# when is it necessary to...



## surname_levi (Aug 20, 2009)

...crack down on fellow EMT's on the job?

ENJOY!


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## medichopeful (Aug 20, 2009)

This is coming from someone out of the profession, so it may be different from what others say. 

I would say when they put yourself or others in danger, they are breaking the law, or they are acting in an unprofessional manner.  I would talk to them first, then raise it to the next level.


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## el Murpharino (Aug 20, 2009)

surname_levi said:


> ...crack down on fellow EMT's on the job?
> 
> ENJOY!



Care to elaborate?  

To answer in a general sense, earlier rather than later.


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## Shishkabob (Aug 20, 2009)

When it crosses the line.








I win.


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## Sasha (Aug 21, 2009)

Linuss said:


> When it crosses the line.
> 
> 
> 
> ...




When you notice it has the potential to cross the line.


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## Seaglass (Aug 21, 2009)

When it crosses the line. And as the newbie on the squad, when it's very clear-cut and I'm the only one who can do anything.

I've only run into one situation so far. One paramedic hates the new type of gloves we switched to. I don't think it's accidental that he's always forgetting, even when reminded. So, I've learned to grab an extra pair and make a show of giving them to him in front of the patient. Works every time.

I'd report him, but I'm worried I'd lose the job. He's related to the jerk I'd report to, and they're very close. He's been at the company forever with a good reputation, while I'm brand new. And so on...


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## Mountain Res-Q (Aug 21, 2009)

Sasha said:


> When you notice it has the potential to cross the line.



Plus 1

Once it has crossed the line (whatever line that may be)... it is too late but to be someone who did't act quick enough...

Case in point...  I know of two SO Jail Deputies that got canned recently... One of them was commiting every sin in the book... charging off-duty meals (his and friends) on the SO Charge Card (including alcohol), getting bored on prisioner transports and pulling vehicles over at random... just to speed by them laughing his butt off, etc...

His newbie partner is a good person that didn't want to rock the boat... so went along with it...  then they got caught.  They were both canned (with good reason), even though she was a good person that got caught up in someone elses screw-ups.  We have mutual friends, and she is really mad at herself for not coming forward earlier and saving her job and reputation...

Sometimes "When it crosses a line" is too late... the sooner appropriate action is take (appropriate being the key word)... the better!


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## medic417 (Aug 21, 2009)

Seaglass said:


> When it crosses the line. And as the newbie on the squad, when it's very clear-cut and I'm the only one who can do anything.
> 
> I've only run into one situation so far. One paramedic hates the new type of gloves we switched to. I don't think it's accidental that he's always forgetting, even when reminded. So, I've learned to grab an extra pair and make a show of giving them to him in front of the patient. Works every time.
> 
> I'd report him, but I'm worried I'd lose the job. He's related to the jerk I'd report to, and they're very close. He's been at the company forever with a good reputation, while I'm brand new. And so on...



Gloves are not needed with every patient.  I think you are making a big noise over a minor personal choice.


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## daedalus (Aug 21, 2009)

Seaglass said:


> When it crosses the line. And as the newbie on the squad, when it's very clear-cut and I'm the only one who can do anything.
> 
> I've only run into one situation so far. One paramedic hates the new type of gloves we switched to. I don't think it's accidental that he's always forgetting, even when reminded. So, I've learned to grab an extra pair and make a show of giving them to him in front of the patient. Works every time.
> 
> I'd report him, but I'm worried I'd lose the job. He's related to the jerk I'd report to, and they're very close. He's been at the company forever with a good reputation, while I'm brand new. And so on...



Your "education" as an EMT does not prepare you to know when gloves are and are not required other than obvious bodily fluids. The writers of the EMT books know that the level of knowledge sucks so bad that they have to tell you to put gloves on for every patient, because they know that the EMT cannot be expected to know when it is really appropriate. Doctors I shadow and RNs wear gloves only around 30-40 percent of the time they touch patients. Also, you are being very inappropriate by forcing this paramedic to place his gloves on in front of the patient. I second the notion that you are making big noise over something you know nothing about, and you are on your way to being "that guy" at your company who no one will want to work with if you keep it up.


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## harkj (Aug 21, 2009)

i agree with medic 417 when youve worked on an ambulance for awhile you learn when you need gloves and when you dont need gloves....im pretty sure you dont go around everywhere wearing gloves...its a personal choice that you make


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## Seaglass (Aug 22, 2009)

I'm aware that wearing gloves isn't always necessary. But I do mean always, for this guy. Blood visibly stuck under nails sure looks like a risk to the next patient to me... if I'm wrong, I'll gladly stop dealing with it.


