From the Guidelines
Septic showers are a critical infection control measure that involves thoroughly washing the entire body with antimicrobial soap and water to remove potential pathogens and prevent infection spread, and their effectiveness depends on thorough washing technique and prompt implementation after exposure. When performing a septic shower, the person should remove all clothing and personal items, which are placed in biohazard bags for proper disposal or decontamination. The individual then showers with warm water and antimicrobial soap, paying special attention to hair, skin folds, and under fingernails where contaminants might hide. The water flows from head to toe to prevent recontamination of cleaned areas. Septic showers are commonly used in healthcare settings, laboratories, and emergency response situations following potential biological exposure. However, it is also important to note that severely immunocompromised patients should be restricted from taking showers to prevent the creation of infectious aerosols, as recommended by the CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC) 1. Additionally, communal facilities such as baths, bidets, and showers should be decontaminated between all patients, especially in high-risk areas such as delivery suites, post-natal wards, and burns units, as suggested by guidelines for prevention and control of group A streptococcal infection in acute healthcare and maternity settings in the UK 1. It is also worth noting that indoor showerheads are a known source of nontuberculous mycobacteria (NTM), and patients with known or previous mycobacterial lung disease or known bronchiectasis may need to avoid showers or other sources of aerosolized water to prevent infection, although a consensus among experts has not been reached on this issue 1. Overall, septic showers are an essential infection control measure, but their implementation should be tailored to the specific needs and risks of each individual and setting. Some key points to consider when implementing septic showers include:
- Using antimicrobial soap and warm water
- Paying special attention to hair, skin folds, and under fingernails
- Preventing recontamination of cleaned areas
- Restricting severely immunocompromised patients from taking showers
- Decontaminating communal facilities between all patients
- Considering the risks and benefits of showering for patients with known or previous mycobacterial lung disease or known bronchiectasis.
From the Research
Definition and Explanation of Septic Shock
- Septic shock is a life-threatening condition that occurs when the body's response to an infection becomes uncontrolled and causes widespread inflammation, leading to organ damage [(2,3,4,5,6)].
- It is a major cause of mortality among hospitalized patients, accounting for 10% of intensive care unit admissions and significant healthcare costs 2.
Treatment of Septic Shock
- Prompt identification and early antimicrobial drug therapy are essential in treating sepsis [(2,6)].
- Appropriate fluid resuscitation plays a central role in treating tissue hypoperfusion due to sepsis 3.
- Vasopressor therapy is required in case of inadequate response to fluid resuscitation, with norepinephrine considered the first choice [(2,3,4,5)].
- The use of vasopressors, such as norepinephrine, epinephrine, and vasopressin, can help improve hemodynamics and reduce mortality [(2,3,4,5)].
Management of Septic Shock
- Early administration of norepinephrine may allow achieving the initial mean arterial pressure (MAP) target faster and reducing the risk of fluid overload 5.
- A more individualized approach is often required depending on several factors, such as history of chronic hypertension or value of central venous pressure (CVP) 5.
- In cases of refractory hypotension, increasing norepinephrine up to doses ≥1 µg/kg/min could be an option, or combining it with other vasopressors such as vasopressin 5.
Septic Shower
- There is no direct information available on "septic shower" in the provided studies [(2,3,4,5,6)].
- The term "septic shower" is not a recognized medical term in the context of sepsis or septic shock [(2,3,4,5,6)].