“People with diabetes shouldn’t inject insulin publicly!”

The BBQ Pit
261

My point is that the mix of bacteria in a public toilet is one that might boggle the mind. I am sorry that I do not have data for you as to the number and variety of germs–do you not think they are present? SD did a column on the cleanliness of public bathrooms awhile back. If I ever figure out how to link, I will. I doubt that a study has ever been done that looks at injection infections: restaurant setting or lavatory setting, but seems anyone can get a grant these days… :slight_smile:

Probably extraneous background info, but it makes me feel better posting it:

In nursing (and in health class, really) there are sterile things, clean things, and soiled/contaminated/dirty things. Your actions with each depends on the task involved and the risks to the pt.

Example: patient has 3 or 4 deep, open, infected wounds. You use clean technique(gloves) to remove the old dressing on wound #1. You then use sterile technique to reapply a new dressing. But you do not go straight from wound to the next.

Even though the wounds are on the same pt (and most likely share “his” germs) you still handwash, don new nonsterile gloves to remove the next open wound’s dressing. And yet again for the third-IOW, you treat each wound as a separate entity. Lots of time and lots of gloves. This applies to dressings done at the bedside. I am not speaking of OR stuff (any OR nurses here/).

We are taught (Ha! more like drilled so that girls used to wake up crying out, “I’m sterile, I’m sterile!” during their OR rotations. It was as funny then as it is now) to respect the differences and act accordingly-in all aspects of care.

Hence, as a nurse, I would never use the same measuring graduate to empty a Foley (bladder catheter) and also a wound drain. The risk of cross contamination, while it might be small, is present. Why take it? In the hospital, we don’t prep meds in the patients toilet–it is considered a dirty area, and it IS dirty.

Why would a public toilet be any different? Hentor has already addressed the common of a decent, DRY surface on which to place the kit. That alone is reason not to use the bathroom for this purpose. Alot of germs are spread via contact. You put the kit on a wet sink ledge, then pick the kit back up–the germs are carried on the kit and are now on your hands etc. Why go there? Why introduce the possibility, however small?

If someone HAD no choice but to use a toilet for injecting, I would reccomend that 1. wash your hands
2. wipe down with a dry paper towel the area around the sink.
3. discard paper towel.
4. wash your hands again, using a paper towel to turn off the faucet.
5. place a few layers of paper towels next to the sink-you are creating a “clean” field.
6. put the kit on the paper towels.
7. wash your hands again.
8. test blood sugar
9. prep injection.
10. wash your hands again, if you feel that you might have touched something during the above process that may have contaminated you.
11. inject insulin.
12. zip up kit, after disposing of sharp appropriately.
13. clean up area.
14. wash your hands again*.
Leave the restroom
It may sound OCD, but it’s not-it’s being careful and cautious. I do not know if diabetics do all this–I doubt it; most probably wash their hands using hand gel and do this at the table, which provides a clean, DRY surface for the kit. Simpler, easier and faster.
*if, for some strange reason, I were to be the one injecting YOU in a public restroom, this is what I would do–it’s quicker than it looks, because it is second nature to me now. If I had clean gloves, I would not do #7 or #10, unless I had contaminated the gloves somehow.

Diabetics are at higher risk for all infections, and caution is the watchword. Sorry to sound school marm-ish, but there it is.

262

No, I absolutely believe those germs are present; I’m just not sure how they’d get onto the needle. Does the diabetic’s hands touch the needle at any point? I was under the perception (quite possibly incorrect) that the sterile needle was covered until seconds before the injection, that the only solid it touched was at the point of the injection, and that there would be very little opportunity for any bacteria to contaminate any part of the process except by settling on the skin at the injection site. Bacteria that were so settled would remain there even after the person returned from the restroom, such that injecting at the table afterwards wouldn’t reduce the risk of contamination.

Not school marm-ish at all. You’re a nurse, and I’m not, so of course you know more about the process than I do. I’m just wondering how the bacteria in a restroom would manage to contaminate the process.

Your examples seem to describe how a contaminated solid should never touch a wound, or touch something that would cause a wound. Does anything, contaminated or not, ever touch the needle pre-injection?

Daniel

263

It shouldn’t, and I would probably just use a new syringe if it did. The syringe is firmly capped until you have to draw up the insulin. So the needle does touch the material covering the insulin bottle. One presumes that this is clean enough. After drawing the insulin, we almost always cap the syringe, because it is usually coming from the fridge, so we have to warm it between our fingers for a few seconds or it is more painful. When we are out, this is less of a requirement, and we may be more likely to go from having drawn it up to giving it immediately. The exposure to air of the needle should be thus fairly limited, and the only surface that it should touch prior to skin is the top of the insulin bottle.