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## harkj (Aug 22, 2009)

well no thats not good, but he is the medic and you are the emt you really cant tell him what to do even though blood under the nails is nasty maybe take some germx and pass it to him after a call lol i worked with a medic that never wore gloves even when doing IVs at first i thought nasty but alot of people that i work with tare off the the index and middle finger anyways because the gloves we use are really thick in the finger tips. its really up to him but if you have that big of a problem with it go to him about it and then go from there.


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## hottrotter18 (Aug 22, 2009)

daedalus said:


> Your "education" as an EMT does not prepare you to know when gloves are and are not required other than obvious bodily fluids. The writers of the EMT books know that the level of knowledge sucks so bad that they have to tell you to put gloves on for every patient, because they know that the EMT cannot be expected to know when it is really appropriate. Doctors I shadow and RNs wear gloves only around 30-40 percent of the time they touch patients. Also, you are being very inappropriate by forcing this paramedic to place his gloves on in front of the patient. I second the notion that you are making big noise over something you know nothing about, and you are on your way to being "that guy" at your company who no one will want to work with if you keep it up.



A captain with a large metropolitan department with 30+ years experience has taught me to ALWAYS wear gloves.
It takes what, 10 seconds to put a simple pair of gloves on while in the rig..
As many of you know, when you walk up to the Patient everything may appear fine, but things can deteriorate quickly from a simple fall injury to cardiac arrest and you have to get your hands dirty..
But hey, i believe in leading by example, so good examples you are
just because others don't wear gloves doesn't make it right.


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## Seaglass (Aug 22, 2009)

harkj said:


> well no thats not good, but he is the medic and you are the emt you really cant tell him what to do even though blood under the nails is nasty maybe take some germx and pass it to him after a call lol i worked with a medic that never wore gloves even when doing IVs at first i thought nasty but alot of people that i work with tare off the the index and middle finger anyways because the gloves we use are really thick in the finger tips. its really up to him but if you have that big of a problem with it go to him about it and then go from there.



It's not just IVs--I was weirded out when I saw someone do that for the first time too, but I didn't make an issue of it. It's seriously never. He uses sanitizer and washes his hands, but you can still see some gunk under and around the nails when we get the next patient. 

So far, I've been doing my best to not make a huge deal of it. He doesn't want them for a patient that isn't spewing something? I don't care. We're approaching someone covered in slime? Then I'll smile and hand them to him along with whatever else he needs. Interestingly, it doesn't happen if we're around medics or higher, but other basics have noticed it.

I've tried bringing it up, but he won't talk. The most I've gotten out of him is that he "doesn't have allergies," but he hates them because they make his hands itch. 

My problems with it are mainly because of patient care, but also because I'm worried about keeping my job. We're supposed to report coworkers who violate company policy. I don't know how strict they are about that yet, but I really don't care to find out the hard way.


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## harkj (Aug 22, 2009)

its not up to you whether your partner wants to wear gloves or not its all up to them thats the thing its personal preference.


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## JPINFV (Aug 22, 2009)

hottrotter18 said:


> A captain with a large metropolitan department with 30+ years experience has taught me to ALWAYS wear gloves.
> It takes what, 10 seconds to put a simple pair of gloves on while in the rig..
> As many of you know, when you walk up to the Patient everything may appear fine, but things can deteriorate quickly from a simple fall injury to cardiac arrest and you have to get your hands dirty..
> But hey, i believe in leading by example, so good examples you are
> just because others don't wear gloves doesn't make it right.



Remind your physician to wear gloves during the entire exam next time you go for a check up. Make sure to tell him that your fire captain said to always wear gloves when dealing with patients.


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## PinkEMT23 (Aug 22, 2009)

*Wearing Gloves*

Personally I woudn't care what my partner does. If he wants to get some sort of diease then thats his problem not mine. If it is company policy to always wear gloves and you are afraid of getting in trouble. Talk to your partner and tell him that if this doesn't get resolved between the two of you then you will have to solve it another way. If your partner respects you as a person and an EMT he will not continue to do something that bothers you.


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## JPINFV (Aug 22, 2009)

PinkEMT23 said:


> Personally I woudn't care what my partner does. If he wants to get some sort of diease then thats his problem not mine. If it is company policy to always wear gloves and you are afraid of getting in trouble. Talk to your partner and tell him that if this doesn't get resolved between the two of you then you will have to solve it another way. If your partner respects you as a person and an EMT he will not continue to do something that bothers you.



So, wait a minute. If my partner wants me to do something that has absolutely nothing to do with my partner, then it's disrespectful to not follow an ultimatum?


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## PinkEMT23 (Aug 22, 2009)

Your partner is like family. I don't know about you but where I work I spend more time with my partner than I do my own husband. My partner would never do something if he knew I felt uncomfortable about it. I understand that old school medics didn't wear gloves back then. That just wasn't something that they felt was really needed. If it is a company policy it doesn't matter who is uncomfortable with what. Policy is Policy....I'm not getting in trouble for something someone else is doing. And when you do something wrong your partner gets in trouble its called being a team.


