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    Default Infectious Diseases - Feedback Requested

    I'm interested in learning about what is being done to reduce the transmission of infectious diseases and would like to get some feedback. Specifically, how genuinely concerned you are about these risks; do you have anything in place, either in the ambulance or in station living quarters, to reduce or eliminate viruses and bacteria (if so, what type of system do you use); outside of hand sanitizers, what products might you use to stop the transmission of these diseases and are you satisfied with them; finally, are you concerned about the contaminants in the air you breathe as well as contaminants found on surfaces.

    I'd appreciate any feedback you may have. Thanks!

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    Quote Originally Posted by Cobra65 View Post
    I'm interested in learning about what is being done to reduce the transmission of infectious diseases and would like to get some feedback. Specifically, how genuinely concerned you are about these risks; do you have anything in place, either in the ambulance or in station living quarters, to reduce or eliminate viruses and bacteria (if so, what type of system do you use); outside of hand sanitizers, what products might you use to stop the transmission of these diseases and are you satisfied with them; finally, are you concerned about the contaminants in the air you breathe as well as contaminants found on surfaces.

    I'd appreciate any feedback you may have. Thanks!
    1:10 bleach solution

    Airborne is a minimal risk (very very minimal). The diesel soot you breathe while loading the stretcher is probably more dangerous then anything you'll encounter in an ambulance.
    I am now a past chief and the views, opinions, and comments are mine and mine alone. I do not speak for any department or in any official capacity. Although, they would be smart to listen to me.

    "The last thing I want to do is hurt you. But it's still on the list."

    "When tempted to fight fire with fire, remember that the Fire Department usually uses water."

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    hand sanitizers are not a stand alone system. Hand sanitizing solutions are used when you are out on the road and can't wash your hands. There is no replacement for hand washing.

    It shouldn't be a question of what else you are doing. That's one of the major problems with the hand sanitizers, they are good, but people think they don't have to wash their hands.

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    As a mechanic, I have the risk of getting everything the guys on the Puke Box are exposed to. Sometimes at the same time.

    The Med guys are good to inform me of what recent patients have been in them, and that they've done a thorough decon of the box, when needed. If I get info that a TB patient or AIDS patient, etc, has been in the box, I sanitize my hands before doing any work. After the work is completed, I wash them thoroughly with warm water and soap, with a brush. Otherwise I just wash my hands with soap and water, when I'm done.

    To be honest, I'm not really that concerned about getting or catching anything. But I do know the possibility of contracting something.

    Now my wife, is a different story. Last year or so, I told her I was in a box with a swine flu patient. She went nuts. The NEXT DAY, she got in line to get the H1N1 shot. I haven't had it yet, and don't plan on it.

    FM1
    I'm the one Fire and Rescue calls, when they need to be Rescued.

    Quote Originally Posted by EastKyFF
    "Firemens gets antsies. Theys wants to goes to fires. Sometimeses they haves to waits."

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    Quote Originally Posted by FIREMECH1 View Post
    As a mechanic, I have the risk of getting everything the guys on the Puke Box are exposed to. Sometimes at the same time.

    The Med guys are good to inform me of what recent patients have been in them, and that they've done a thorough decon of the box, when needed. If I get info that a TB patient or AIDS patient, etc, has been in the box, I sanitize my hands before doing any work. After the work is completed, I wash them thoroughly with warm water and soap, with a brush. Otherwise I just wash my hands with soap and water, when I'm done.

    To be honest, I'm not really that concerned about getting or catching anything. But I do know the possibility of contracting something.

    Now my wife, is a different story. Last year or so, I told her I was in a box with a swine flu patient. She went nuts. The NEXT DAY, she got in line to get the H1N1 shot. I haven't had it yet, and don't plan on it.

