# Decon. Decon



## RookieRescue1 (Aug 19, 2012)

Looking for a decontamination spray to use on my uniform in between calls. I just started working as an EMT a week ago and I really concerned about spreading contaminates especially when I'm visiting my mom, who has weak lungs or my girlfriend, whose nephew is 3 years old. Any suggestions?

Also a decontamination spray for the gurney would be nice, one that doesn't contain bleach.


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## Veneficus (Aug 19, 2012)

Don't get dirty and wash you hands with soap.


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## JakeEMTP (Aug 19, 2012)

If a spray existed for your uniform, it probably would also have some very toxic side effects.  

After work, remove your dirty uniform, wash up and put on clean clothes before visiting family and friends. You should not be wearing your uniform, especially after a long shift of patient contact while off duty anyway. 

If you must see a family member while on duty, make sure you have washed your hands well and don't hug them while wearing your uniform. 

If your family wants to see you in uniform, put on a clean one or take a picture of yourself for them to look at.  

To be dirty, the dirt or bacteria that you are carrying does not have to be visible. Some do believe their hands are not dirty unless they actually see something.


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## DrParasite (Aug 19, 2012)

JakeEMTP said:


> You should not be wearing your uniform, especially after a long shift of patient contact while off duty anyway


but the ladies love me when I go to the bar after work, that EMT patch is like a total chic magnet!!!!

on a more serious note, change your uniform in between shifts.  if they get dirty, change your uniform.  always carry a spare uniform in your car.  wash your hands and use the alcohol cleaner between patient contacts.


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## Joe (Aug 19, 2012)

Those little cavi wipes (or whatever they are called. Red,purple,or green top) wipes seem to do the job amd they havent faded my crappy poly uniform. I guess if your that concerned lysol your self after every contact. I have had partners do that.


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## JakeEMTP (Aug 19, 2012)

Joe said:


> Those little cavi wipes (or whatever they are called. Red,purple,or green top) wipes seem to do the job amd they havent faded my crappy poly uniform. I guess if your that concerned lysol your self after every contact. I have had partners do that.



There seems to be some lack of education when it comes to infection control.

Having any of that stuff on you close will not be good for someone coming into contact with you who has breathing problems or who is a small child. 
If you read the instructions,  these things are meant for hard surfaces for the product to make contact with totally. Neither are meant for cloth.
For some bacteria and viruses a bleach product is required. That also would not be good on a uniform. 

The best thing you could do for your partners and their patients is to ask for more training on infection control and safe practices that will not be harmful to them or their patients.


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## Veneficus (Aug 19, 2012)

JakeEMTP said:


> There seems to be some lack of education when it comes to infection control.
> 
> The best thing you could do for your partners and their patients is to ask for more training on infection control and safe practices that will not be harmful to them or their patients.



Exactly this.

Although I do subscribe to the idea of reasonable exposure to developing immune systems. 

I also go with the theory that if I think I am an infection risk to hugging a family member then I am an infection risk to myself and it is time to change anyway.


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## Joe (Aug 19, 2012)

I only use the cavi wipes to disinfect blood. Im not head to toe wiping myself down after every call.in a perfect world you should change your uniform after every contact.

About the smell. Do you wipe down the stretcher? Doesnt that smell still linger?  So in theory i shouldnt be wiping down the gurney?


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## Veneficus (Aug 19, 2012)

Joe said:


> I only use the cavi wipes to disinfect blood.



I like 3% h2o2.



Joe said:


> in a perfect world you should change your uniform after every contact.



I respectfully disagree. 

I can see dozens of patients in a shift. Including a multitude of septic ones. If somebody suggested changing scrubs between each of them even if the scrubs are not grossly contaminated I think they would be laughed at and may be informally run through the DSM requirements for OCD and paranoid delusions. 

As something to remember, most tech level healthcare providers are given absolute rules and extreme positions to ensure safety with the understanding they were not given enough initial education to make reasonable decisions.

Overtime, experienced providers develop exceptional ability in "not getting dirty"

in bypass and valve repair/replacement surgery, it is considered "elegant" the peak of skill and efficency not to get even a drop of blood on anything except your gloves and wound margins. (which are properly cleaned prior to taking the patient to post op)

If there is an increased risk of infection in the back of an ambulance, than an increased level of BSI is in order. Including putting masks or other coverings on patients as well as providers.

Scrubbing yourself down afterword implies you already got something on you. (not to mention borders on psychotic)

Considering that most opportunistic infections are opportunistic from natural flora, what do you expect to catch?

