# Being an EMT is scary!



## hoisanjai (Jan 9, 2008)

I have start my job as an EMT for week now. The job is pretty scary I had a MRSA pt. and a HIV+ patient. After the call I believe I have caught everything. I am so paranoid. For the MRSA pt. we have to t/p her back to his nursing home. When you enter the room we have to have a full body BSI gowns, masks, and gloves. But then we were supposed to throw away all the BSI in the room with the pt. after you are done assessing him. Then I thought to myself, how am I safe with the pt. in his room with all my BSI off. I mean I am basically breathing the same air he is, how am I myself safe?

The next day I had a HIV+ pt. I was like :censored::censored::censored::censored:, cmon I don't a pt. like this. we had to t/p her back to her nursing home so when i went in of course I had gloves on. But the room smelled so bad it feels like you could of caught HIV by breathing the air. After we're done with the pt. we have to take out off our gloves and push the stretcher back to our rig I was so scared that I might have caught HIV by touching the cot. Plus it's winter time. I have minor cuts near my nails and fingers on my hands from dry skin. Her belongings were on the stretcher and I was so scared to touch anything on the stretcher. But then I know HIV is transferred from blood, but then I am still scared that it can be transferred from the things they have touched. I came home., I told my mom I had a HIV+ pt. she freaked out and she was like. How am I gonna throw your clothes in the washer tomorrow. I am like, I don't know.

PEOPLE I AM SO SCARED!!!NOW I FEEL LIKE QUITTING THE JOB!!! ALSO KNOWING THAT THE RIG IS CONTAMINATED WITH GERMS!!!


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## worknplay (Jan 9, 2008)

hmm... 
I worked at a nursing home for 3 and a half years before becoming an EMT. I've been around all of these things and some, day after day, hour after hour. Universal precaution, BSI, hand washing, moisturizing, and you're fine. It's good to be cautious but you shouldn't be so paranoid over things like touching an HIV patient's belongings.
I hear that even the chance at catching HIV from a contaminated needle stick is a lot lower than most people think. I don't remember the percentage exactly. 
If you're that paranoid perhaps this isn't the field for you? 

Good luck!


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## JPINFV (Jan 9, 2008)

hoisanjai said:


> I have start my job as an EMT for week now. The job is pretty scary I had a MRSA pt. and a HIV+ patient. After the call I believe I have caught everything. I am so paranoid. For the MRSA pt. we have to t/p her back to his nursing home. When you enter the room we have to have a full body BSI gowns, masks, and gloves. But then we were supposed to throw away all the BSI in the room with the pt. after you are done assessing him. Then I thought to myself, how am I safe with the pt. in his room with all my BSI off. I mean I am basically breathing the same air he is, how am I myself safe?



One thing to know about MRSA is that it is not always air born. A lot of times an infection is localized to a specific wound or opening on the body. Even when it is in the nares, the patient would be under droplet precaution (think sneezing) and it shouldn't be a problem unless your right next to the patient (i.e. gowning/degowning at the door). Furthermore, my understanding is that MRSA is rather weak virus as long as you are not immunocompromised. This doesn't mean not to take precautions, but the reason why nursing homes and hospitals are hit hard is because of the high population density of these environments and that population is normally sick (hence why they are in a hospital or nursing home). Standard precautions, special precautions (what is listed on the door. If unsure, please speak to the patient's nurse), and good hand washing will protect you. 


> The next day I had a HIV+ pt. I was like :censored::censored::censored::censored:, cmon I don't a pt. like this. we had to t/p her back to her nursing home so when i went in of course I had gloves on. But the room smelled so bad it feels like you could of caught HIV by breathing the air. After we're done with the pt. we have to take out off our gloves and push the stretcher back to our rig I was so scared that I might have caught HIV by touching the cot. Plus it's winter time. I have minor cuts near my nails and fingers on my hands from dry skin. Her belongings were on the stretcher and I was so scared to touch anything on the stretcher. But then I know HIV is transferred from blood, but then I am still scared that it can be transferred from the things they have touched. I came home., I told my mom I had a HIV+ pt. she freaked out and she was like. How am I gonna throw your clothes in the washer tomorrow. I am like, I don't know.


Unless your having sex with your patients, then this really shouldn't be a problem. As with MRSA, use standard precautions and wash your hands (this is good for a vast majority of things that you WILL be exposed to in healthcare, such as c-diff, VRE, MRSA, and a dozen other bugs. If you're specially concerned about HIV then check out this website (Google is your friend).


> PEOPLE I AM SO SCARED!!!NOW I FEEL LIKE QUITTING THE JOB!!! ALSO KNOWING THAT THE RIG IS CONTAMINATED WITH GERMS!!!



The world is contaminated with germs. Your car/house/dog/kitchen/bathroom (actually, according to Myth Busters, your toilet seat is should be pretty germ free) is COVERED with germs and it was like this long before you started working in EMS and will be like that long after you leave EMS. This is why God gave us an immune system.


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## hoisanjai (Jan 9, 2008)

gah... i don't know some days I think... life is precious and someday I don't give a rat's ***  I think ... I should value life more and just enjoy the days that I am in EMS and just take BSI precautions.


