Don't Hospital Kill You:

A Response to CNN's Health Feature "Don't Let a Hospital Kill You"

Five Good Tips for Staving Off Hospital Super Infections

by Josh Day

If you haven't read my previous response to a CNN health feature, "Are You an Obnoxious Patient?" you can check that out here. And yes, you read that correctly. The CNN original article was entitled "Are You an Obnoxious Patient?"

And this one's entitled... "Don't Let a Hospital Kill You." Ha!

The loaded title aside, this featurette offered five practical tips about how you can avoid picking up a secondary infection from a medical environment.

CNN point #1: Bring Your Own Toys

CNN states:

At the pediatrician's office, don't let your child play with the toys or books in the waiting room. "They're covered with bacteria," McCaughey says. Also, don't let your child crawl on the floor; bacteria there could get into cuts on their knees or hands. "This is one place you ought to keep your child sitting still or on your lap," she says.

Truly this is sage advice! This ounce of common sense is so simple and practical, it's a wonder it's not everyday knowledge.

Allow me to one-up it.

Why subject your child to the germy waiting room anyway? Set up your appointment so you can have both parents or guardians (or a friend) with you. Keep your child in the car while one of you waits with him and the other sits in the waiting room to be called. Bring a lot of toys and games to keep your child happy as chances are it's going to be a long wait.

Granted, this isn't going to win you any friends with the nursing or administrative staff, but they can't stop you from doing this. Stay pleasant and don't let them bully you out of your decision.

Quick note on "sick" and "well" waiting rooms... Unlike the exam room which has a sterile sheet that's changed after each person, all waiting room chairs and carpeted floors hold colonies of bacteria. Also, most likely the sick and well waiting rooms are connected by the same ventilation system so airborne bacteria can easily strike while you sit and wait for up to two hours.

Would it not be easier to keep your kid in the car in a familiar environment, or try to hold him still for two hours and keep him off the floor and away from cool-looking toys?

CNN point #2: Heat Up Your Car

Yes, we know that sounds strange. But studies show staying warm before and during surgery can help you fight infection. So the Institute for Healthcare Improvement suggests that in cold weather, you heat up the car, wear warm clothes on the way to the hospital, ask the hospital staff to give you plenty of blankets while you wait for surgery, and ask how they plan to keep you warm during surgery.

Some good advice. I don't really have anything to add here.

CNN point #3: Want to Touch Me? Wash Your Hands First.

Many people feel uncomfortable asking this. Nahum suggests putting it like this: "I didn't see you wash your hands. Do you mind doing it in front of me?"

Dr. Vicki Rackner, a patient advocate, also has a few ideas for lightening things up. "In the hospital, you can have the grandkids make a sign that says, 'Please wash your hands and keep Grandma healthy.' "

I can't stress how important it is to wash one's hands, especially in hazardous environments like urgent care clinics, hospitals, and ERs. As a card-carrying germophobe, I make it a point for my hands to come into minimal surface contact with everything.

This doesn't just apply to hospitals. I limit what I touch in public -- grocery stores, gas stations, restaurants, etc. Viruses and bacteria love hands and the surfaces they touch.

I always wash my hands when I get home (not with antibacterial soap but a plain old bar of soap).

Very important note: avoid touching your face during a period where you may be exposed to germs. This includes your ears, which may conduct bacteria and viruses into your system faster than your nose or mouth. I never touch my face when I'm out in public.

If you've just been to the ER (and had to wait an hour in the waiting room), immediately strip down when you get back home and wash all of your clothes. I've spoken with an ER nurse who does this religiously when she gets home. Her kids know not to touch her until she's showered and changed into fresh clothing.

Ever wonder why a contagion can so rapidly tear through an airplane or a cruise ship? Recycled air, cramped quarters, breathing other people's coughs and sneezes (think being stuck in a packed waiting room for hours or even days). If you're a frequent cruiser, you've probably noticed how often a mini-epidemic strikes the ship during the last days of the cruise.

CNN point #4: Ask Where that Syringe Has Been

Doctors' offices sometimes reuse syringes -- it's unusual, but it happens. In fact, there have been 14 documented outbreaks of hepatitis since 1999 because of reused syringes. The recent outbreak in Nevada [2008], where 50,000 people will be notified that they might have been infected at a colonoscopy clinic, is one example.

Wow. I'm not even going to comment on this one.

CNN point #5: Having Surgery? Speak up!

If you or a loved one has a urinary catheter in the hospital, be extra vigilant -- they can become breeding grounds for bacteria. First, ask if one is truly necessary. "If the patient is awake and oriented and alert and can use a bedpan, it may not be needed," says Dr. John Jernigan, a medical epidemiologist at the CDC. If you get one, make sure it comes out ASAP, since the longer it's in, the riskier it becomes.

Ask the same questions about central venous catheters, (also called central lines), another potential host for bacteria. "My brother was in the hospital and needed a central venous catheter for his procedure," Jernigan says. "The day after surgery, I asked the nurse, 'Are you all still using this? Do you still need it?' And she checked and came back and said, 'We don't need it anymore, we'll take it out.'"

Nahum says it all boils down to this: Passivity kills. "People need to start participating instead of just being spectators when it comes to their medical care," she says. "You need to do your due diligence."

More sound advice. Passivity does kill, and your risks go up the longer your duration in the hospital. I'd add only one thing... consider surgery the very last option. Exhaust all other treatment choices, including possible alternative treatments.

Even a so-called minor surgery can have devastating effects on your body as a whole. Expect to not be yourself for some time, possibly years, depending on the severity of the operation.

Never take the prospect of surgery lightly. If your doctor seems to think surgery is just another pill to swallow and brushes off your concerns or desires for non-surgical treatments, consider shopping elsewhere for medical services.

Original CNN article source: http://www.cnn.com/2008/HEALTH/05/01/ep.avoiding.infection/index.html