Do you scrub yourself down everytime you handle money? Because that is some dirty stuff. It is usually off the charts for bacteria and fungi when tested.

Wash your hands and don't get stuff on you.


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## Aidey (Aug 19, 2012)

RookieRescue1 said:


> Also a decontamination spray for the gurney would be nice, one that doesn't contain bleach.



Why? We use bleach for a reason. Some things are only killed by bleach, or only killed in a reasonable amount of time by bleach. 

Ever had norovirus? Trust me, once you have you will understand why we use bleach.


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## RookieRescue1 (Aug 19, 2012)

All good suggestions, thanks. Changing clothes and showering up is the best option, only thing is my station is ghetto and we don't have one. If they did, I'd just shower up there and put my uni in garbage bag. I guess I'll just have to bring extra clothes to change into after my shift and wash my hands really well.. lol


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## RookieRescue1 (Aug 19, 2012)

All good suggestions, thanks. Changing clothes and showering up is the best option, only thing is my station is ghetto and we don't have one. If they did, I'd just shower up there and put my uni in garbage bag. I guess I'll just have to bring extra clothes to change into after my shift and wash my hands really well.. lol 

N I just whether a spray to cut down on waste. I hear there is one that you don't have to scrub to work.


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## JakeEMTP (Aug 19, 2012)

Veneficus said:


> I like 3% h2o2.
> 
> 
> 
> ...



In a hospital?   CDC guidelines for MDRO patients suggest isolation and isolation covers to protect the scrubs. Isolation stethoscopes and separate equipment are used.  It is not being paranoid but an awareness of how easily some bacteria are spread. If you ever get a chance to work in some specialty areas like transplant, CV Surg units, some ORs and neonatal units, they may ask you wear their scrubs. Many will have their own lounges and the employees do not leave the area. 

Lab coats are not encouraged in the hospital and you will find doctors leaving the ties at home which once were a requirement for residents to wear at the bedside. 

Hands are also scrubbed and it is not paranoid to wash your own body in a shower after work. Many hospitals provide that for their employees. It is just commonsense and there have been enough data from people and items being cultured. 

While a young health 20 y/o EMT probably won't catch anything easily unless they do have a wound that is open, you must think of the patients.  They are the ones who are at risk.  

Letting your guard down and forgetting about basic protection leads to the consequences which can be a financial hit for the employer in a hefty fine and the loss of life as someone knew it if an infection is acquired through carelessness.

The ambulance is not an Operating room where you are doing open heart surgery where the air is filtered many times over and every piece of equipment is cleaned, all the staff are gowned, wearing hair bonnets and booties as well as the cutting instruments being sterilized.  The surgical site with the surrounding skin is also cleaned. There is absolutely no way you can compare an OR and ambulance.


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## RookieRescue1 (Aug 19, 2012)

Anyone heard of odoban, Lysol Neutra Fabric Mist, or Febreze, antimicrobial? . All of them claim to kill 99% bacteria, a list of viruses, and it's safe to use on fabrics?


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## DrParasite (Aug 19, 2012)

Veneficus said:


> I like 3% h2o2.


which would be great, except h2o2 is an extremely poor antiseptic; it doesn't kill anything.  but it does bubble up and foam, and it's a great way to identify if something is contaminated with blood.  applying h202 to blood results in the peroxide changing to water and releasing oxygen.

alcohol is much better at killing the germs and killing anything in blood.


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## Tigger (Aug 19, 2012)

DrParasite said:


> which would be great, except h2o2 is an extremely poor antiseptic; it doesn't kill anything.  but it does bubble up and foam, and it's a great way to identify if something is contaminated with blood.  applying h202 to blood results in the peroxide changing to water and releasing oxygen.
> 
> alcohol is much better at killing the germs and killing anything in blood.



It does however get the actual blood stain out if applied quickly. We use it to get the blood off of a player's jerseys during games. They wear the special high number "blood jersey" and one of us goes and sprays the soiled one down with h202, gets the blood out, and then uses alcohol to disinfect it before giving it back to the player. Alcohol in itself is a rather poor stain remover.


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## akflightmedic (Aug 19, 2012)

RookieRescue1 said:


> Anyone heard of odoban, Lysol Neutra Fabric Mist, or Febreze, antimicrobial? . All of them claim to kill 99% bacteria, a list of viruses, and it's safe to use on fabrics?



Yeh great idea  (sarcasm)  Start spraying yourself down and see how many allergic reactions or respiratory conditions you aggravate.