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## TheDoll (Jan 9, 2008)

awhile ago, i was reading something about people who are new to the medical field. particularly, i was reading about med students. apparently, it is very common for them to think that they have the diseases, disorders, etc that they are studying. this can happen at any level of people working in the medical field. part of the reason i was looking into this is because i was having similar thoughts when i was working in the burn unit. learning this little bit of info helped me calm down a lot. i wash my hands a lot--there is nothing like a good old fashioned hand washing. it's even better than the alcohol gel, but if you can't wash your hands, the gel is better than nothing. also, i clean the truck and our instruments including the cot like crazy. i spray down the cot after every run, and things like the monitor after every use. once a shift i wipe down the entire inside of the ambulance. that's the best i can do, so, i do it. also, i don't have those thoughts anymore about getting every kind of illness either!


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## Ridryder911 (Jan 9, 2008)

Simple cure for most exposures... [size=+3]Wash your hands with soap & water[/size]..

Don't be a freak about germs... be cautious, be wise, and most important [size=+2]be  informed & educated[/size]. 

Read up on infection control, and the body way of protection. You are exposed to just as much MRSA, HIV, and Hep C at the movie theatre and restaurant that you just ate at. 

I worked with some germaphobics, after they refused to become informed and learn, personally assisted them leaving the field. Apparently no-one told them that sick people have them while they went to EMT school. 

You are more a danger to autoimmuned patients than they are to you. You are the carrier of most of the "germs"...

R/r 911


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## hoisanjai (Jan 9, 2008)

hmm....have anyone of you ever got exposed?


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## Flight-LP (Jan 9, 2008)

Exposed everyday on the ambulance.................We have several frequent flyers with Hep and HIV, we get a few MRSA and VRE patients as well. It's no big deal, just educate yourself and follow appropriate precautions...............


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## hoisanjai (Jan 9, 2008)

i am talking about exposed as in HIV+ pt. spilled all over your or stabbed you stuff and stuff....


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## Flight-LP (Jan 9, 2008)

hoisanjai said:


> i am talking about exposed as in HIV+ pt. spilled all over your or stabbed you stuff and stuff....



Yes I have been vomited on, bled on, and spit on by people with various contaminant diseases. Once again, now for the third time, educate yourself and utilize the appropriate precautions and you will not have a problem........


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## JPINFV (Jan 9, 2008)

Make sure that you that you get any vaccines that you can also. Things like hep A, heb B (Twinrix vaccine covers both Hep A and Heb B), DTaP (diphtheria, tetanus, and pertussis), and Menningitias are all vaccines that either need to be updated every so often or aren't normally given to children (ex MMR).


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## Ridryder911 (Jan 10, 2008)

Yes, I have been exposed several thousand times... like everyone else, every trauma call, every sick call, every time I go to McDonald's I am sure someone has Hepatitis B somewhere.. (why, do you think they tell them to wash their hands?) 

I was exposed by an HIV patient in mid 80's when there were no med.'s and they bit through 2 pairs of gloves. Yes, I did some soul searching. At that time you had 100% chance of death. As well, as employers not covering you.. 

Things have changed. 

I have been contaminated by needles, spit, piss, poop, blood, pus, hockers, loogeys... you get the picture. One attempts to BSI, but let's be realistic it doesn't happen when your prepared. 

Did you not know sick people had germs when you attended EMT course? Did you not realize that you would be exposed to such communicable diseases such as T.B., herpes, chicken pox, measles, HIV, MRSA, VRSA, and the dreaded Hep alphabet ( including the non alphabet one)... ? 

Surely, this was no surprise. 

Like I described before, become educated upon infection control and the body natural defense mechanisms, and how you right now have staph & E. coli . . yes, it is natural... 

If you don't want to be exposed.. it is simple. Get out. You will be exposed in any healthcare portion from dispatch to medical records. 

I personally would recommend some reading and studying like you should had done in EMT course. ...

Good luck, 

R/r 911


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## hoisanjai (Jan 13, 2008)

Ridryder911 said:


> Yes, I have been exposed several thousand times... like everyone else, every trauma call, every sick call, every time I go to McDonald's I am sure someone has Hepatitis B somewhere.. (why, do you think they tell them to wash their hands?)
> 
> I was exposed by an HIV patient in mid 80's when there were no med.'s and they bit through 2 pairs of gloves. Yes, I did some soul searching. At that time you had 100% chance of death. As well, as employers not covering you..
> 
> ...




all my friends who I graduated from EMT class are all paranoid about the same issue I am paranoid about right now.


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## TheDoll (Jan 13, 2008)

Ridryder911 said:


> Yes, I have been exposed several thousand times... like everyone else, every trauma call, every sick call, every time I go to McDonald's I am sure someone has Hepatitis B somewhere.. (why, do you think they tell them to wash their hands?)
> 
> I was exposed by an HIV patient in mid 80's when there were no med.'s and they bit through 2 pairs of gloves. Yes, I did some soul searching. At that time you had 100% chance of death. As well, as employers not covering you..
> 
> ...


easy, there. when i started working on the burn unit (during my emt class) i was not aware of the extent of some of the communicable diseases around. it was kind of a shock and a little freaky. it wasn't enough to make me quit, but it was enough to make me worry a little. so instead of closing the door on a career in the medical field, i asked a lot of questions. i talked to people around me who worked at all different levels in the medical field, and i learned a lot. it helped me feel a lot better to gather information and ask questions.

hoisanjai,
i hope you keep asking questions about this bc it's important to be aware of. like we've said before wash your hands and clean your equipment like your stethoscope. 
also, if you experience an exposure such as a bite or needle stick. let your supervisor know right away and follow protocols. i was exposed a few months ago when i was debriding a patient in the burn unit. one of her blisters squirted in my eye--how gross is that? i'm fine, i'm not worried, and i've followed protocol. good luck, and you'll get through this anxiety about germs, i'm sure.


