner, smaller droplets can travel farther. We are mostly concerned with the respiratory aspects but they can enter the body other ways like mucus membranes and open wounds.

Speed of spread—nobody actually KNOWS how fast it spreads. How is this? Once again to actually deliver a definitive diagnosis you HAVE to have test results. No test no real statistics. Until the test results are reported you only have presumptive cases. Typically there are reporting cycles for ease of explaining we will say that the reporting cycle is daily at noon. 1^st report says that there are 2 confirmed cases. [they seldom report negative results in the media] . 2^nd report say that there are 2 new CONFIRMED cases which would indicate that the cases have DOUBLED. OK project that out and it will sound scary. NOT everyone [total population] is tested, not every one of those who are sick get tested [because there are not enough tests nor staff to be able to do the tests] EVEN IF the media would report ALL of the results of the tests for covid 19 [total number of tests done broken down to the number that are positive AND the number that showed negative] this would give us a better picture of how fast this spreads BUT it still is blurry at the point because we do not have large enough numbers. When we get larger numbers tested the % will change and the DEATH RATE will decrease. This still does not paint a real picture of the situation as MOST people still will not be tested even if sick and most wont go in to their doctor unless they are REALLY sick so we don’t know how many actually have the covid 19. Point being that the media to a large extent are fear mongers. You should talk with YOUR doctor to get an idea of how you should be reacting.

Standard precautions sometimes referred to as universal precautions depends on what term is in vogue in your area. Basically the simplest explanation is treat everybody as if they have everything and then you don’t have to worry [as much]. Avoid contact with body fluids period. Don’t get any closer than is needed to accomplish what you have to do. WASH your hands well and often with plain soap and water before AND after contact, especially if you know you have been contaminated. Keep your hands away from your mucus membranes in most cases this means your face. Real sun light is your friend. The UV light deactivates most germs. Cover your [or the patient’s] cough/sneezes, keep your hands away from mucus membranes-yours and others.

Ppe when used appropriately AND correctly! Ppe can do 2 basic things depending on why you are doing it… IF you are healthy it will help protect you IF you pay attention. If you are sick it cuts down on you contaminating others and other things.

Gloves can be occlusive like plastic or rubber whatever for dealing with wet stuff. Can be cloth so that you can wash them after use for dry stuff and to remind you to keep your hands away from mucus membranes.

Masks there are several kinds we will limit this discussion to N95, surgical disposable and cloth reusable. N 95 [100] indicates the efficiency of the filtering expressed as a % removed. So 95% of the particulates [dust or germs] are removed from the air you breath IN [ so there is no such thing as more than 100% in reality] the N95 masks that I have used have a one way valve which makes it easier to exhale—exhaled air is NOT filtered at all. So do NOT waste an N95 mask thinking that it will contain the sick person’s germs.

Surgical and cloth masks do not filter much out of the air but when used as intended they are very effective for reducing the transmission of germs. How masks work, most masks just redirect the air flow to the sides which slows down the force of airflow so droplets fall or drop out ie so droplets don’t travel as far. If something splashes on you the mask should at least keep it from directly touching you and depending on how much gets on your mask it gives you time to change the mask. In the case of you being the sick person it will help contain the spray when you cough, sneeze or even talk. You may not be aware of it but every time you speak or exhale, moisture and droplets ARE coming out of you and can get on others which is why sick folk NEED to wear masks.

Masks alone do NOT provide total protection but they DO help.

EYE protection is often needed depending on the risks. Germs CAN enter your body through your eyes. Stuff gets on your eyeball and the tears wash that stuff to the lachrymal duct into your nose, down into your mouth or into your lungs. EYE protection can be simple as your eyeglasses if you wear them everyday to see [contacts do not protect you at all]. Or you can have safety glasses that kinda look like regular glasses up through goggles which do not let any air/particles get to the eyes. There are also face shields that go over the whole face. Often people will wear the mask, glasses/goggles AND the face shield too. All depending on risks.

GOWNS or aprons go over you to contain stuff [btw I use the term STUFF to keep from making a detailed list of all the things involved, most folks can figure out by the context. I don’t feel like typing it all out and most are not interested in reading an extra 500 words, this is not a peer reviewed article in a medical journal]

What do we do and how to prep

Supplies and provisions- stock as IF you knew there was a big blizzard coming and be ready to shelter in place for at least 2 weeks. Many folk in WY and other places only shop on a monthly basis, so maybe consider having enough to skip a shopping trip.

Everyone needs certain things like TP and dish soap, you need enough to ride out the storm but you most likely don’t need a warehouse full. Do you? Unless of course you own a store of some kind. How much you get depend totally on your assessment of how long you will have to SIP [shelter in place] BUT do it before the storm so others can get what they need too.

Keep a journal of the happenings of the day, DO include what you use each day and over a period of time you will have the information needed to project out and budget for what you need. Write down what you learned from the experience and what you wish you had known ahead of time or what you wish you had ore or less of.

Cross ref