    FM1
    The good thing for you (other then the YUCK factor) is that a good portion of these bugs won't live long outside the body. Hepatitis B being a big and scary exception.
    I am now a past chief and the views, opinions, and comments are mine and mine alone. I do not speak for any department or in any official capacity. Although, they would be smart to listen to me.

    "The last thing I want to do is hurt you. But it's still on the list."

    "When tempted to fight fire with fire, remember that the Fire Department usually uses water."

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    Quote Originally Posted by ChiefKN View Post
    The good thing for you (other then the YUCK factor) is that a good portion of these bugs won't live long outside the body. Hepatitis B being a big and scary exception.
    Which makes me wonder why anyone involved in emergency services hasn't gotten inocculated against HBV...

    In no particular order:
    • Frequent, effective handwashing.
    • Hand sanitizer before and after patient contact (followed by proper handwashing asap)
    • Universal precautions (or whatever we're calling them this week) for every patient.
    • Dispose of biohazards and single use EMS gear properly and promptly.
    • Decon durable EMS gear promptly after each patient use.
    • The gear Decon area is for decon only. Not for cleaning the house mops, truck sponges, or anything else.
    • Cover your cough.
    • Keep the station clean. Sanitize as needed but don't overdo it and breed super germs.
    • Make cleaning light switches, phone handsets, keyboards, door knobs, and the remote for the TV part of your regular housecleaning routine -- especially during flu season.
    • Stay home from work when you have casually communicable illnesses like cold or flu. (Our biggest infectious disease exposure is each other.)
    "Nemo Plus Voluptatis Quam Nos Habant"

    The Code is more what you'd call "guidelines" than actual rules.

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    Don't forget about MRSA also. I have had this wonderful infection twice. 1-10 bleach will kill it.

    Also don't forget about the NIBP cuff and normal blood pressure cuffs.
    Bring enough hose.

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    We're mandated to carry our PIC kits on us at all times when on an EMS job. It's a fanny pack that has sanitizing gel, gloves, goggles, booties to slip on over our shoes, a few N95 masks, and such. I keep my watch fastened to the PIC kit. Your watch can be the most contaminated part of your uniform. Just think of what it comes into contact with on a daily basis. Better to keep it nearby, but not in contact with the environment.

    Some officers require that we wear our protective eyewear at all times during pt contact. Not a bad practice, actually. You'll avoid vomit, blood splashes, droplets, etc.

    Each of our station mops is designated to a certain area: halway, kitchen, bathroom/locker room, EMS unit, and oil. We change mop heads regularly.

    For a suspected AFRI (swine flu symptoms) per dispatch, only the medics will make pt contact, thus preventing exposure to the rest of the engine crew and maybe the medic driver if not also a medic. Ususally a suspected AFRI is a BS sick call anyway, so I'll just place the engine in service if I'm on the ambulance that day.

    We have gel sanitizers on the walls at our stations.

    Make sure to turn the ambulance cot upside down when cleaning. Blood splashes from IV attempts can wind up on the underside of the frame.

    All EMS surfaces and equipment, including the cab get the bleach tx daily, along with wipedowns using cavi wipes after each call, and bleach again if necessary.

    An old partner of mine did a culture of an ambulance steering wheel once to see what the lab would find. They found gonorrhea. Seriously. I actually clean the cab first since I'll have gloves on while in the back anyway. If we get a call first thing in the morning, at least I've hit the steering wheel, radios and the MDT.
    "The democracy will cease to exist when you take away from those willing to work and give to those who are not." Thomas Jefferson

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    Quote Originally Posted by edpmedic View Post
    An old partner of mine did a culture of an ambulance steering wheel once to see what the lab would find. They found gonorrhea. Seriously. I actually clean the cab first since I'll have gloves on while in the back anyway. If we get a call first thing in the morning, at least I've hit the steering wheel, radios and the MDT.
    Explains why the steering wheel is always sticky.

    I am now a past chief and the views, opinions, and comments are mine and mine alone. I do not speak for any department or in any official capacity. Although, they would be smart to listen to me.