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## hoisanjai (Jan 13, 2008)

TheDoll said:


> easy, there. when i started working on the burn unit (during my emt class) i was not aware of the extent of some of the communicable diseases around. it was kind of a shock and a little freaky. it wasn't enough to make me quit, but it was enough to make me worry a little. so instead of closing the door on a career in the medical field, i asked a lot of questions. i talked to people around me who worked at all different levels in the medical field, and i learned a lot. it helped me feel a lot better to gather information and ask questions.
> 
> hoisanjai,
> i hope you keep asking questions about this bc it's important to be aware of. like we've said before wash your hands and clean your equipment like your stethoscope.
> also, if you experience an exposure such as a bite or needle stick. let your supervisor know right away and follow protocols. i was exposed a few months ago when i was debriding a patient in the burn unit. one of her blisters squirted in my eye--how gross is that? i'm fine, i'm not worried, and i've followed protocol. good luck, and you'll get through this anxiety about germs, i'm sure.



My fear is only on the incurable diseases that are out there.


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## TheDoll (Jan 13, 2008)

hoisanjai said:


> My fear is only on the incurable diseases that are out there.


okay, then learn how they are spread, how to prevent spreading them, how likely you are to catch them, and what the effects are if you do happen to catch one.


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## Stn2Emtb (Jan 13, 2008)

I work at a hospital and before I worked on a rig.  I had never really been around MRSA or VRE.  I have since learned that it depends on WHERE the MRSA or VRE is.  If it is Airbourne (ie sputum, etc) then you need to think about covering the pt with a mask.  If it is in a wound or stool standard BSI will keep you from getting it.  Don't be stupid and you will be fine.


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## AnthonyM83 (Jan 13, 2008)

To be fair the original poster merely showed apprehension about communicable diseases. I don't see much wrong with that.

As far as HIV, you could probably make out with most your HIV+ patients and smother your face in their dirty pillows and not AIDS.


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## hoisanjai (Jan 14, 2008)

I am scared that somewhere along the lines I will make a mistake and that will be it for me. Like the days I haven't wear gloves with some patients, and one time when I was washing my hands on a call and I had a scratched on my arms and I didn't know how I got it, whether not the clipboard for my paperwork scrape me or whatever scrape me was infected. I am just worried about my life. That's all...and I know I am paranoid as hell. Maybe this might go away soon. Will it be better if you work in a hospital setting? I also heard that you get paid more in hospital setting.


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## Ridryder911 (Jan 14, 2008)

I guess my message is to get educated before entering the workforce. Definitely I would not work in Haz-Mat without knowing the dangers, labels, chemical reactions, or work in a medical laboratory before knowing the dangers, and processes of diseases, blood borne pathogens, etc.. 

Why don't we require the same? 

Being ignorant is not an excuse for the patients sake or yours. One would not to expect to enter a bio-hazard area (in reality what a communicable disease is) without knowing methods of spreading, time exposure, dangers, and treatment. Diseases do not care if you do not know or are aware, as well exposing patients with autoimmune syndromes can & will *kill* them. 

Sorry, I was a Burn Nurse for a couple of years. We would not allow any students to observe unless they understood isolation methods and methods of infection control. It was more for the patent's sake, but yes; prevent cross contamination. 
All EMT's should be taught the basics methods of contamination, infection control, and different types of exposures. 

Medicine is not a game, what we deal with, expose to can and will alter someones life. Again, diseases are not discriminatory and will affect any level of certification. Hence, the reason Microbiology should be mandated before any EMS courses.. we are part of medicine are we not? 

R/r 911


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## MSDeltaFlt (Jan 14, 2008)

Just about everybody here has been puked on, spat on, snotted on, pissed on, and shat on.  You name it, it's been done to us.

Do like Rid said, get more education.  Be and stay vigilant.  Downgrade the self-admitted paranoia to caution.  God created antibodies for a reason.  Trust them, but do not rely soully(?sp) on them.  Wash properly, follow ALL your company's policies and procedures, and the odds of you being just fine are better than you think.


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## Stn2Emtb (Jan 16, 2008)

I was merely trying to convey that MRSA and VRE are not something to be afraid of.  Most everybody if not everybody carries the virus. Its just weather or not your body chooses to react to it or not.  I was very aprehensive myself, Especially when I was Pregnant. The more I learn about it the more I understand. I don't like it and I don't want it but because I work in the health care field I'm at higher risk than Joe Schmoe down the street.  Mainly what I want to say is Relax and use your head you will be fine.  Becareful out there everyone.


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## VentMedic (Jan 16, 2008)

Afraid, no. But, you need to have great respect for the potential harm these bacteria and viruses can do to you and to your patients if you get laxed with cleaning and BSI.  Infection control should not be taken lightly.  

Methicillin-Resistant Staphylococcus Aureus (MRSA) and Vancomycin-Resistant Enterococci (VRE) are bacteria and not viruses. 

Tuberculosis, TB, is caused by bacteria called Mycobacterium tuberculosis.  
Multi-drug resistant tuberculosis called MDR-TB is also prevalent in some areas. 

Hepatitis C (HCV) and Human Immunodeficiency Virus (HIV) are viruses. 

HCV can live outside the body on surfaces for several days. 
HIV is a very fragile virus and does not survive long outside the body. 

