Would You Tell

[CFRBryan347768]

Is it wrong to go into a house with gloves allready on? What I mean is im not afraid of germs or anything but the second my hands get/clamy/sweaty gloves are not going on. So when we get toned out I put gloves on, and no one has ever really said anythingto me except this 1 person i just worked with me he literally demanded i take my gloves of after we got into the house. When he started telling me to take them i off i figured it was because i there was a latex allergy so i just pulled a pair of no-latex gloves on and thought i'd be good but once again he told me to take them off. I refused now even though there was no bodily fluids i still like to keep my gloves on? Am I so wrong? And can any one think of a reason why this guy wanted my gloves off?

 

[Sapphyre]

Some providers (even into the textbooks) are advocating "selective BSI." Meaning, if there's little to no chance of coming into contact with bodily fluids, don't even bother with gloves. Your choice on that.

 

[Fire219man]

my gloves go on before I leave the squad. You never know what your going to walk into.

 

[skyemt]

well, i'll tell you about "selective BSI"....

do you need gloves on every call? of course not...
but, if you now have to figure out when you need them and when you don't, it adds one more thing for you to think about...

the only exposure incident we had in the recent past, was someone who employed selective BSI... this person became involved with the patient, when the nature of the call changed she forgot/too distracted to put on gloves...
then, found out there was an exposure issue with regards to fluids and a small cut on this emt's hand...

btw, that emt no longer uses "selective BSI"...

you never know exactly what you are dealing with right away, and it really is no inconvenience, to me anyway, to put on gloves before i get to the scene..

maybe it is overkill, but i won't forget them the time i need them most.

 

[Sapphyre]

very true sky. I was answering the last question. Personally, I prefer gloves all the time. What's it matter. BTW, I prefer nitriles, really would not like to develop a latex allergy.

 

[BossyCow]

All gloves all the time. If you wait until you enter the house or directly see the pt. the putting gloves on can be seen as a delay. When my husband was in medic school, he walked in gloveless to a woman in labor. As he walked in the door, baby came out... he reached out and caught it, barehanded and had to fill out all the exposure forms since the mother was diagnosed with Chlamydia. He will never, ever go into a residence without gloves on first.

I've seen some practice the selective BSI, but I've never figured out how that works with universal precautions.

 

[Ops Paramedic]

Your are not wrong in wanting to wear gloves on every call or for any patient, no one can fault you, however they can fault you if you don't wear them and you are exposed. Gloves are also not that expensive that you cannot use a pair for every call, and sometimes i would not even touch someone's door handle without gloves (Now if the door looks like that, can you imagine what the patient looks like).

I understand the sweaty hands, and having to don a pair of gloves prior, but be careful of that as gloves tend to loose their efficacy after a period of time. It is recommend that you don a new pair of gloves every 20 minutes or so. Thus you can considder to don a second pair over the first.

To throw a stone in the bush: Does your personal General Practitioner wear golves every time he/she examines you??

 

[MedicPrincess]

If we are going inside somewhere I am usually putting them on as we are walking up the place. Outside calls....they are on as I am stepping out of the truck.

Shouldn't matter when you put them on, as long as they are on before you reach the patient.

I did have a "duh" moment the other day though. On my lastest 48hr shift, at about hour 41 we had a diabetic call. We initially tried PO efforts to raise the BS, and when they failed I turned around to get the IV bag. Put the tourniquet on. Cleaned my site. Stripped off my gloves. Pulled out the needle and when I turned to the patient it hit me what i had just done.

 

[Jon]

I'm a practioner of "selective BSI". I've got a thigh pocket full of gloves, and I usually only put them on once I make patient contact. Intact skin is a VERY good barrier... and I try to make sure I've got no open cuts or sores on my hands (when I do, I wear gloves more often).

Think about the last time you visited YOUR physician. Did he put gloves on before he listened to lung sounds? NO! Did he put gloves on before he checked your prostate? YEP! SELECTIVE BSI... use what is needed.

Universal precautions are used SELECTIVELY! Do you wear a gown and facemask on EVERY call? NO! So why wear gloves?

Also... If I'm wearing gloves on a call, I often go through 2-3 or more PAIRS... I take off my gloves when I transition to touching something that should be "clean" (like my clipboard, radio, or cell phone)... EVEN IF I'VE NOT TOUCHED BLOOD OR OPIM WITH THE GLOVES.

One of my biggest pet peeves is the EMT who wears one pair of gloves from beginning of call to end... even when they make up the stretcher. Gloves, when worn, are ASSUMED to be dirty... I like my stretcher to be CLEAN when it is made for the next patient.