Seriously need to do some education and chill out.


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## bigbaldguy (Aug 19, 2012)

This forum seems to have a serious and sudden case of the grumpies. Can we all take it down a notch please.


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## Joe (Aug 19, 2012)

How do you get the smell out of the back of the rig after your friendly urban outdoors man decided to poop his pants before taking a nap in the sun? Im sorry but im going to lysol/febreeze the smell away. There is no amount of time with the doors open that will make that go away. And while im at it, i will febreeze my uniform on the back half of a 48 because i know my pts dont want to smell swamp a$... do you know how many people have had an allergic reaction/ respiratory distress caused by me smelling decent or my rig smelling nice? Id be more worried about the strong sani wipes before i worried about the vanilla sunshine medley that i spray in my rig.

Sorry bbg, didnt see your anti grumpy post before i hit submit. Ive said mybpeace now im out. Back to your regularly scheduled programming


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## Aidey (Aug 19, 2012)

You spray vanilla sunshine medley in my rig and I will be the one killing you.


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## Medic Tim (Aug 19, 2012)

Joe said:


> How do you get the smell out of the back of the rig after your friendly urban outdoors man decided to poop his pants before taking a nap in the sun? Im sorry but im going to lysol/febreeze the smell away. There is no amount of time with the doors open that will make that go away. And while im at it, i will febreeze my uniform on the back half of a 48 because i know my pts dont want to smell swamp a$... do you know how many people have had an allergic reaction/ respiratory distress caused by me smelling decent or my rig smelling nice? Id be more worried about the strong sani wipes before i worried about the vanilla sunshine medley that i spray in my rig.
> 
> Sorry bbg, didnt see your anti grumpy post before i hit submit. Ive said mybpeace now im out. Back to your regularly scheduled programming



You wear the same uniform for 48 hours......
We all have spare uniforms at our primary station if you gets soiled. We are encouraged to not wear our uniforms home or to work. If I am going straight home and am not dirty I usually wear my uniform home. If i have to go somewhere I shower and change at the base. We use detol(sp) or special wipes for our strethchers and equipment. We have a peppermint spray for those really funky calls.


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## Doczilla (Aug 19, 2012)

Ah, i remember the first time I felt truly gross: going to a "welfare check" in a trailor park, where the guy had expired a week ago and thus was marinaing in the oven-like trailer in the florida summer. And of course, we had to go inside to find some I.D. Looked like a bowl of gumbo. 

In my infinite 19-year old wisdom, I decided to throw that uniform in a biohazard bag and chuck in some of those tree-shaped car fresheners for good measure. The next day, when I opened the bag to wash it, i was greeted by the fragrant aroma of strawberries and rotting flesh. To this day, I'm scared to use those things. Someone should take me on Maury.


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## Veneficus (Aug 19, 2012)

JakeEMTP said:


> If you ever get a chance to work in some specialty areas like transplant, *CV Surg units*,* some ORs *and* neonatal units,* they may ask you wear their scrubs. Many will have their own lounges and the employees do not leave the area.



:rofl: 

Actually, they are all controlled units and we have seperate scrubs for the ORs (nice bright red) with limits on where you can actually go with them. (which is pretty much preop, OR, post op, and the locker room)

Then you have to change into either the white or green ones respectively.

Using isolation equipment is not the same as changing your uniform. Nobody strips down after putting on some gloves,a gown or a mask unless they are contaminated with body fluids or tissue. 



JakeEMTP said:


> Lab coats are not encouraged in the hospital



Depends on the hospital, but I make every effort to not wear one whenever possible. 

Despite studies showing patients like it better when they can identify the roles of various providers, I like it better when they can't. 

I try to obscure the name tag too.



JakeEMTP said:


> and you will find doctors leaving the ties at home which once were a requirement for residents to wear at the bedside.



From a study done in Britian by NHS. 

But again, no concern of mine, I go from street cloths to scrubs and back with the goal of looking as casual as possible as not to be identified.   



JakeEMTP said:


> Hands are also scrubbed



Are you referring to scrubbing in for surgery? Because I don't see too many (read anybody) actually scrubbing outside of that environment. 

I don't even see rescrubbing when an operation goes beyond the 3 hour mark despite studies showing that after 3 hours so much flora from the deep skin layers migrate to the surface it is equivalent to not scrubbing at all. 



JakeEMTP said:


> and it is not paranoid to wash your own body in a shower after work. Many hospitals provide that for their employees. It is just commonsense and there have been enough data from people and items being cultured.