*Colonization *is the presence, growth, and multiplication of the organism without observable clinical symptoms or immune reaction. 

MRSA - Colonization may occur in the nares, axillae, chronic wounds or decubitus ulcer surface, perineum, around gastrostomy and tracheostomy sites, in the sputum or urine. One of the most common sites of colonization in both patients and employees is the nose (anterior nares). While personnel may become colonized with MRSA (as they may with susceptible S. aureus), they rarely develop infections.

Enterococci are normally found in the bowel and the female genital tract. When exposed to antibiotics for any reason, the drug-resistant bacteria may survive and multiply, resulting in an overgrowth of drug-resistant enterococci in the bowel, referred to as colonization.

*Infection* refers to invasion of bacteria into tissue with replication of the organism. Infection is characterized by isolation of the organism accompanied by clinical signs of illness such as either fever, elevated white blood count, purulence (pus), pneumonia, inflammation (warmth, redness, swelling), etc.

*Mode of Transmission* - MRSA is transmitted primarily by contact with a person who either has a purulent site of infection, a clinical infection of the respiratory tract or urinary tract, or is colonized with the organism. Hands of personnel appear to be the most likely mode of transmission of MRSA from patient-to-patient. MRSA can be present on the hands of personnel after performing such activities as wound debridement, dressing changes, tracheal suctioning, and catheter care.

*Reservoirs for MRSA* - Colonized and infected patients are the major reservoir of MRSA. MRSA has been isolated from environmental surfaces including floors, sinks, and work areas, tourniquets used for blood drawing, and blood pressure cuffs. Evironmental surfaces should be routinely disfected to reduce the bacterial load. 

*Reservoirs of VRE *- Enterococci are part of the normal flora of the gastrointestinal tract and female genitourinary tracts. Most infections with these microorganisms have been attributed to the patient's endogenous flora. However, a recent study found VRE is capable of prolonged survival on hands, gloves, and environmental surfaces. E. faecalis was recovered from countertops for 5 days; the E. faecium persisted for 7 days. Thus environmental surfaces may serve as potential reservoirs for nosocomial transmission of VRE and need to be considered when cleaning equipment.

Healthcare workers can have skin lesions infected with MRSA and should be treated. Decolonization should be considered for those employees with persistent MRSA nasal carriage (ex. chronic sinusitis), especially if the healthcare worker had contact with patients who were subsequently found to be positive for the same strains.

This information is to educate and not to frighten.  Most of the bacteria and viruses mentioned may not affect a healthy individual but can be deadly to the next patient you transport if you do not take a few simple precautions.  Patients trust you and it is up to you to see that you do them no harm.  That means learning about and diligently practicing good infection control.  

Also, if you have small children, don't let them play with your stethoscope. Don't keep your stethoscope around your neck directly on your skin.  Change your clothes and wash well before entering your living quarters especially if you have elderly or very young children in your household.  Don't take your work home with you by way of bacteria and viruses. 

If your place of employment does not offer adequate infection control information, check the continuing education classes for healthcare professions at the local community college (or online).  Most will offer inexpensive 2 -3 hour classes on various infection control issues.   

If, after you get much more education and you still have concerns about patient care and contracting a disease, you may need to re-evaluate your career choice.   Healthcare is not for everyone and for some reason future EMTs (and Paramedics) don't always realize how much patient care and contact is involved when they enter these very short training programs.   A healthcare worker must be able to provide quality patient care and if personal concerns prevent that, then the patient may suffer.


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## Arkymedic (Jan 16, 2008)

duplicate post please delete.


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## Arkymedic (Jan 16, 2008)

VentMedic said:


> Afraid, no. But, you need to have great respect for the potential harm these bacteria and viruses can do to you and to your patients if you get laxed with cleaning and BSI. Infection control should not be taken lightly.
> 
> Methicillin-Resistant Staphylococcus Aureus (MRSA) and Vancomycin-Resistant Enterococci (VRE) are bacteria and not viruses.
> 
> ...


 
Very well written post as always Vent. Thank you.


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## SC Bird (Jan 16, 2008)

Obviously there is a greater risk of exposure working in the environments that we do...  But it's something that I think one really has to be 100% aware of...but do not let it consume you.  It may begin to hinder your ability to properly care for your patient.  

....but if you really want to get down to it....just think about the possibilities of exposure at the hotel rooms you stay in are (DO NOT TOUCH THAT REMOTE!!!!!) or on the door handles to bathrooms at rest stops or just everywhere.

That's why I love me some handwashing....

-Matt


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## MyLoveIsMyBaby (Nov 24, 2008)

Okay I heard enough. The nursing homes and facilities don't know everything. I have dry skin and I begin to think it's MRSA, my son hasn't got it nor my fiance, it's probaly not MRSA. Yesterday I brought a pt to a continuing care facility in a hospital from dialysis, dispatch sent text stating pt has MRSA in urine and blood. Took precautions, and got there, once on scene stated to nurse that pt has MRSA, showed text from dispatch and said yeah dialysis said take precautions. They had no record of pt having MRSA. In a room with another pt w/o MRSA. They started flipping looking for a history and all. BE careful. ALWAYS ALWAYS WEAR GLOVES. I don't know if MRSA is airborne, or if gloves are suiteable, cause I recently went to a few, still trying to find out if I was at risk or not. Why not wear gloves? ALWAYS wear gloves, u never know. Goes to show that our worst enemy in the field can b the healthcare providers next to us.