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## harkj (Aug 22, 2009)

PinkEMT23 said:


> Your partner is like family. I don't know about you but where I work I spend more time with my partner than I do my own husband. My partner would never do something if he knew I felt uncomfortable about it. I understand that old school medics didn't wear gloves back then. That just wasn't something that they felt was really needed. If it is a company policy it doesn't matter who is uncomfortable with what. Policy is Policy....I'm not getting in trouble for something someone else is doing. And when you do something wrong your partner gets in trouble its called being a team.



i dido that


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## Sasha (Aug 22, 2009)

So all you smarty pants are telling me that not only do you know what a ickies patient may or may not have immediatly, but you also know there's nothing on your hands that you could've picked up somewhere and are now bringing to an immunosupressed patient?

Gloves are not just for your protection, but the protection of the patient as well.

They take two seconds, why not wear them even when they aren't needed? It's just another safe guard between you and the patient to benefit both of you.


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## medic417 (Aug 22, 2009)

Sasha said:


> smarty .



ummmmmmm  smarties!!!!!!!!!!!!!!!


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## Sasha (Aug 22, 2009)

Ooooh candy!!!


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## JPINFV (Aug 22, 2009)

Sasha said:


> So all you smarty pants are telling me that not only do you know what a ickies patient may or may not have immediatly, but you also know there's nothing on your hands that you could've picked up somewhere and are now bringing to an immunosupressed patient?
> 
> Gloves are not just for your protection, but the protection of the patient as well.
> 
> They take two seconds, why not wear them even when they aren't needed? It's just another safe guard between you and the patient to benefit both of you.



It's a question of balance and thought. Does your physician know what you have/don't have when he comes in and shakes your hand at the beginning of an office visit? Now, sure, I'm all for wearing gloves pending an evaluation of the situation, but after an evaluation is done based on the ickyness of the patient (hopefully the provider is practicing good hygiene), a decision about gloves could be made on an informed level.

For additional thought, I'll post the same survey I posted in a thread about hygiene and osteopathic manipulation lab on SDN.

Quick survey.

1. T/F Our bodies have an entire army devoted to killing tiny weeny bad guys?

2. Y/N I wash my hands between paying for fast food and sitting down to eat.

3. Y/N When getting drive through, I always wash my hands between paying and eating.

4. Y/N I understand that money, and by connection my wallet, are very dirty thing.

5. T/F I don't live in a plastic bubble insulating myself from the outside world.



The really is an option between 'never wear gloves' and the nuclear option of 'always wear gloves.'


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## Sasha (Aug 22, 2009)

*1. T/F Our bodies have an entire army devoted to killing tiny weeny bad guys?* My body does, but how do I know my patient's has a normal immune system? How do I know that they are not immunosupressed and the icky I just picked up from the ambulance door handle is not going to land them a lengthy hospital stay?

2. *Y/N I wash my hands between paying for fast food and sitting down to eat. *Yup. I wash or sanitize my hands prior to eating.

3. *Y/N When getting drive through, I always wash my hands between paying and eating*. Yes sir, I do. I have hand sanitizer if I am eating on the go. But was that not covered in the previous question? 

4. *Y/N I understand that money, and by connection my wallet, are very dirty thing.* You are getting redundant, my dear friend. Can you not think of better arguments? I understand all of the above.

5. *T/F I don't live in a plastic bubble insulating myself from the outside world.* You don't have to live in a plastic bubble to understand that gloves are not only for your protection but the protection of the patients. We are not talking about a doctor's office visit where there is a chart and a history presented to you, we are talking about emergent or urgent situations.

There is a good middle, and I'm not talking about using gloves for everything from pushing the stretcher to opening doors etc. I am talking about direct patient care. Gloves are such a simplisitc device and an additional safeguard between you and your patient, it takes a few seconds to put them on. So why on earth would you argue against them?


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## NEMed2 (Aug 22, 2009)

How I love the debates about gloves & PPE. 
I generally put my gloves on as I am walking up to the pt.  That being said, do I wear them *every* time? No. Do I sometimes take them off after I get into the ambulace, only to take a bp or provide some care that doesn't require my touching body fluids. Sure.  But I also use hand sanitizer before I touch a pt without gloves on. And I wash my hands after every call.  I'm not going to ride around wearing gloves 24/7 just in case I get a pt that is ucky.  Who knows what I touched after putting my gloves on but before I get to the pt. Is it ideal to wear gloves every time you have pt contact? Yes. Is that reality for most? Not even close.

