Iatrogenic, doctor induced, disease is a term now becoming common, but now we need to make nosocomial a more common word—it isn’t even in the spell checker. Nosocomial refers to that new portion of iatrogenic problems acquired while in the hospital. In this month’s New England Journal of Medicine (NEJM) there was a casual mention that half of US hospital surgeries are now having an infectious complication. The Wikipedia article for nosocomial has statistics for France which break down the various common ones, over there, as urinary tract 40% , skin 11%, surgery site 10% and lungs 10%. It is difficult to know these causes with even modest accuracy but the problem must be huge if it causes 88,000 US hospital deaths per year. However, in general the problems are obvious and the preventions are also obvious.
A list of potential Nosocomial infection sources
- Hospitals have a concentrated mass of sick people in them carrying a wide variety of infections.
- Doctors, nurses and patients move about spreading infections on their hands and clothes.
- Patients are in a weakened and susceptible condition and some are dieing.
- Doctors and nurses are inured to some disease and become passive carriers.
- Patients are away from home where they are adapted to their local environment.
- The air within the hospital circulates and carries some infections.
- All medical procedures are invasive and transmit living organisms.
- The whole experience is stressful and if sustained decreases resistance and increases susceptibility.
The current method for reducing exposure to these problems is to get the person out of the hospital as quickly as possible. This has the incidental effect of lowering costs. There is also an effort to make the public healthier by informing them to lose weight and exercise more but it isn’t working. In any case most people will make at least one trip to a hospital, even if it is their last journey, and we should do everything possible to make it possible for them to survive the trip. The question becomes how to maximize survival by minimizing exposure to the hospital.
The answer is to never fully enter the germ filled hospital environment by wearing a bio-protective suit.
Here is the plan: You have a package delivered to your home by your driver and helper just before you are scheduled to enter the hospital. The package is pre-loaded with everything that is going to be needed by the procedures which the doctors will be doing. This package will be manufactured and stocked in a place far away from any hospital or other source of infection. Special sites for manufacture of these maximally clean cocoons could be set up in high altitude deserts where they are naturally isolated and sterile. The package contains appropriate cocooning materials and the instructions for using them. A preloaded speaker style telephone will be in the package and turned on to keep you in contact with the hospital personnel who will be attending to your needs. The nurse in the hospital and your on site guide can help you through the procedures without you ever having to touch the phone. It would go something like this, depending upon the situation, of course.
You take the package labeled Package 1 to your bedroom and prepare to take a shower by taking off all of your clothes. Next you open the package and take the one inside labeled Package 1A – shower materials. And take with you into your bathroom and prepare to take a warm water shower. Place the unopened packaged of towels on the floor right next to the bath tub so you can reach them easily while still standing in the tub. Get into the shower tub and use the soap provided labeled Package 1A which is just inside of the main package 1 and take a good long shower of 5 minutes washing your hair and head to toe with the soap three times to be sure you are perfectly clean. Rinse thoroughly for two minutes top to toe then turn off the water and take out the top towel and dry off, head to toe. Toss the towel onto the floor and stand on it and take the second towel and dry off again. Now while holding onto something for balance step into the cocoon suit boots provided at the bottom of the package. When your feet are fully into the boots of the cocoon suit pull the suit up over your shoulders and then put can your arms out into the suit’s arms. Now pull the top up over your head and pull the draw string tight. You are now completely sealed against outside germs. The suit will be inflated at this time from air being blown in from a filtered fan. The suit is much bigger than your body to give you plenty of space to wiggle around inside of it.
You will not remove this suit until you come home and it is made of a material which will protect you from germs. The air coming into the suit is carefully filtered to remove all foreign particles. Even if the power to the fan fails there is enough air inside for an hour of breathing but if the power fails for very long and there isn’t a nurse to help you get it going again you can open the face plate and breath normally through a filtering surgical face mask. There may be a face mask inside of the suit which will be used by the doctor later. The point of this cocoon balloon is to totally isolate your body from the hospital environment and the outside world until you come home to an environment where you are already adapted. You may be requested to keep it on for a day or so even after you get home or possibly be told to go straight to your bathroom and take it off immediately and put it into its original sterile bag. And then immediately to put that bag into the outside garbage container because it just might have some germs on the outside of it from the hospital.
After you have the cocoon on you may be requested to put on a second wearable outfit. This one is specifically designed for the procedure which you will be having at the hospital. This outfit wraps totally around the area which the doctor will need access to with several layers of clear plastic and some clear glass windows for the doctor to observe his procedures while they are in progress. All of the equipment which the doctor needs will be inside of this outfit. There are numerous holes with special fittings and several with built in surgical gloves already sealed into the outfit. It is designed to prevent any air, liquid or instruments from ever having to be introduced from the outside environment of the hospital. Once the doctor begins the procedures the various layers are inflated, with highly filtered air, for separation which gives the doctor access to the various equipment needed for the procedures.