The Shield & Stand STAL

Presented by Al Wickheim

Effective At-Source Bio-Hazard Shielding

• 23 of my 30+ years doing ALS for BC Ambulance in Victoria and Vancouver.

• Worked on Baffin Island and around the province doing air-evacs.

• One year as a coroner in Victoria.• In 2009 I was part of an I/C - H1N1

training team for BCAS.• The Yankauer seemed desperately in

need of improvement so I went to work on it.

About Al Wickheim

Hospital Acquired Diseases

An Expensive Problem

Costs you never recover…

Risks for Your System

Short Term Risks

• Staffing

• Sickness benefits

• Overtime

Long Term Risks

• Business continuity

• Recruitment, Retention, Accreditation

• Liability

• Suctioning with Yankauer

• Abscess I&Ds

• Wound irrigation

• J-tube flushing

• Patient transport

• Active resuscitations

High-Risk Aerosol Generating Procedures

• Clean-up is either expensive, or worse, in-expensive.

• Too often incomplete.• My experience had been on

protecting myself, not infection spread.

• High risk procedures are reacted to rather than prepared for.

• Rx and disinfectants are losing ground.

• Pathogens are evolving in direct response to treatments.

Incomplete Cleaning

IT'S OUT OF CONTROL

The Infection Control Hierarchy

Most effective

Least effective (PPE)

• PPE is a taxi, a tanker, a smuggler of sickness. • PPE does not confine or contain contaminants.• PPE is a partial solution with significant

problems. • PPE has become over-relied upon.• Least reliable, least effective, least predictable.

Personal Protection Equipment

Will this be messy?

• Doing the same thing over and over again one can not expect a different outcome.

• This abscess can spurt meters or be confined to its source

Vectors – Irrigation splash, 2 gloves, 1 gown, 1 syringe,

1 patient and ? things unseen

Last line of Defence now Front line Offence?

And still the numbers are rising

The STALShield & Stand

Engineered Controls

Most effective

Least effective

STAL Goes Here >>

• Partitions in triage areas and public spaces.• In-line Fr. suction catheters for ET Tubes.• Automatic door openers/pass cards.• And…The STAL Shield and Stand.

Examples of Engineered Controls

About the STAL Shield & Stand

• It protects personnel AND patients,AND the medical environment.

• It's use is pro-active rather than reactive.• At-source blockade of the uncontrolled

expulsion of contaminants.• Reduces cross contamination.• Provides securement of Yankauer during use.• Shields and enhances dimensional aspects of the scalpel.• Should reduce staff and institutional down-time.• Cost effective.• Provides primary and secondary contamination reduction.• Reliable and predictable.

The STAL protects many times more area than a face shield. Including the face shield itself.

Large Protection Area

The STAL clearly reduces the spread of contamination.

STAL Reduces Contamination

• Suctioning with Yankauer

• Scalpels for I&Ds

• Wound irrigation

• J-tube flushing

• Eye irrigation

• Patient transport

• Critical care wards

STAL Applications

• In VIHA Emergency Rooms• Royal Jubilee• Victoria General• Saanich Peninsula• Cowichan District

• Comments are all positive. • Improved packaging and disposal procedure for

use with Yankauer and tubing. • Quick story – ICU Manager & G.P. ‘tubing

Where the STAL is in use

When PPE is indicated against droplet, vaporized, expectorated, spurted or

splashed infective agents and contaminants or while engaged in AGP’s, the STAL Shield should be reccomended. It can

block, shield and reflect fomites and protect the work environment, including patients,

HealthCare Workers, visitors and equipment and in fact, the institution itself.

Recommended Use

The STAL is simple and it works!

Thank you

Video, Q & A and Handouts

• 3 minute STAL video by Prodaptive

http://www.youtube.com/watch?v=0hoF490xoJw

Create a new blank slide for itChoose Insert > Movies and Sounds > Movie from File

Select your video wherever it lives on your laptop.Choose "Automatically" as opposed to 'When clicked"

Click and drag the corners of the video so it's nice and big on the slide.Test the powerpoint and see if it plays ok for you..

http://www.bioquell.com/resources/blog/considering-the-role-of-the-environment-in-the-transmission-of-mdr-gnr/ 

http://energyalliancegroup.org/video-reveals-sneezes-can-travel-far-thought-mail-online/

http://www.who.int/gpsc/5may/Glove_Use_Information_Leaflet.pdfhttp://www.cdc.gov/h1n1flu/guidelines_infection_control.htm

https://www.gov.mb.ca/health/publichealth/cdc/docs/ipc/rpap.pdf

» MERS Cases Still Climbing» Published: Apr 21, 2014» » By Michael Smith, North American Correspondent, MedPage

Today» The number of cases of Middle East coronavirus (MERS-CoV) has

topped 300, by some estimates, and the outbreak continues to evolve, driven by two large healthcare-associated clusters.

» Saudi Arabia announced 14 new cases over the weekend associated with the cluster in Jeddah, bringing the total to 67 cases, according to a list maintained by FluTrackers.com.

» Included in that total is a Greek man who was treated in Jeddah for suspected typhoid fever, flew home April 17, and is being treated for confirmed MERS infection, the World Health Organization said Sunday. The agency said in a release that the man's contacts are being traced but so far none has fallen ill.

» The FluTrackers.com list puts the global number of cases at 322 since the virus was first recognized in 2012.