Seaglass-  Is is possible that now your partner isn't as conscious of grabbing a pair of gloves, knowing that you have a spare in your pocket that you will hand him if the pt is ucky? Try having a conversation with them, again, about it.  Make it a topic that can't be avoided.  Maybe they don't know how you feel about it and would take it into consideration.  Or, maybe your partner will think your still a little green and laugh it off.  At least then you will know.

It is necessary to... report another EMT if they are more f-ed up than your pt.  Sorry, but if you're coming to work hammered or after what looks like a week long moon shine bender, you are asking to be reported, disciplined/fired, and lose your cert.  I have a thing against someone consciously endangering their partner, pt and innocent bystanders.  There are a ton other reasons to report someone, but that is my little pet peeve.


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## harkj (Aug 22, 2009)

I prefer to wear gloves when its needed but not all the time and germs are everywhere whether your working or not


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## PinkEMT23 (Aug 22, 2009)

*Gloves*

I agree with harkj and ventmedic. When you are shopping at the store pushing a buggy around you don't wear gloves. We go on many calls where gloves aren't needed because you may never even get close enough to the patient to need them. That is unless you force every pt you come in contact with to go to the hospital. I never said I didn't think gloves should be worn. I don't always wear them but I don't put them on until I know they are needed. With that said don't worry what your partner does. Protect yourself. No matter what anyone says about the crew's safety comes first. You come before your partner. If you don't protect yourself how can you protect your partner or anyone else. I mostly have a tendency to not wear gloves with little kids. I don't know about you but when I was a child going to the doctor scared the crap out of me so I try to make kids as comfortable as possible. Not scare them with gloves. But once again like I said before....BSI is very important but if you are going to choose not to wear them on every call, for the entire call make sure you use good judgment.


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## HotelCo (Aug 22, 2009)

JPINFV said:


> Remind your physician to wear gloves during the entire exam next time you go for a check up. Make sure to tell him that your fire captain said to always wear gloves when dealing with patients.



I make my doctor wear gloves during an examination. If he touches me without them, chances are he does it with other patients.


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## BruceD (Aug 23, 2009)

Physician would be a bit of a different scenario

In addition to having prior medical information on almost every patient encountered, they have the facilities & time to wash/sanitize hands before and after every patient and are also seeing patients (for the most part) in very controlled environments where sudden surprises like kneeling down in a puddle of fluids are not as likely.

Just a thought...
-B


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## JPINFV (Aug 23, 2009)

How often are you kneeling down in blood? Seriously now. Not every call (in fact a very small minority) are multisystem traumas with puddles of blood that you're sloshing around. Regardless, there's still those moments between being able to see the scene and actually ariving at the patients side that would give you the opertunity to decide on a proper course of action in terms of PPE. 

Besides, where are you going that lacks proper hand washing facilities. Every emergency room, nursing home, assisted living facility, and every other care facility I've ever been to has had a sink. Every ambulance I've been on have had some sort of hand sanitizer.


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## PinkEMT23 (Aug 23, 2009)

I don' t know what podunk town you live in but mva's, shootings, stabbings, etc happen where I work at least 5 of every 10 calls. One year where I work counts as 3 years experience anywhere else due to the high call volume and all the trauma we have. My towns first homicide happened while I was sleeping at the station across the street so dancing around in blood is nothing uncommon around here. That said, I wear my gloves and always bring extra uniforms with me. I wouldn't want my family getting into an ambulance or being handled by a medic or emt that is nasty. This all boils down to you do what you have to do to protect yourself and your patient. If your partner don't want to comply that's his or her problem not yours . You did your job by trying to help but if they don't want to listen, you can tell them till your blue in the face and they aren't going to do it until they want to themselves.


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## medic417 (Aug 23, 2009)

PinkEMT23 said:


> I don' t know what podunk town you live in but mva's, shootings, stabbings, etc happen where I work at least 5 of every 10 calls. .



I have to throw the BS flag.  There is no system in the USA that at least 50% of their calls are serious trauma as you are claiming yours are.  You may have a busy system that gets a lot of calls for serious trauma but I bet you are probably just like everyone else that gets 90% of calls that the patients could and probably should have gone by private car to the ER and probably just to a clinic for most of them.   

Until you provide documentation flag stays in place.


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## JPINFV (Aug 23, 2009)

PinkEMT23 said:


> I don' t know what podunk town you live in but mva's, shootings, stabbings, etc happen where I work at least 5 of every 10 calls. One year where I work counts as 3 years experience anywhere else due to the high call volume and all the trauma we have. My towns first homicide happened while I was sleeping at the station across the street so dancing around in blood is nothing uncommon around here. That said, I wear my gloves and always bring extra uniforms with me. I wouldn't want my family getting into an ambulance or being handled by a medic or emt that is nasty. This all boils down to you do what you have to do to protect yourself and your patient. If your partner don't want to comply that's his or her problem not yours . You did your job by trying to help but if they don't want to listen, you can tell them till your blue in the face and they aren't going to do it until they want to themselves.