Yes, many hospitals do. 

No, many providers don't. 

Life is not a sterile environment. 1 in 5 people are carriers for MRSA, should we start mandating bleaching people's noses?

There is a difference between prudent infection control and spending enormous amounts of money for minimal gains. There is also a line between prudence and phobia. 



JakeEMTP said:


> While a young health 20 y/o EMT probably won't catch anything easily unless they do have a wound that is open, you must think of the patients.  They are the ones who are at risk.



Patients are at risk from what providers wear home?

Never heard that before.

Perhaps the patient is at risk from what the provider is wearing?

But realisticaly no more so than any other casual contact.  



JakeEMTP said:


> Letting your guard down and forgetting about basic protection leads to the consequences which can be a financial hit for the employer in a hefty fine and the loss of life as someone knew it if an infection is acquired through carelessness.



I will remember to pour h2o2, isopropanol, and bleach on myself in the effort of making sure nobody could ever get an infection from me or trace it :lol:

Sorry, mixed infection control up with an internet treatment for preventing herpes during unprotected sex. (patient complained of pain, redness, and swelling after doing it)

I think I will stick to what I am doing.



JakeEMTP said:


> The ambulance is not an Operating room where you are doing open heart surgery where the air is filtered many times over and every piece of equipment is cleaned, all the staff are gowned, wearing hair bonnets and booties as well as the cutting instruments being sterilized.  The surgical site with the surrounding skin is also cleaned. There is absolutely no way you can compare an OR and ambulance.



Actually, I can. 

Because I know that most infections come from a patient's own flora. Which doesn't actually change from one environment to another. Only the amount does.

I also know that the chance of coming into contact with body fluids in surgery is many times greater than that of an ambulance. Not to mention introducing infection to a patient through an open wound.

I appreciate your effort in attempting to look smart, but I actually spend a lot of time in both C/T surgery and neonatal intensive care. Attempting to point out incubator specific stethoscopes as means of protecting family members, the point of the OP, which in your effort to seem impressive you totally ignored, seems like trying way too hard to me.

I'll say it again.

Wash your hands. Don't get dirty.


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## Tigger (Aug 19, 2012)

So much for not being grumpy...

Common sense goes along way when it comes to infection control. Considering how many providers completely fail at avoiding cross contamination with soiled gloves and whatnot, I'd concentrate on that before dousing one's body with  rather pungent sprays. 

Don't be intimidated by those that don't clean the stretcher either, which is often common in the IFT setting sad as it is. Change the sheets and wipe the straps and rails. It's doesn't take that long and is the right thing to do.


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## CANDawg (Aug 19, 2012)

I don't know about you guys, but I wear full HazMat gear whenever I interact with a patient.


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## bigbaldguy (Aug 19, 2012)

Bit off topic but at the gym I go to its mostly medical folks. It always creeps me out when they come in straight from their shift and use the equipment in their scrubs. Yes it's mostly in my head but still ick.


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## mycrofft (Aug 19, 2012)

Nothing special or magic to do.

1. Wash your hands. Remember to wash exposed arms.

2. Avoid unnecessary contact. That means wear gloves, carry stuff without hugging it to your torso, wear the disposable gowns when needed or anticipated, and plan your moves during transfers, lifts etc. Tricky to keep good body mechanics, so the gown is a good idea.

3. Wash clothes if they get spoojed, or bag em and wash them at home. Use enough detergent, and a cold wash to remove any chunky matter*, then as warm as possible; then, the trip through the drier will finish the job for most pathogens.

The secret is in substrate, microbes do not exist on their own. They are on droplets (some microscopic), dust, the glove powder you snap into the air, the clothing fibers you shed off a dirty uniform, but more frequently snot, saliva, pus, blood, etc. Wither goes the substrate, so goes the microbe. 

If your uniform has substrate on it, you need to change it to protect yourself, but you can don a disposable gown or other barrier to help prevent spreading it around.

Medicinal hydrogen peroxide is a good cleaning agent and is a bleach, it will kill anaerobes like a machine gun (I've "seen" staph turn and run when using it for precleaning before dressing changes) , but more important is not to mask or "devon", but to clean.

*brains, for example.


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## mycrofft (Aug 19, 2012)

BBG, ever hear of iatrogenic superinfections?


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## bigbaldguy (Aug 19, 2012)

mycrofft said:


> BBG, ever hear of iatrogenic superinfections?