 

[Ridryder911]

Leave the unit with gloves on. Sorry, it is not just for the my sake, but the patients sake. Anyone that wants to expose the patient to what EMT's have touched is a foolish provider. Sorry, there are many autoimmune compromised patients out there, they do not need exposed or compromised, as we do not either.

Patients expect gloves nowadays. It has been a norm for the past 25 years, and personally would not any of my caregivers to touch or perform any procedure without gloves on.

Read the literature of what "clean" EMS units growing in them, MRSA, Staph, E-coli, etc.. and you want to touch? Selective BSI is a gamble, and roll of the dice that the patient has full immunity, and that patient has not just went and had a B.M. and washed their hands. Sorry, not a germaphobic, but realistic...

R/r 911

 

[enjoynz]

I always put gloves on before leaving the ambulance.
They only come off if I'm driving to hospital.
If I'm doing the patient care, they stay on until the patient has been placed on a ED bed.
I then remove them, wash my hands and get fresh linen to remake the stretcher.
A habit my manager has enforced in me.

Cheers Enjoynz

 

[MSDeltaFlt]

Demand?!? You never demand ANYONE to go against any BSI. That makes absolutely no sense to me.

Also, what does your service's P&P say? I'll bet they say something like, "Put the cotton-pickin' gloves on".

 

[LucidResq]

Think about the last time you visited YOUR physician. Did he put gloves on before he listened to lung sounds? NO! Did he put gloves on before he checked your prostate? YEP! SELECTIVE BSI... use what is needed.

Your doctor doesn't wear gloves because he knows you probably don't have tuberherpechlamydisyphilis or whatever. You've probably been seeing him for a while, he probably knows your history, and you're probably getting a routine check-up. You've come to see him and you've entered his space.

In EMS you are walking into someone else's space, and who knows what will greet you when you open the door. Someone vomiting blood everywhere, placentas flying around, particularly explosive diarrhea... the nature of the business warrants being less than selective when it comes to wearing gloves, in my opinion. You have no idea who these people are, no idea what germs they're carrying, and no idea when they're going to shoot out some of their warm, wet sticky stuff right at you.

In EMS, a situation that does not warrant the use of gloves can suddenly become a situation that absolutely warrants the use of gloves faster than you can get a pair on. That's the key reason why I think gloves should be put on prior to walking into a scene.

 

[wexlerk13]

seriously, your partner sounds like certifiable clown. If he isn't your commander or boss or whatever you have, don't even listen to that non-sense

 

[seanm028]

Personally, I would not work with that partner anymore. I guess we don't all have the luxury of picking and choosing partners, though.

 

[Airwaygoddess]

Better to have them on, be ready to go!

 

[EMT815]

I used to not wear gloves on the "routine" medical calls, never had a second thought about it until I had one pt who had some incontinence issues that we didn't know about.I reached under her to help move her onto a stair chair and ended up covered in urine. I learned my lesson and now I always put on my gloves before leaving the rig.

 

[AJemt]

gloves are on before i leave the truck (usually put on enroute to the call) or as i am walking in the door (if i have a hard time getting them on). gloves come off before i hop in the truck if i am driving (load the pt, strip off gloves and toss in redbag trashcan, hop in front to drive) and go back on as i am walking towards the back door of the ambo to pull pt out to go into hospital. if i have to decon/wipe down the litter gloves are on for that, otherwise after i strip the old linens off i remove my gloves to remake the litter. depending on how sweaty my hands are and the pts condition/complaint i MIGHT take them off enroute to the hospital but usually not. 'selective bsi' only works if you know for absolutely sure and certain there is no risk of exposure - what happens when your pt who was fine and c/o just a bit of upset stomach/not quite feeling right codes? time is of the essense....don't waste 45-60 seconds trying to put on a pair of gloves (that never seem to go on right when you need them to be on quickly!).
if the pt questions me i tell them that it is for their protection as well as mine - never had anybody ask questions beyond that (or i tell them it is company policy - that works too).
never EVER had a partner tell me to take them off.....i would tell that partner that it is your decision to wear gloves and unless the pt is allergic to latex you are not taking them off and if they are you will switch to nitrile/non-latex (though personally i like my company which is strictly non-latex gloves - never know when someone will be allergic). if you have a problem with this person continueng to insist then speak wiht your supervisor about it. good luck!

 

[rmellish]

Gloves on when I enter the scene. Off once we unload the patient in the ER, or if I'm driving, off before I open the ambulance driver door. (Nothing says whacker like driving with gloves...)

Anyhow, I will remove them on long transports (1hr+) if I'm not doing anything with the patient. Always sanitize after they come off, and put on a fresh pair before resuming patient contact.

 

[TheMowingMonk]

with my squad its mandatory protical that we wear gloves on every call, its the first thing i do when i arrive where ever the call is.