Let's assume that number is right. What do those calls come in as, elderly patient fall down/go boom? I highly doubt that you come rolling up to a massive traumas most of the time thinking it's something simple, especially gun and knife club patients. The only thing I'm advocating is using your brain, not sticking a carrot in your ear and going, "Durr, I'm frail, all of my patients are bleeding out and have Hep C, HIV, MRSA, and every other assorted disease possible." There's a middle ground where people who choose the nuclear option generally fail to see. It's exactly the same issue with people who are against selective spinal immobilization and want to back board everyone with trauma.


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## Sasha (Aug 23, 2009)

> Besides, where are you going that lacks proper hand washing facilities. Every emergency room, nursing home, assisted living facility, and every other care facility I've ever been to has had a sink. Every ambulance I've been on have had some sort of hand sanitizer



Why would you even need to wash your hands if nothing on your hand was a danger to the patient and nothing on them is a danger to you? 



> "Durr, I'm frail, all of my patients are bleeding out and have Hep C, HIV, MRSA, and every other assorted disease possible."



I think you are failing to see gloves are not just for your protection but the patient's as well.


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## HotelCo (Aug 23, 2009)

If you don't wear gloves when touching a patient, you're a fool. End of story.


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## JPINFV (Aug 23, 2009)

You wash your hands because of simple hygene. Patients touch everything in a facility. Does anyone wear gloves the entire time they are in a health care facility? Patients aren't confined to their rooms, so the entire facility is going to be cross contaminated with patient germs, so for the entire 'gloves every patient, every time,' argument to be truely valid, then gloves need to be worn from before you enter a facility until you leave the facility. 


Yes, gloves protect the patient, but the vast majority of patients have immune systems also and aren't living in negative pressure isolation rooms. They are going to be exposed to the same things everyone else is just by simply walking around their facility. Healthcare facilities may be 'clean,' but the vast majority of facility patient care space is anything but sterile.


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## JPINFV (Aug 23, 2009)

HotelCo said:


> If you don't wear gloves when touching a patient, you're a fool. End of story.



How about we keep this to a logical discussion and not revert to name calling? Mmmkay?


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## HotelCo (Aug 23, 2009)

JPINFV said:


> How about we keep this to a logical discussion and not revert to name calling? Mmmkay?



It's the way I view the subject, so I said it.


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## JPINFV (Aug 23, 2009)

Then the logical conclusion is that anyone who doesn't wear gloves in public is a fool too. 'Healthy' people have germs too afterall.


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## HotelCo (Aug 23, 2009)

JPINFV said:


> Then the logical conclusion is that anyone who doesn't wear gloves in public is a fool too. 'Healthy' people have germs too afterall.



If you want to take it that far, be my guest.


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## JPINFV (Aug 23, 2009)

Well, do you know what the last 5 people to walk open the door at a commercial venue (say, a 7-11) had? When the last time the door was really cleaned? Same goes for the last 5 people who handled the dollar bills in your wallet. Why bet on them and bet against all patients?


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## HotelCo (Aug 23, 2009)

JPINFV said:


> Well, do you know what the last 5 people to walk open the door at a commercial venue (say, a 7-11) had? When the last time the door was really cleaned? Same goes for the last 5 people who handled the dollar bills in your wallet. Why bet on them and bet against all patients?



Good point. Let's just throw PPE out the window.


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## rescue99 (Aug 23, 2009)

HotelCo said:


> Good point. Let's just throw PPE out the window.



Think I'm gettin a phobia!!! :wacko:


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## JPINFV (Aug 23, 2009)

HotelCo said:


> Good point. Let's just throw PPE out the window.



False dichotomy.  Should systems that practice selective spinal immobilization just not immobilize anyone then?


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## HotelCo (Aug 23, 2009)

JPINFV said:


> False dichotomy.  Should systems that practice selective spinal immobilization just not immobilize anyone then?



Are you saying that we should pick and choose which patients we wear gloves with, and not use them during all patient contact?


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## JPINFV (Aug 23, 2009)

Do you pick and choose which patients get oxygen? Spinal immbolization? 

Yes. I say that just the rest of the PPE, glove use should be based on (or a better wording, discontinued based on) the providers assessment of the situation. Do you wear goggles, N-95, and a gown on every patient contact or is the decision to use those aspects of PPE based on an assessment of the patient?


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## HotelCo (Aug 23, 2009)

JPINFV said:


> Do you pick and choose which patients get oxygen? Spinal immbolization?
> 
> Yes. I say that just the rest of the PPE, glove use should be based on (or a better wording, discontinued based on) the providers assessment of the situation. Do you wear goggles, N-95, and a gown on every patient contact or is the decision to use those aspects of PPE based on an assessment of the patient?