Damnit, do you have any idea how much studying I have to do and now you've given me the perfect excuse to go on a google walkabout? Sigh. If anyone needs me I'll be on google for the next 45 minutes.

I haven't googled it yet but I'm guessing super staph tye thing? Mrsa maybe.


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## Jon (Aug 19, 2012)

Several folks I consider experienced providers have referenced education.

I think they are spot on.

You ever notice that more experienced providers tend to wear less BSI? And when they do, they are more likely to wear it correctly?

It bugs the hell out of me when I see n00bs that insist on putting gloves on in the front of the truck, and then wear that ONE PAIR for the entire call.

I do a couple of things to try to protect myself and those I care about. My boots don't go beyond the front door of my apartment, and my work uniform (especially pants) gets washed in hot water. I also try to wipe down my cell phone every night (bleach wipes, usually) - because that is probably the dirtiest thing I carry.

Some other things: I try to be careful about what I do in uniform, and what I do with gloves on vs. not.

For the record: There is NOTHING wrong with deconning your gear/equipment between patients, in fact, you SHOULD be doing that. Have a spare uniform, and change if/when it's dirty. Otherwise - use PROPER BSI, and be careful about bringing stuff home.


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## JakeEMTP (Aug 19, 2012)

Veneficus said:


> :rofl:
> 
> Actually, they are all controlled units and we have seperate scrubs for the ORs (nice bright red) with limits on where you can actually go with them. (which is pretty much preop, OR, post op, and the locker room)
> 
> ...




Your post is not very impressive and you seem to want to thrash solid educations and infection control awareness instead of providing useful information. Some of the information you have provided can actually be harmful. It is time EMS takes infection control seriously and this no joke. To make it out as one further demonstrates a need for education. 

You have restated much of what I said like the controlled environment and separate scrubs. 

But, you are out of touch with most infection control policies in place in the hosptials.  If you want to work in a hospital or gain more information about it, you need to contact the infection control office for the latest literature and polices.

The AMA and the University of Arizona are in the United States and those are excellent sources of information on the research done. Every country does research and can publish their findings. Maybe you just stumbled on one from Britain and the NHS.

You are obsessed with H2O2 as a disinfectant for everything. No you should not pour a mixture of H2O2, bleach and isopropanol on yourself to prevent infection. This is not 1980 and we have learned alot from HIV and AIDS.  Please do not ever advise someone to do this. Definitely do NOT ever tell someone that putting bleach in their nares takes care of MRSA. What did you get such misinformed information? 

I already addressed the original post directly right after he posted.  

Education is key.  I seriously hope no one takes infection control to be a joke as you seem to be doing.   Some of the examples you have given are for the OR where there are also showers and cleaning stations. Ambulances do not have that luxury and will see many patients each shift in an uncontrolled environment.


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## Aidey (Aug 20, 2012)

JakeEMTP said:


> You are obsessed with H2O2 as a disinfectant for everything. No you should not pour a mixture of H2O2, bleach and isopropanol on yourself to prevent infection. This is not 1980 and we have learned alot from HIV and AIDS.  Please do not ever advise someone to do this. Definitely do NOT ever tell someone that putting bleach in their nares takes care of MRSA. What did you get such misinformed information?



Um, I'm pretty sure he was being sarcastic...I don't think any one except for you actually thought he was advocating doing any of those things.


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## Veneficus (Aug 20, 2012)

Aidey said:


> Um, I'm pretty sure he was being sarcastic...I don't think any one except for you actually thought he was advocating doing any of those things.



I actually saw a patient who did that.

But I hear that there were recent bans on the RT forum which corresponds to an increase in posting here.


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## Asclepius911 (Aug 20, 2012)

Dumb fact---H2O2 hydrogen peroxide is pretty bad stuff,  its a free radical after propogation stage it makes your skin possibly age quicker or can cause cancer (take multi vitamins  especially C and E and you will rarely get sick)


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## Veneficus (Aug 20, 2012)

JakeEMTP said:


> Your post is not very impressive and you seem to want to thrash solid educations and infection control awareness instead of providing useful information. Some of the information you have provided can actually be harmful. It is time EMS takes infection control seriously and this no joke. To make it out as one further demonstrates a need for education..



Laughter without a tinge of philosophy is but a sneeze of humor. Genuine humor is replete with wisdom.
- quoted in Mark Twain and I, Opie Read

I would also point out that sarcasm invokes emotion and stimulates the same CNS centers which causes people to remember things that involve profanity more than communication that doesn't.

I don't think it requires really more education, so much as the application of it.