264

The worst ever is coach class toilets on overseas flights - especially loooooong overseas flights, with LOTS of kids on the plane. I think after about 6-8 hours many parents just give up and decide to let the children regress to the level of barely trained gibbons, where everything in the loo - and I do mean EVERYTHING - becomes a new toy of infinite wonder and discovery. I’ve been on flights with a quarter-inch of “liquid” sloshing around on the matting, and “stuff” smeared like fingerpaints on the walls, handles…

No way do I use those for a shot. No fucking way.

265

milroyj, quit being a jerk. This is the fifth warning for you. I am going to discuss this with the moderation staff.

Lynn
For the Straight Dope

266

AWW GEEZ! Are you just trying to torture me! I have to fly across country Saturday morning. I may not drink or eat anything at all from now til then. :eek:

Regress to the level of barely trained gibbons… now that’s comedy gold!

267

And not only are we at higher risk, we tend to heal more slowly when we get infected. Infections also tend to raise blood sugar levels, adding yet another complication to our lives. A couple of years ago, I had a major abcess/boil in my right arm. The swelling was the size of a grapefruit. From start to finish, I think that I spent about four months trying to get that thing healed, including some time in the hospital. I had several courses of oral antibiotics and a few different kinds of IV antibiotics. I developed an allergy to another antibiotic. I had to have a home health nurse come out to my house for a few weeks to give me antibiotics by IV after I was released from the hospital. All told, I think that my out of pocket expenses for that abcess totalled at least $5000…this isn’t including what my insurance paid out. I would really, really prefer not to go through that again. It wasn’t fun. I will do my best to avoid any germs I can.

268

Well, those germs most likely don’t get onto the needle. But people drop things or miscalculate where the counter/table is and knock stuff off etc. Excluding the lavatory as a possible place is just increasing the safety net for a good, clean injection–in an injection, only the needle and the insulin are sterile. If Hentor was to fumble with the bottle of insulin at the table, chances are it will fall either in his lap or on the table(and it wouldn’t break). Not so in the toilet-where the tile floor would break the glass vial. If he dropped the syringe, chances are he would disspose of that one, and get a new one-I wouldn’t use a syringe that had dropped on a bathroom floor, no matter if it was capped-but I could see using a needle(capped) that fell onto a clean, dry tablecloth. Hope that helps, you Daniel . :slight_smile:

So, really, using the “clean” environment of the table just eliminates potential problems–both physical and emotional. Except for those souls who are rocked to the core by the sight of a father taking care of his son. Perhaps this thread has given them food for thought and now they will volunteer to clean all the public restrooms wherever they dine out. :cool:

Lynn --you bring up very valid points. I was going to, but hesitated after the strawman/drama queen tactics. It only makes sense to eliminate as many potential problems that one can. Noone expects a bad asthmatic to sit in the smoking section–why do we expect diabetics to increase their exposure to hazards?
I hafta work tomorrow, but already feel like I did a shift! :wink:

269

In the medicine cabinet, for the last six years.

Why was that again? Oh, right:

270

Whoopsie. Don’t know how that happened.

Corrected link.

271

It does; my curiosity on the subject is satisfied, and I agree that doing theses shots in the bathroom seems like a bad idea for sanitary reasons. Thanks for being patient with me!
Daniel

272

“Dude, gimme another hit off that Sociopolitical Analysis of late-20th-Century Capitalism in post-Keynesian Lithuania!”

Daniel

273

I see this is a huge thread and I’ve only just gotten started so forgive if I’m being redundant in my comment but I just want to say that, for the most part, unless other diners are totally minding business other than their own, there is no reason to even notice. My sister has to inject pretty much while the food is in front of her (because, God forbid she should watch her diet - but that’s another story) and is able to do it so quickly and matter of factly that I’ve never actually caught her doing it and I’m right at the table with her. She injects insulin into her abdomen. It’s like a little magic trick almost! Same goes for the blood testing which is done in her finger.

274

Yeah, I remember that one. Especially this part:

So where do you prepare your food, again?

275

I just have one thing to say:

I hope that our society will someday evolve to a state where a man’s welfare will be considered more important than cosmetic appearances and other such selfish concerns.

276

Amen. I consider “Miss Manners” and her ilk to be trolls of humanity.

277

I’ll never forget the day 7 years ago I saw a sign declaring “no sleeping on stairs” next to a church staircase. still, so many years later, it rings so symbolic to me.

I Thank God there are some compassionate people out there

278

If you were to actually check out Miss Manners (can’t speak to her ilk - does she have any?), you would find that she never, ever, ever suggests endangering health to accomodate people’s over-squeamishness. In fact, she has commented quite negatively on such squeamishness.

Ann Landers, on the other hand…

279

Oy!, not so much on this issue, but the idea that one random putz is arbitrarily supposed to be this font of wisdom about shit that no one should ever spend more than a second thinking about anyway just bugs the shit out of me.

280

Cagey Drifter, thanks for the link. That’s what I’m talking about, just showing some compassion to your fellow humans.