Additional PPE is based upon my assessment of the situation. Gloves are a minimum on all calls.


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## JPINFV (Aug 23, 2009)

...but you don't know if the patient coughs. What if you catch something because the patient unexpectedly coughs and you weren't wearing a mask?


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## HotelCo (Aug 23, 2009)

JPINFV said:


> ...but you don't know if the patient coughs. What if you catch something because the patient unexpectedly coughs and you weren't wearing a mask?



I get where you're going, and it doesn't matter. I'm still going to wear gloves during every call.


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## JPINFV (Aug 23, 2009)

Ok... and I'm not saying you aren't. Especially if you aren't using latex, you won't -harm- a patient wearing gloves. On the other hand, I'm not going to condone giving someone a hard time if they take a BP without gloves on.


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## HotelCo (Aug 23, 2009)

JPINFV said:


> Ok... and I'm not saying you aren't. Especially if you aren't using latex, you won't -harm- a patient wearing gloves. On the other hand, I'm not going to condone giving someone a hard time if they take a BP without gloves on.



It's a personal choice. However, it's my opinion that you should wear them during all patient contact.


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## Pudge40 (Aug 23, 2009)

harkj said:


> i agree with medic 417 when youve worked on an ambulance for awhile you learn when you need gloves and when you dont need gloves....im pretty sure you dont go around everywhere wearing gloves...its a personal choice that you make



Hmm funny all the people I have ever run with at my service wears gloves for EVERY patient BEFORE we make patient contact.


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## Pudge40 (Aug 23, 2009)

JPINFV said:


> Well, do you know what the last 5 people to walk open the door at a commercial venue (say, a 7-11) had? When the last time the door was really cleaned? Same goes for the last 5 people who handled the dollar bills in your wallet. Why bet on them and bet against all patients?



Well since you could be exposed to someone else's saliva on a door handle I guess we can do away with pocket masks and BVMs too.


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## Luno (Aug 23, 2009)

*The Breaks...*

Okay, in my opinion, it is never your job as an EMT to "crack down" on another EMT of equal rank/responsibility.  Educate, provide constructive criticism, request compliance with known directives, etc... are all acceptable, however a "crack down" is above your paygrade, over stepping your boundaries, and you may be "cracked back" simply because you have assumed more responsibility than you are granted and may handle.  I've seen this usually from "sophomoric" providers who truely live up to the meaning of "wise fool."  Give a provider 6mo-12mo and a few hundred patients, they think they know it all, yet another year, and they realize how much they didn't know.  Yes, I was one of those as well, and I was reminded to step back into my preassigned place.  Having moved on to management, I am able to look back and see the error of my particular ways, and while I thought I was helping, I was actually hindering the learning process.


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## daedalus (Aug 23, 2009)

HotelCo said:


> If you don't wear gloves when touching a patient, you're a fool. End of story.


Actually you demonstrate ignorance (used in a respectful tone) of the function of the integumentary system, of microbiology, and of the proper use of PPE if you use gloves on every patient. HotelCo, I see a pattern in your postings on this forum and they are generally negative and rarely supported by facts. Your post is just the kind of post that causes tempers to flare and results in a locked thread where we could have otherwise had intelligent discussion and carried the thread to a proper end. Why call others a fool? I think that we would all have a friendlier conversation if we were face to face in a bar


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## Sasha (Aug 23, 2009)

daedalus said:


> Actually you demonstrate ignorance if you use gloves on every patient. HotelCo, I see a pattern in your postings on this forum and they are generally negative and rarely supported by facts.



You must be confusing ignorance for caution!


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## HotelCo (Aug 23, 2009)

daedalus said:


> Actually you demonstrate ignorance if you use gloves on every patient. HotelCo, I see a pattern in your postings on this forum and they are generally negative and rarely supported by facts.



Because most of my posts are opinions. 

Perhaps I'm a negative person? I don't know. lol


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## HotelCo (Aug 23, 2009)

daedalus said:


> Actually you demonstrate ignorance of the function of the integumentary system, of microbiology, and of the proper use of PPE if you use gloves on every patient. HotelCo, I see a pattern in your postings on this forum and they are generally negative and rarely supported by facts. Your post is just the kind of post that causes tempers to flare and results in a locked thread where we could have otherwise had intelligent discussion and carried the thread to a proper end.



Well, I apologize if I am causing tempers to flare. I certainly don't mean to start and fights. I also try not to beat around the bush when it comes to my views.

I'm probably religious about wearing gloves during patient contact because I often have cuts and scrapes on my hands.


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## daedalus (Aug 23, 2009)

Sasha said:


> You must be confusing ignorance for caution!



