Sneezing Advice for Doctors

The following is an article from The Annals of Improbable Research, now in all-pdf form. Get a subscription now for only $25 a year!

(Image credit: Artur Bergman)

compiled by Ernest Ersatz, Improbable Research staff

Medical personnel must deal with sneezing by both patients and themselves. Insights and advice often get transmitted informally. The formal professional literature does include a few instances where the trade secrets are made quasi-public. Here are three such cases.

Gross: Eye Surgery on a Sneezing Patient
“Cataract Surgery in Patient Who Sneezes,” Jay Gross, Journal of the American Medical Association, vol. 253, no. 2, January 11, 1985, p. 202. Gross explains:

[The] phacoemulsification [method for removing cataracts from the eye] uses only a 3-mm incision, which would be enlarged to 7 mm to insert an intraocular lens. Another advantage of the phacoemulsification is that it is done with an essentially closed eye and there is much less risk of severe damage to the eye due to coughing or sneezing during surgery. Also, it is much easier to control such an event if it were to occur. 

Face Mask Facing
“If Wearing a Mask, Which Way Should You Face for a Sneeze?” Janet K. Schultz, AORN Journal, vol. 31, no. 7, June 1980, pp. 1190-1192. The author advises:

Since droplets expelled forward are trapped by the mask, the best way to face when sneezing, coughing, humming, or talking, is directly facing the wound. Turning to the side merely projects microorganisms and mucus toward the wound, and the principles of asepsis forbid turning your back on the sterile field.

Detail from the study “Excuse Me! J. Granville-Chapman and R. L. Dunn Review the Etiquette of Sneezing in Surgical Masks.”

Etiquette of Sneezing in Surgical Masks
“Excuse Me! J. Granville-Chapman and R. L. Dunn Review the Etiquette of Sneezing in Surgical Masks,” J. Granville-Chapman and R.L. Dunn, BMJ (Clinical Research Edition), vol. 335, no. 7633, 2007, p. 1293. The authors, at Salisbury District Hospital, Salisbury, UK, report:

Sneezing etiquette and the efficacy of masks in the operating theatre remain a subject of debate. Standard teaching dictates that one must face the wound when sneezing, so that droplets escape backwards, via the sides of the mask. A literature search found no clear demonstration of this principle. We therefore tested the hypothesis that one should face the wound when sneezing into a surgical mask in theatre....

Our study does not, however, support this hypothesis. A few droplets of spray escaped sideways, but no substantial numbers passed behind the surgeon’s head. Our photographs show that the most important visible escape of spray comes from below the mask on to the surgeon’s chest. We therefore recommend that surgeons should follow their instincts when sneezing during operations.

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This article is republished with permission from the January-February 2017 issue of the Annals of Improbable Research. You can download or purchase back issues of the magazine, or subscribe to receive future issues. Or get a subscription for someone as a gift!

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