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## VentMedic (Nov 24, 2008)

MyLoveIsMyBaby said:


> Okay I heard enough. The nursing homes and facilities don't know everything. *I have dry skin and I begin to think it's MRSA, my son hasn't got it nor my fiance, it's probaly not MRSA.* Yesterday I brought a pt to a continuing care facility in a hospital from dialysis, dispatch sent text stating pt *has MRSA in urine and blood*. Took precautions, and got there, once on scene stated to nurse that pt has MRSA, showed text from dispatch and said yeah dialysis said take precautions. They had no record of pt having MRSA. In a room with another pt w/o MRSA. They started flipping looking for a history and all. BE careful. ALWAYS ALWAYS WEAR GLOVES. I don't know if MRSA is airborne, or if gloves are suiteable, cause I recently went to a few, still trying to find out if I was at risk or not. Why not wear gloves? ALWAYS wear gloves, u never know. Goes to show that our worst enemy in the field can b the healthcare providers next to us.


 
I am going to suggest you do some serious reading and enroll into one of the many programs at a health care facility or college. You obviously do not have a clue what MRSA is. 

There are such things as a new diagnosis of a MRSA infection that can be treated and/or is colonized. 

Wear gloves, wash hands and get an education about medicine or at least enough knowledge to know how to approach the subject at a professional level. There are many, many different bacteria, viruses and spores out there just waiting for the unsuspecting EMTs and their patients. At this point I would say your patients may have more to worry about since you have no clue about infection control. YOU can do them more harm.


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## jerellem (Nov 24, 2008)

"I came home., I told my mom I had a HIV+ pt. she freaked out and she was like. How am I gonna throw your clothes in the washer tomorrow. I am like, I don't know." - Classic! LMAOOOOOO if you're THAT scared you need to try something else. I'm super paranoid of that kinda stuff too but thats too paranoid. My gf's mom is possible HIV+ and I see her all the time ride in the car with her, etc. Its not like germs are just chasing people down and relentlessly hacking into their system and taking over the world lol. Just remember BSI and stay educated.


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## BossyCow (Nov 24, 2008)

I'm still trying to wrap my head around his mother doing his laundry for him! I work in a vollie agency and there has been more than a time or two that I've changed into scrubs at the ER and carried my clothes out of there in a biohazard bag for laundering at the station. 

You should have a clean set of clothes at the station that you can change into as well as laundry facilities there.


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## Ridryder911 (Nov 24, 2008)

jerellem said:


> "I came home., I told my mom I had a HIV+ pt. she freaked out and she was like. How am I gonna throw your clothes in the washer *tomorrow*. I am like, I don't know." - Classic! LMAOOOOOO if you're THAT scared you need to try something else. I'm super paranoid of that kinda stuff too but thats too paranoid. My gf's mom is possible HIV+ and I see her all the time ride in the car with her, etc. Its not like germs are just chasing people down and relentlessly hacking into their system and taking over the world lol. Just remember BSI and stay *educated*.



Hmm... a little cross infection? Maybe a little education is really in order. I am far not a germ phobic but as well educated enough to know that mixing clothes with contaminated clothes is a good way to expose everyone. As well many health care providers are MRSA + as carriers also Hep B. 

If you don't believe that "germs" are not getting into more into systems than usual, you need to read up in geriatric care and microbiology. Yes, health care providers need to understand that there are more and more resistant bacteria. Hence there is NO cure as they mutate and become resistant to antibiotics. Even simple hand washing with anti-bacterial soap has consequences. 

It is one thing to be paranoid and another to be laxadazical in infectious diseases.


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## Bosco578 (Nov 24, 2008)

I burn my uniform after evey call and then take an acid shower......I then blow the ambulance up just in case..........


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## Code 3 (Nov 24, 2008)

Bosco578 said:


> I burn my uniform after evey call and then take an acid shower......I then blow the ambulance up just in case..........



Sounds costly...:blink:

I'm not nearly as paranoid as some that are posting in here; however, I'll be the first to admit of my OCD when it comes to the rig. I will wipe down the CPU, door handles, mic, window/lock buttons, radio, etc. I think cross-contamination is a huge problem that people often overlook. You'll also get a swift boot the to butt if you try and get inside the cabin with your gloves still on.


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## Oregon (Nov 24, 2008)

Bosco578 said:


> I burn my uniform after evey call and then take an acid shower......I then blow the ambulance up just in case..........



I hear acid showers are great for reducing those fine lines and wrinkles!

As I was gloving up a day or two ago (to wrap up a nasty thumb lac. on another EMT) I was considering what might be on my gloves...and in his wound, now.  I think I'm going to start carrying my gloves in a ziploc or something, not just shoving a wad of 'em into my pocket before I go out.  Not that my pockets are full of cow poo or anything, but still.


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## MagicTyler (Nov 25, 2008)

My dad was an x ray student in the late 80's and had indirect contact with an AIDS pt, he touched her shirt with his ungloved hand. She had no open wounds, there was no blood, he simply touched her shirt ... He ended up in a full procaution room for 24 hours while they made sure he wasn't HIV positive.
:wacko:
A few weeks ago he got an AIDS pt's blood on his arm while he was starting an IV... He just went and washed his hands...
^_^
Education can change things...


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## reaper (Nov 25, 2008)

A lot of it is how the media blows things out of proportion. In the 80's and 90's they had everyone scared to touch an AIDS pt. Then it was Avian Flu,SARS and now MRSA.

