Bacterial colonization of respiratory therapists' pens in the intensive care unit.

BACKGROUND: Prevention of nosocomial infections is of paramount importance. Person-to-person transmission of microorganisms is well recognized, but the role of fomites in nosocomial infection is not as well understood. Incomplete cleaning of equipment and patient rooms, and medical devices used with multiple patients are well-described means of transmission, but little attention has been paid to nonmedical devices as fomites. We collected bacteria from writing implements (pens) used by respiratory therapists in an intensive care unit, following their work shifts. METHODS: We obtained pens from 20 respiratory therapists, and cultured, enumerated, and identified the bacteria. RESULTS: Bacteria were found on 17 of the 20 pens. The mean +/- SD number of colony-forming units was 126 +/- 277 (range 0-1,250). Coagulase-negative staphylococci were found on all 17 pens. Micrococcus species were found on 4 pens. CONCLUSIONS: Although we found no organisms that are regularly associated with nosocomial infections (eg, methicillin-resistant Staphylococcus aureus or Gram-negative bacilli), pens can be fomites responsible for nosocomial infections. Protocols to reduce the transmission of infectious agents may need to be extended to writing instruments. One possible measure is to assign specific writing instruments to specific rooms.

Comparison between the C-leg microprocessor-controlled prosthetic knee and non-microprocessor control prosthetic knees: a preliminary study of energy expenditure, obstacle course performance, and quality of life survey.

This study investigated energy expenditure and obstacle course negotiation between the C-leg and various non-microprocessor control (NMC) prosthetic knees and compared a quality of life survey (SF-36v2) of use of the C-leg to national norms. Thirteen subjects with unilateral limb loss (12 with trans-femoral and one with a knee disarticulation amputation) participated in the study. The mean age was 46 years, range 30-75. Energy expenditure using both the NMC and C-leg prostheses was measured at self-selected typical and fast walking paces on a motorized treadmill. Subjects were also asked to walk through a standardized walking obstacle course carrying a 4.5 kg (10 lb) basket and with hands free. Finally, the SF-36v2 was completed for subjects while using the C-leg. Statistically significant differences were found in oxygen consumption between prostheses at both typical and fast paces with the C-leg showing decreased values. Use of the C-leg resulted in a statistically significant decrease in the number of steps and time to complete the obstacle course. Scores on a quality of life index for subjects using the C-leg were above the mean for norms for limitation in the use of an arm or leg, equal to the mean for the general United States population for the physical component score and were above this mean for the mental component score. Based on oxygen consumption and obstacle course findings, the C-leg when compared to the NMC prostheses may provide increased functional mobility and ease of performance in the home and community environment. Questionnaire results suggest a minimal quality of life impairment when using a C-leg for this cohort of individuals with amputation.

Does ambient light affect the accuracy of pulse oximetry?

OBJECTIVE: Determine whether ambient light affects the accuracy of pulse oximetry readings. DESIGN: Prospective, repeated-measures study. SETTING: A photographic darkroom. SUBJECTS: Forty-five faculty and students at a university, none of whom had pale skin, dark skin, or evidence of cardiopulmonary disease. Any nail polish was removed. METHODS: Five light sources were individually tested: incandescent, quartz-halogen, infrared, fluorescent, and bilirubin light. A pulse oximetry probe was placed on the subject's finger, and the finger and probe were placed sideways under each light source, on a predetermined mark. RESULTS: The greatest difference in pulse oximetry reading between any of the light sources was 0.5%. Repeated-measures analysis of variance yielded a p value of 0.204. CONCLUSIONS: Ambient light has no statistically significant effect on pulse oximetry readings. Even had the differences been statistically significant, the magnitude of the differences was small and thus clinically unimportant.