No. The skin is designed as our first defensive line against infection. The multiple layers protect our insides, and sebum is slightly acidic and destroys pathogens. Tears and saliva contain enzymes which battle pathogens as well. The use of gloves on every patient drives up costs for your service and wastes supplies, increases your own risk of an allergy, makes patients feel like aliens, and is just unnecessary.


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## Sasha (Aug 23, 2009)

daedalus said:


> No. The skin is designed as our first defensive line against infection. The multiple layers protect our insides, and sebum is slightly acidic and destroys pathogens. Tears and saliva contain enzymes which battle pathogens as well. The use of gloves on every patient drives up costs for your service and wastes supplies, increases your own risk of an allergy, makes patients feel like aliens, and is just unnecessary.



Skin gets broken. My cuticles, for example, are always torn. Some patients don't have the best immune system. It is unnecessary in your own view, but do we have to name call and make wild accusations based on the fact someone chooses to be cautious when using gloves?


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## fma08 (Aug 23, 2009)

daedalus said:


> No. The skin is designed as our first defensive line against infection. The multiple layers protect our insides, and sebum is slightly acidic and destroys pathogens. Tears and saliva contain enzymes which battle pathogens as well.



People still get sick through out the year correct? Your skin is not only the first line defense, but also the habitat of many different species of bacteria, and in some people's case, other organisms as well. The gloves are not just for our protection, but protection for the patients as well.


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## Sasha (Aug 23, 2009)

fma08 said:


> People still get sick through out the year correct? Your skin is not only the first line defense, but also the habitat of many different species of bacteria, and in some people's case, other organisms as well.* The gloves are not just for our protection, but protection for the patients as well*.



That sentence looks oddly familiar.


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## fma08 (Aug 23, 2009)

Sasha said:


> That sentence looks oddly familiar.



It was so good, I thought I'd go ahead and restate it for emphasis.


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## Sasha (Aug 23, 2009)

fma08 said:


> It was so good, I thought I'd go ahead and restate it for emphasis.



Maybe someone will actually listen to it now.


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## fma08 (Aug 23, 2009)

Sasha said:


> Maybe someone will actually listen to it now.



Wouldn't count on it.


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## medic_texas (Aug 23, 2009)

The skin is our first line of protection from infection however if you do not wash your hands well, clean your equipment GREAT, and practice good general hygiene overall, I think you will find yourself getting sicker more than others. 

I see a lot of medics run a call, keep their gloves on (the same ones they used to assess, load, and treat with) and drive to the hospital, never removing their gloves.  

So when YOU get back into the truck and drive the truck, you're touching all of the germs your partner left for you from the last call.


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## Seaglass (Aug 25, 2009)

Thanks for the advice, everyone.

So, I tried talking with that medic again. I got the same answer with a few more details. The new gloves make his hands itch, and overwashing or lots of hand sanitizer makes them dry and crack. He's not too worried about running into immune-suppressed patients, and never gets sick himself. 

The immune suppression thing isn't true. We run elderly, HIV+, chemo, and all sorts of other people who get sick easily fairly often. But I wasn't going to make it an argument, since I'm new.

So, I talked with one of the basics who'd had the same issue with this medic. Then we talked to the supply guy. Long story short, stocking a box of latex gloves isn't going to be an issue. I'm also grabbing a little bottle of unscented lotion and putting it by the hand sanitizer. We'll see how it goes. 

By the way... it's possible to be allergic to anything, but has anyone ever seen anyone allergic to nitrile gloves? He says he has no allergies, but if his hands always itch when he wears them...


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## Sasha (Aug 25, 2009)

Seaglass said:


> Thanks for the advice, everyone.
> 
> So, I tried talking with that medic again. I got the same answer with a few more details. The new gloves make his hands itch, and overwashing or lots of hand sanitizer makes them dry and crack. He's not too worried about running into immune-suppressed patients, and never gets sick himself.
> 
> ...



Are the gloves the kind with aloe on the inside, by chance? We have some crazy nitrile gloves floating around with aloe on the inside to keep your hands from drying out (It just makes them wet and oily!) that make MY hands itch for some reason.


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## Seaglass (Aug 25, 2009)

Sasha said:


> Are the gloves the kind with aloe on the inside, by chance? We have some crazy nitrile gloves floating around with aloe on the inside to keep your hands from drying out (It just makes them wet and oily!) that make MY hands itch for some reason.



Nope--I've seen those, but we don't use them. Glad about that, since they are pretty gross. We just use plain nitrile, far as I know. Though I keep meaning to take a look at the box and make sure of that.


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## exodus (Aug 25, 2009)

Sasha said:


> Are the gloves the kind with aloe on the inside, by chance? We have some crazy nitrile gloves floating around with aloe on the inside to keep your hands from drying out (It just makes them wet and oily!) that make MY hands itch for some reason.