You are in the healthcare field. Take the time to research the different diseases and take universal precautions. There is no reason to live in fear! Most of these have been around for a long time and we have dealt with them before the hype.


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## VentMedic (Nov 25, 2008)

reaper said:


> A lot of it is how the media blows things out of proportion. In the 80's and 90's they had everyone scared to touch an AIDS pt. Then it was Avian Flu,SARS and now MRSA.


 
It wasn't totally the media when it came to AIDS. In fact the media was kept in the dark for quite some time about the seriousness. We were kept in the dark at the beginning. That was the only time in my career I was not allowed to open the chart for transfer information and was literally dressed by the hospital staff. All info was passed through the top. 

We got our hospital isolation advice from the same centers (CDC) that advises on Ebola. The initial isolation rooms and practices were taken from that. At that time, Ebola was one of the few very deadly diseases known. Only a few people were allowed in the wing that housed "those patients". All supplies used including dishes were disposible and placed in biohazard containers (not just the bags). Some hospital staff were refusing to care for the patients. At first they used the health hazard potential and when the disease was named GRID they cited religious reasons if the health risk didn't get them relied from duty on "that" floor.

Our patient population at that time was very unique if anyone knows the history of Miami in the early 1980s. To be honest, that was a scary time because of the unknown factors but fortunately the education came quickly in our area. It was terrifying to see hundreds of people dying so rapidly from a horrible death. I know I personally lost more than my share of friends and co-workers during that time and the many years to follow.

Florida also has the sad story where firefighters did not want to fight the fire that destroyed the Ray brothers home in 1987 out of fear they would get HIV.

Luckily, universal precautions came out of this and increased education to all disciplines (except for some in EMS). As an RRT, I do have access to some serious filtered respirator equipment for some invasive procedures and certain pulmonary patients. 

I do take extra precautions to protect myself and those around me with intubated or any patient I'm using a BVM with by placing a filter between the patient and bag exhaust valve. If running CPAP/BiPAP on some patient with suspicious CXRs, I'll try to get them to an isolation room quickly. Portable CPAP was thought to be the star player in the event of a serious respiratory disease outbreak but recent white papers on the subject have presented a different view from a contamination point of view. 

If on a ventilator, I make sure anyone breaking the circuit has protection from spray. Single limb circuits on transport ventilators get an HME filter to protect all crew members on the team as well as any members of the general public they pass. Too few CCT teams fail to realize how easy it is to contaminate a portable ventilator by not placing a filter by the circuit port and can literally infect every patient that machine comes in contact with. 

In the ambulance, you can always wear a mask with any respiratory patient that has purulent secretions and cough. Keep yourself healthy. Don't over tire by working too many hours. A healthy body and universal precautions should protect you. Just be mindful of where your clothes and shoes have been. I have yet to wear either home in 30 years regardless of how good I look in them. I definitely cringe when I see any EMS/Fire employees handling the fruits and veggies at the market.


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## Emtint08 (Nov 27, 2008)

*understood!!*



hoisanjai said:


> I have start my job as an EMT for week now. The job is pretty scary I had a MRSA pt. and a HIV+ patient. After the call I believe I have caught everything. I am so paranoid. For the MRSA pt. we have to t/p her back to his nursing home. When you enter the room we have to have a full body BSI gowns, masks, and gloves. But then we were supposed to throw away all the BSI in the room with the pt. after you are done assessing him. Then I thought to myself, how am I safe with the pt. in his room with all my BSI off. I mean I am basically breathing the same air he is, how am I myself safe?
> 
> The next day I had a HIV+ pt. I was like :censored::censored::censored::censored:, cmon I don't a pt. like this. we had to t/p her back to her nursing home so when i went in of course I had gloves on. But the room smelled so bad it feels like you could of caught HIV by breathing the air. After we're done with the pt. we have to take out off our gloves and push the stretcher back to our rig I was so scared that I might have caught HIV by touching the cot. Plus it's winter time. I have minor cuts near my nails and fingers on my hands from dry skin. Her belongings were on the stretcher and I was so scared to touch anything on the stretcher. But then I know HIV is transferred from blood, but then I am still scared that it can be transferred from the things they have touched. I came home., I told my mom I had a HIV+ pt. she freaked out and she was like. How am I gonna throw your clothes in the washer tomorrow. I am like, I don't know.
> 
> PEOPLE I AM SO SCARED!!!NOW I FEEL LIKE QUITTING THE JOB!!! ALSO KNOWING THAT THE RIG IS CONTAMINATED WITH GERMS!!!



I understand completely!!!I went through the same thing yesterday in the ER.  I have been very good about taking precautions going into the patients room but sometimes with a stat transfer they don't tell you a lot.  In the year I have been with the ER I have never had four back to back patients with hiv, hep c, Cdiff and MRSA.  I had that day yesterday and it was the only day that I managed to cut myself.  I took as many precautions as I could without making the patient feel any worse than they already did.  I washed my hands a million times and I didnt walk into the house with my clothes on.  I had my husband come out to the car with a bag, stripped in the car, put a robe on, put the clothes in the bag and through them in the washer.  The key is to remember, which is difficult to do in this situation, what is contact and what is airborne precautions.  If you are gowned and gloved up, and masked in airborne situations, you should have no worries.  I was also told on top of this, if you have a good immune system you should not be at risk.  I did and felt the same thing yesterday, even though I know what contact precautions are and what to do.  Ironically, HIV is really nothing you need to worry too much about because its very difficult to get without real physical contact, or body fluid swap.  The virus doesnt last long at all once it is airborne.  HEP C on the other hand is a much different story. But still involves some kind of bodily fluid exchange.  As long as you are gloved up, you should be okay.  Don't worry, I think you'll survive this.  But it does make you think, doesnt it?