    "The last thing I want to do is hurt you. But it's still on the list."

    "When tempted to fight fire with fire, remember that the Fire Department usually uses water."

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    Quote Originally Posted by ChiefKN
    The good thing for you (other then the YUCK factor) is that a good portion of these bugs won't live long outside the body. Hepatitis B being a big and scary exception.
    Not too worried about HBV either. All mechanics are given the HBV 3 shot vaccine since some work with sewer equipment, and a few (like me) work on the Puke Boxes.

    As for the "YUCK FACTOR", I'm Ok with it, until I smell it. Let the dry heaves begin.

    FM1
    I'm the one Fire and Rescue calls, when they need to be Rescued.

    Quote Originally Posted by EastKyFF
    "Firemens gets antsies. Theys wants to goes to fires. Sometimeses they haves to waits."

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    Default Thanks for your responses

    Thank you, I appreciate everything that's been said. Does ambulance decontamination vary across the board or are there standards in place by OSHA, the CDC, or any organization; and how tightly are they followed?
    "Without deviation from the norm, progress is not possible" - Frank Zappa

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    I know our State EMS Certification agency has regulations. I believe they are based off of DOT or OSHA. Basically, using a germicide/bacteria/virus killing solution, spray everything down, let it set the required time, wipe and rinse or repeat.

    In our dept, we clean the PT care area of the ambulance after every run, including the cot, monitor, etc. Weekly (if we haven't had a reason to do it already in addition to the weekly cleaning), we do a thorough decon of everything in the ambulance. We also decon the inside of the cab weekly and wipe it daily. No gloves are allowed to be worn while driving after PT contact. We have Purell hand sanitizer all over the place. We also wash our hands as soon as possible after PT contact.

    Most guys just wear gloves during PT care. We have one guy that wears an N95 on EVERY EMS run (even injuries). First time I ran with him, I showed up second on scene and he was waiting outside with his mask on. Kind of a little strange, but hey, it's his health and right to protect it. We have PPE kits, but never seen anyone put one on. If the PT is coughing a lot and it doesn't affect treatment, we might put a mask on them.

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    Quote Originally Posted by zzyyzx View Post
    Most guys just wear gloves during PT care. We have one guy that wears an N95 on EVERY EMS run (even injuries). First time I ran with him, I showed up second on scene and he was waiting outside with his mask on. Kind of a little strange, but hey, it's his health and right to protect it.
    I hope he's buying his own masks -- they aren't cheap. A pair of sinlge use gloves is a quarter. Each N95 mask is more like a buck and a quarter. Caution is one thing but it sounds like he might be overdoing it just a tad.
    "Nemo Plus Voluptatis Quam Nos Habant"

    The Code is more what you'd call "guidelines" than actual rules.

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    Quote Originally Posted by DeputyMarshal View Post
    Caution is one thing but it sounds like he might be overdoing it just a tad.
    Or he's got a good dose of OCD
    "Without deviation from the norm, progress is not possible" - Frank Zappa

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    Quote Originally Posted by zzyyzx View Post
    We have one guy that wears an N95 on EVERY EMS run (even injuries). First time I ran with him, I showed up second on scene and he was waiting outside with his mask on. Kind of a little strange, but hey, it's his health and right to protect it. We have PPE kits, but never seen anyone put one on. If the PT is coughing a lot and it doesn't affect treatment, we might put a mask on them.
    Someone needs to have a talk with that boy. Seriously, it shows a lack of professionalism to wear your gear inappropriately.

    There is no need to wear a N95 mask on an injury call. A case of gangrene, a code brown... okay.
    I am now a past chief and the views, opinions, and comments are mine and mine alone. I do not speak for any department or in any official capacity. Although, they would be smart to listen to me.

    "The last thing I want to do is hurt you. But it's still on the list."

    "When tempted to fight fire with fire, remember that the Fire Department usually uses water."

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