I love those gloves!!! The green ones right?


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## exodus (Aug 25, 2009)

When your partner gets pulled over with a patient in the back. (This happened last week or the week before)
When your partner forgets things excessively.
When your partner relies on GPS 100% (And it fails most the time)


I am no longer working with this partner as of Sunday :]


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## firecoins (Aug 25, 2009)

90% of US curreny has traces of cocaine. I must be an addict.  Wonder if we should wear gloves when handling cash.


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## Seaglass (Aug 25, 2009)

exodus said:


> When your partner gets pulled over with a patient in the back. (This happened last week or the week before)
> When your partner forgets things excessively.
> When your partner relies on GPS 100% (And it fails most the time)
> 
> ...



That's really bad. Did he get ticketed?


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## JPINFV (Aug 25, 2009)

firecoins said:


> 90% of US curreny has traces of cocaine. I must be an addict.  Wonder if we should wear gloves when handling cash.



I guess only if the money called an ambulance to go to the emergency room.


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## Seaglass (Aug 25, 2009)

firecoins said:


> 90% of US curreny has traces of cocaine. I must be an addict.  Wonder if we should wear gloves when handling cash.



Absolutely. It's a filthy and corrupting influence, doncha know.


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## exodus (Aug 25, 2009)

Seaglass said:


> That's really bad. Did he get ticketed?



Nah, he got a lecture from the cop, and then from me. And then from the PT, and then from our Sup. He drove the wrong way down a road (He was following GPS, whaddya know), thankfully it was around 2am so nobody was on it...

EDIT: Since then I've taken GPS away from him.


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## Seaglass (Aug 25, 2009)

exodus said:


> Nah, he got a lecture from the cop, and then from me. And then from the PT, and then from our Sup. He drove the wrong way down a road (He was following GPS, whaddya know), thankfully it was around 2am so nobody was on it...
> 
> EDIT: Since then I've taken GPS away from him.



Non-critical patient, I'm guessing? 

I hate GPS systems. They're helpful when they work, but when they don't, it can be really bad, and a few people I run with barely know how to use the book we carry for backup. A fire department I know had so much trouble when they switched over to GPS that they're now back on map plates, maybe forever.


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## Sasha (Aug 25, 2009)

Seaglass said:


> Non-critical patient, I'm guessing?
> 
> I hate GPS systems. They're helpful when they work, but when they don't, it can be really bad, and a few people I run with barely know how to use the book we carry for backup. A fire department I know had so much trouble when they switched over to GPS that they're now back on map plates, maybe forever.



Keep your GPS' maps up to date and it shouldn't be a problem. I used a GPS when I worked private IFT (Still cannot for the life of me use a map book.), and we went all over the state with no problem.


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## Sasha (Aug 25, 2009)

exodus said:


> Nah, he got a lecture from the cop, and then from me. And then from the PT, and then from our Sup. He drove the wrong way down a road (He was following GPS, whaddya know), thankfully it was around 2am so nobody was on it...
> 
> EDIT: Since then I've taken GPS away from him.



I'm wondering what gives you the right, since I presume you are both basics, to lecture him and take things away from him?


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## wyoskibum (Aug 25, 2009)

Sasha said:


> I'm wondering what gives you the right, since I presume you are both basics, to lecture him and take things away from him?



LOL! Playing "Devils Advocate" I see!


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## Sasha (Aug 25, 2009)

Let me change that. Persuming you are both normal field employees and one of you is not a supervisor since I don't believe a paramedic is the boss of anything but patient care and does not have the right to lecture the EMT.


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## exodus (Aug 25, 2009)

Sasha said:


> I'm wondering what gives you the right, since I presume you are both basics, to lecture him and take things away from him?



Experience on him to lecture why map books are important, and I have the right to take the GPS away from him because it is mine.  GPS is updated, it's just a cheap model and really slow. It works fine if you use common sense and don't look at the map portion of the GPS, but strictly listen to distances coming up and street names.

Oh yeah, not using it to get the freeway also helps when you're in an area you know.


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## Seaglass (Aug 25, 2009)

Sasha said:


> Keep your GPS' maps up to date and it shouldn't be a problem. I used a GPS when I worked private IFT (Still cannot for the life of me use a map book.), and we went all over the state with no problem.



I think the county has to update it for us, though I'm not really sure. And we're supposed to memorize the main roads of our response area, anyways. It's not that hard here.



			
				Sasha said:
			
		

> Let me change that. Persuming you are both normal field employees and one of you is not a supervisor since I don't believe a paramedic is the boss of anything but patient care and does not have the right to lecture the EMT.



Self-preservation? h34r:


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