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## Emtint08 (Nov 27, 2008)

*nice*



Bosco578 said:


> I burn my uniform after evey call and then take an acid shower......I then blow the ambulance up just in case..........



LOL.  I like that.  Hope your kidding!!


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## Ridryder911 (Nov 27, 2008)

Emtint08 said:


> Ironically, HIV is really nothing you need to worry too much about because its very difficult to get without real physical contact, or body fluid swap.  The virus doesnt last long at all once it is airborne.



Actually the HIV virus has been found to stay alive on Formica up to two weeks. 

R/r 911


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## Emtint08 (Nov 27, 2008)

*Wow*



Code 3 said:


> Sounds costly...:blink:
> 
> I'm not nearly as paranoid as some that are posting in here; however, I'll be the first to admit of my OCD when it comes to the rig. I will wipe down the CPU, door handles, mic, window/lock buttons, radio, etc. I think cross-contamination is a huge problem that people often overlook. You'll also get a swift boot the to butt if you try and get inside the cabin with your gloves still on.



Thats very thorough.  And I am sure your partners and patients would feel very appreciative of that.  I totally get it now, after having worked both the rig and ER.  But it does seem some people in the ER, especially those who have been around a while, are getting too complacent with this stuff, and THAT scares me. I used to have a partner who was more than OCD.  After every call he would bleach and Virex the heck out of the unit to the point where I wasnt allowed to open the door to get into the unit.  It was BIZARRE.  Thorough, but Bizarre.  I am surprised I wasnt transported to the ER myself, with the fumes and chemicals floating around.  My other partners would get kind of rude with him and joke around with him.  Evidentally he was not usually this germaphobic, until an infected individual touched him once, and that freaked him out.  He went the whole other direction on the subject.  There has got to be a happy medium.


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## RESQ_5_1 (Nov 27, 2008)

I use BSI and universal precautions at all times. However, knowing the world is not a sterile environment, and knowing that attempting to completely sterilize the world is impossible I do what I can to protect myself and my patients. Coming into contact with microorganisms is inevitable. And as far as the fruits and vegetables at the grocery store, I'm sure worse things have come into contact with those than EMS workers. I wash my uniform with my other clothes. If I've already come into contact with something, I'm sure I won't be able to clean every surface I have contacted until I can decontaminate my uniform. Or, even my boots for that matter. I have handled many MRSA patients. And, 90% of those I found out were MRSA+ AFTER bringing them to the receiving facility. 

I wash my hands after using the washroom (yes, even off duty). I wash my hands after pt contact. Even if that means seconds prior to using the washroom and then washing them again. I wash my fruits and vegetables before I prepare them (as recommended by both the store I bought them from, and the grocer who sold them). 

Unless you live in a bubble of sterility at home, YOU are going to contaminate everything you touch. After you have completely cleaned and sterilized your rig, how do you respond to calls? do you don full isolation and sterile gloves? If not, you are contaminating surfaces. Were you wearing a sterile uniform, gloves, and boots when you deconned your rig? If not, you were contaminating right after you cleaned it. 

As Rid said, be educated. Be cautious. Use your BSI and hand washing. There is absolutely NO WAY your rig is completely microorganism free. And, your chances of being infected by said organisms is greatly decreased by using UNIVERSAL PRECAUTIONS. I have worked in the Healthcare feild for about 12 of the last 15 years. And I have NEVER had so much as a cold from any pt I've contacted.


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## EMTinNEPA (Nov 27, 2008)

hoisanjai said:


> all my friends who I graduated from EMT class are all paranoid about the same issue I am paranoid about right now.



Jesus H., what kind of EMT class did you attend?


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## blynn (Nov 29, 2008)

hoisanjai said:


> all my friends who I graduated from EMT class are all paranoid about the same issue I am paranoid about right now.


I hope you and your class are not planning on going through medic school then..

Being cautious and smart about what we do in the field is okay...but the way you're talking, sounds like you may need to rethink your career field.


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## mycrofft (Nov 29, 2008)

*Hey think about it...*

If every bacterium reproduces by fission, and like flatworkms each one knws what the others know, or they can at least understand each other....than it's a whole big conspiracy, starting with the first bug and growing onwards!!!! Run while you can! Run, I say!

Seriously, people with fear of heights don't take up skydiving, if you are afraid of microbes, you need to go somewhere else. Nothing personal, but go.:wacko:


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## emtashleyb (Dec 1, 2008)

WOW. They warned us in class of what we would be exposed to. Its not just in ems go to a resturant anywhere there are germs. Get educated and always use bsi dont be so paranoid. If its already laid out in your fate your going to get something its going to happen. Im not saying be lax just dont go overboard no reasn to hyperventilate over it. Wash your hands with soap and water, clean off your equipment and dont put dirty gloves in your pockets when your done with them. (seen it happen before). I admit I do not wear my boots in my house and as soon as I close my front door I strip and take my clothes to the washer if Ive been bled, pooped, pissed, spit, vomited on just due to the fact that my kids will stand there and try to jump me like a pack of starving dogs as soon as I get over the baby gate. But there are germs everywhere we cant make the world germ free so get educated and quit freaking out about it if you cant get over the whole hermaphone thing maybe ems isnt for you


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## Brooks416 (Dec 1, 2008)

As said by most here hand washing with soap is the best. This brings back an old wives tale about having to eat a pound of dirt as a kid to stay healthy when you grow up. Hummmmm Builds a good immune system doesn't it.


