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I don't disagree that this is a great stall strategy or in a more positive light a way to refine/limit the scope of a new practice to areas where it might be helpful.  But at my previous hospital, in a busy pediatric ED, having to identify and contact clinicians and often other families who had been exposed to a child ultimately diagnosed with pertussis was the rule rather than the exception.  We were spectacularly bad at selectively identifying which child with a cough should be masked and isolated and which one had a simple cold.  Honestly, I am not sure where the solution should lie.

David

-----Original Message-----
From: Pediatric Emergency Medicine Discussion List [mailto:[log in to unmask]] On Behalf Of Cunningham, Frank
Sent: Wednesday, August 02, 2017 9:38 AM
To: [log in to unmask]
Subject: Re: Respiratory Isolation

I agree with Doc. This is the strategy to take.

Frank Cunningham, MD

-----Original Message-----
From: Pediatric Emergency Medicine Discussion List [mailto:[log in to unmask]] On Behalf Of Doc Holiday
Sent: Wednesday, August 02, 2017 10:04 AM
To: [log in to unmask]
Subject: Re: Respiratory Isolation

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Ideal start would be to ask the infection control department to provide the data on which they are basing their recommendation. If they have some, then it might save you the hassle of looking for studies which prove that masks are NOT needed - I suspect you will not find much in evidence for the absence of benefit for this...


I find that often the best approach to such amazing ideas is enthusiasm! Offer to join forces with them to conduct a proper research project to see whether this will actually be a beneficial intervention. Ask that implementation of any changes is delayed until after there is evidence for its benefit. Once they agree to the project, the process should take long enough for the idea to die waiting... Or the cost or sample size calculation, when put down on paper, scare off people from even trying the study!




________________________________
From: Pediatric Emergency Medicine Discussion List <[log in to unmask]> on behalf of Amy Groen <[log in to unmask]>
Sent: 02 August 2017 14:27
To: [log in to unmask]
Subject: Respiratory Isolation

Hi all!  Question for the group:

Our infection control department is trying to impose respiratory isolation in our emergency department from triage.  They are wanting every patient presenting with a cough or a history of a cough to wear as mask until in the room and then want the treatment team to wear gown/gloves/mask.  This is crazy to me but I need to go into this meeting with data and literature to help my cause.  I can't find any great studies so was wondering if you have a policy that you can share with me?  If you know of any literature....let me know.  If you think this is how it should be, I will understand and go with it.

Thanks so much!
Amy Groen
Medical Director
Blank Children's Hospital Emergency Department Des Moines, IA

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