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Intravesicular BCG instillation and P2/N95 mask use

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  • #76991
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Hi all

    Does anyone have any evidence or advise about the need to use P2 N/95 masks for intravesicular instillation of BCG? My understanding is that the current product comes in a closed system for instillation, so in my view an N95 masks need not be worn during the instillation process. Does anyone have any evidence or advice on this?

    Thanks
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
    T +61 7 3326 3068 | F +61 7 3607 2226
    E michael.wishart@svha.org.au |
    W https://www.svphn.org.au

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    #77001
    Mona Schousboe
    Participant

    Author:
    Mona Schousboe

    Position:

    Organisation:

    State:

    Hi Michael
    I cannot see any reply to your question regarding P2/N95 mask and BCG
    instillation for bladder cancer. I have not got any reference to your
    specific question but I have plenty of experience with BCG as a BCG
    vaccinator and laboratory reception of urine from treated patients.
    Bladder installation might be using a closed system, however, that is not
    the only risk of exposure. If a cystoscope is used it will be contaminated.
    The Urine from the BCG infected bladder will be positive for mycobacteria
    for some time ( laboratory experience) and staff might be handling the
    urine, if the patient is catheterised, and can get exposed from that
    source. As a BCG vaccinator, I never used masks of any kind as I found eye
    protection and protection from needle sticks most important, and in your
    scenario handling contaminated equipment and BCG colonised urine.
    Regarding the choice of mask, in my opinion, P2 would suffice as droplet
    exposure is the most like risk.
    Best wishes
    Mona
    Mona Schousboe
    FRCPA, MPH

    On Thu, Jul 9, 2020 at 4:26 PM Michael Wishart
    wrote:

    > Hi all
    >
    >
    >
    > Does anyone have any evidence or advise about the need to use P2 N/95
    > masks for intravesicular instillation of BCG? My understanding is that the
    > current product comes in a closed system for instillation, so in my view an
    > N95 masks need not be worn during the instillation process. Does anyone
    > have any evidence or advice on this?
    >
    >
    >
    > Thanks
    >
    > Michael
    >
    >
    >
    >
    >
    > *Michael Wishart *| Infection Control Coordinator, CICP-E
    >
    >
    > St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD
    > 4032
    >
    > *T *+61 7 3326 3068 |* F* +61 7 3607 2226
    >
    > *E* michael.wishart@svha.org.au |
    >
    > *W *https://www.svphn.org.au
    >
    >
    >
    > [image: cid:image001.jpg@01D46C86.4CDB6090]
    >
    > [image: Stop the Flu before it stops you]
    >
    >
    >
    >
    >
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    #77002
    Anonymous
    Inactive

    Author:
    Anonymous

    Position:

    Organisation:

    State:

    Hi Michael,

    These guidelines are a little old now (2012), however they do reference wearing an N95 mask.

    https://anzuns.org/wp-content/uploads/2011/12/ANZUNS-Clinical-Guidelines-Intravesical-Instillations-20121.pdf

    Kind Regards
    Terry McAuley
    Director
    MSc Medical Device Decontamination

    PO BOX 2249, Greenvale, VIC Australia 3059
    Mobile: +61 (0)438 109 692
    Email: terry@steamconsulting.com.au
    Website: http://www.steamconsulting.com.au

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    From: ACIPC Infexion Connexion On Behalf Of Mona Schousboe
    Sent: Friday, July 10, 2020 6:41 PM
    To: ACIPCLIST@ACIPC.ORG.AU
    Subject: Re: [ACIPC_Infexion_Connexion] Intravesicular BCG instillation and P2/N95 mask use

    Hi Michael
    I cannot see any reply to your question regarding P2/N95 mask and BCG instillation for bladder cancer. I have not got any reference to your specific question but I have plenty of experience with BCG as a BCG vaccinator and laboratory reception of urine from treated patients.
    Bladder installation might be using a closed system, however, that is not the only risk of exposure. If a cystoscope is used it will be contaminated. The Urine from the BCG infected bladder will be positive for mycobacteria for some time ( laboratory experience) and staff might be handling the urine, if the patient is catheterised, and can get exposed from that source. As a BCG vaccinator, I never used masks of any kind as I found eye protection and protection from needle sticks most important, and in your scenario handling contaminated equipment and BCG colonised urine. Regarding the choice of mask, in my opinion, P2 would suffice as droplet exposure is the most like risk.
    Best wishes
    Mona
    Mona Schousboe
    FRCPA, MPH

    On Thu, Jul 9, 2020 at 4:26 PM Michael Wishart <Michael.Wishart@svha.org.au> wrote:
    Hi all

    Does anyone have any evidence or advise about the need to use P2 N/95 masks for intravesicular instillation of BCG? My understanding is that the current product comes in a closed system for instillation, so in my view an N95 masks need not be worn during the instillation process. Does anyone have any evidence or advice on this?

    Thanks
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
    T +61 7 3326 3068 | F +61 7 3607 2226
    E michael.wishart@svha.org.au |
    W https://www.svphn.org.au

    ______________________________________________________________________
    This email and any attachments to it (the “Email”) is confidential and is for the use only of the intended recipient, and may not be duplicated or used by any other party without the express consent of the sender. If you are not the intended recipient of the Email, please notify the sender immediately by return email, delete the Email, and do not copy, print, retransmit, store or act in reliance on the Email. St Vincent’s Health Australia (“SVHA”) does not guarantee that the Email is free from errors, viruses or interference. Emails to and from SVHA or its related entities may be scanned and filtered in locations outside Australia.
    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

    The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

    Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

    Replies to this message will be directed back to the list. To create a new message send an email to acipclist@acipc.org.au

    To send a message to the list administrator send an email to admin@acipc.org.au

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    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

    The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

    Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

    Replies to this message will be directed back to the list. To create a new message send an email to acipclist@acipc.org.au

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    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

    The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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