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## jochi1543 (Dec 1, 2008)

I'm more afraid of getting stabbed or beat up than catching a disease, to be honest. Seems like a much more plausible outcome.


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## Bosco578 (Dec 1, 2008)

*Code Brown*

I'm more worried about my partner farting in the cab.....


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## Sasha (Dec 2, 2008)

You mean they want you, as a health care professional, to touch and deal with SICK people?? Blasphemy!


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## MedicMeJJB (Dec 2, 2008)

I have been a CNA for 6 years in and out of several ECF's and in recently in a hospital on a Med/Surg unit... not to mention being an EMT for 2 years.. I've had pt's with MRSA, VRE, C-DIFF, HIV, HEP, TB... I've never gotten anything for anyone thus far.. and geez we are probably all carriers now for working where we do, I even think my immune system has gotten stronger. Don't be so paranoid, wash your hands, wear your gloves, wash your hands again, ... don't touch your face.. easy enough


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## Mongoose (Dec 4, 2008)

*Exposure*

Didn't they teach you in EMT school that HIV from needlesticks occurs 0.3% of the time? Get your Hep-B shot, that reduces risk by 90% I believe. If I am wrong someone please correct me. Hep-C risk by needlestick is less than 2%. I am unsure of the percentages for MRSA but typically exposure is blown out of proportion by the masses.

Just follow BSI precautions, wash your hands as often as possible. I carry wrap around safety goggles with me at all times, as well as a surgical mask that you can put on a spitter if need be.

As was mentioned before me, I'm more worried about getting shot, stabbed or run over than I am about picking up a gift that keeps on giving.


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## VentMedic (Dec 4, 2008)

Mongoose said:


> Hep-C risk by needle stick is less than 2%. I am unsure of the percentages for MRSA but typically exposure is blown out of proportion by the masses.


 
As for as needle sticks, it depends on how many sticks you do and your typical population although some healthcare workers can be Hep-C positive. Don't let your guard down when using sharp objects or around blood just because they don't fit the typical image of someone who is Hep-C. The Hep-C virus, unlike HIV which is very fragile outside of the host, can remain on a surface for several days or weeks if not properly cleaned. 

You may have to worry a little more if there are still EMT(P)s that leave dirty needles laying around carelessly or if they stick them into the bench or stretcher mattress. That is one of my pet peeves when an engine medic (1 or 4 on a truck) needs sticking practice and hasn't gotten enough experience to also watchout for the safety of others. They may also be doing the stick in someone else's ambulance where they won't be responsible for cleaning up the mess. If a patient is also stuck multiple times, keep track of the needles. It is not uncommon for a few to leave their missed stick needles still in the patient or in the sheets and forget them to where someone in the ED gets stuck later. 

MRSA, VRE and C-Diff are quite common. You are not going to read about an elderly person dying from a staph infection in the newspaper like you would a young person because old people are not news worthy and just "routine nothing calls" to some in EMS. However, just like you are concerned about being stabbed or shot, immunosuppressed and elderly patients have that same fear of getting sick from one of these bacterias or viruses which can also kill them. You must practice good BSI and infection control to protect them as well as yourself. 

You would be surprised as how easily and how deadly even a flu virus is to the elderly or immunosuppressed (includes chemo) population. If you are working sick, keep everything you touch in the patient area clean and wear a mask when you are near the patient. 

Of course, MRSA, VRE and C-Diff are not just for the old and sickly. Some young healthcare workers are carriers of MRSA. They may need to be treated and that is then when the C-Diff gets them after the heavy antibiotic therapy. 

So essentially, you (and the patients) probably have more to worry about from your own co-workers if they lack safe stick practices and haven't bothered to learn about infection control.


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## sixmaybemore (Dec 4, 2008)

EMTinNEPA said:


> Jesus H., what kind of EMT class did you attend?




Well, you know, I have to say that having something in theory and then in practice - it's different. It's new. If you've not worked in the medical field before, then this IS a new and scary experience. It can be overwhelming. And you know what? That's okay. It's okay to give yourself time to get used to all the "rules" of how to keep yourself safe from things a lot of people aren't exposed to on a daily basis. 

To the OP - it's okay. You'll get used to the precautions, and you won't be as scared (well, either that or it becomes a signal that this isn't the field for you).


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## rhan101277 (Dec 5, 2008)

Well you are going to die one day, might as well go out with a bad disease.

Joking aside, just be careful.  Don't give less pt. care because you are scared of contact.


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## jazminestar (Dec 5, 2008)

ha tonight we did a tx: of a lady back to a snf, and the RN at the hospital was like 'okay guys, she has mrsa purcations' i said what kind???  she said in the ulcer aka bed sore on her butt.........i was like 'so basically if i keep my hands off of her butt should be cool right??' then we giggled about it and moved on..........

a friend of mine who works at another company down here in san diego, is super dooper paranoid about everything it seems, and he's thinking he that he might have to reconsider being in this field........

i think everyone has pretty much said all you can do, stay educated, wear your gloves, be aware of cross contamination and don't go kissing your pt's or rubbing your bare hands all over there sores or play with the urine or feces and you should be cool


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