Some people struggle to remember or perform even the simplest tasks, others make it look easy and effortless. I beleive the term used to describe it is being "educated beyond intelligence." 




JakeEMTP said:


> You have restated much of what I said like the controlled environment and separate scrubs...



Yes, it is called an anecdote. 



JakeEMTP said:


> But, you are out of touch with most infection control policies in place in the hosptials.  If you want to work in a hospital or gain more information about it, you need to contact the infection control office for the latest literature and polices.



Funny that, but the hospitals (multiple) that I am at do not seem to think so. But I thought instead of working in a hospital, I would become a stand up comic or a movie star.

Which reminds me of one of my favorite quotes from Shakespeare:

"I am better than thou art now. I am a fool. Thou art nothing." 

Really though, they make policies for people to follow without thinking. Guidlines for those without insight. 

Infection control, like all safety, is a behavior modification. When something is truly mastered, it is done without effort or conscious thought.



JakeEMTP said:


> The AMA and the University of Arizona are in the United States and those are excellent sources of information on the research done. Every country does research and can publish their findings. Maybe you just stumbled on one from Britain and the NHS.



The British one was credited as the first, it made news throughout the medical community when it was published. We give credit for the Helical structure of DNA to Watson and CricK as the first, we do not name those who later reproduced the observation. 



JakeEMTP said:


> you are obsessed with H2O2 as a disinfectant for everything.



Obsessed? 

An interesting choice of words.

It removes blood out of clothing quite well. It is used by medical manufacturers and servicers in a vaporized form to sterilize everything from endoscopy tubes to post offices thought contaminated with anthrax. 

It is a fairly useful chemical.

I use water a lot too, but I wouldn't call it an obsession. 



JakeEMTP said:


> No you should not pour a mixture of H2O2, bleach and isopropanol on yourself to prevent infection. This is not 1980 and we have learned alot from HIV and AIDS.  Please do not ever advise someone to do this. Definitely do NOT ever tell someone that putting bleach in their nares takes care of MRSA. What did you get such misinformed information?.



I treated a patient for a chemical burn on his genitalia after he admitted finding such information on the internet after he had an itching sensation after unprotected intercourse with a stranger.

Funny enough, I advised him never to do that again or take medical advice off the internet. My collegues and I still laugh about it. 

If somebody suggested one pour toxic chemicals on their genitalia I don't think it would be taken seriously. But when it comes disguised with technical terms and as medcal advice, it smehow gains credibility.

I came up with the bleach analogy because most hospital disinfectants contain bleach and MRSA is a constant topic in the hospital.

Again, the ability to apply conceptual knowledge in jest is the mark of understanding. Not the ability to recite publications or policies from memory.



JakeEMTP said:


> Education is key.  I seriously hope no one takes infection control to be a joke as you seem to be doing.   Some of the examples you have given are for the OR where there are also showers and cleaning stations. Ambulances do not have that luxury and will see many patients each shift in an uncontrolled environment.



I hoe they do take it as a jok and laugh at it. Because then they will remember it.

I can assure you, when 8 theatres of cardiac surgery let out within minutes of each other. Nobody fights for positioning in the 2 showers stalls.

They just change out of the scrubs and go to fight for positioning exiting the parking lot.

If you actually knew or plan to spend time in surgery, you would know that.


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## Doczilla (Aug 20, 2012)

How is there no emote for popcorn? :angry:


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## CANDawg (Aug 20, 2012)

Doczilla said:


> How is there no emote for popcorn? :angry:


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## mycrofft (Aug 20, 2012)

Asclepius911 said:


> Dumb fact---H2O2 hydrogen peroxide is pretty bad stuff,  its a free radical after propogation stage it makes your skin possibly age quicker or can cause cancer (take multi vitamins  especially C and E and you will rarely get sick)




Maybe if you bathed in it, daily. Petri dish or patch tests, maybe. It's a bleach, not for the eyes or left in contact indefinitely anywhere. (WHo invented this hydrogen peroxide gel I see once in a while?). 

Judicious use on a localized area of skin for cleaning and disinfection is ok, and when in doubt, go 50/50 with normal saline as we do to irrigate cerumen out of ears. (Preceded and followed by a normal saline rinse and repeated otoscopic exam. Peroxide fizzing behind a ruptured tympanum is not a pretty thing). 

I just woke up: NO, mixing chlorine bleach and peroxide is NOT a good thing to contemplate. Vigorous foaming, release of poison gas and fairly exothermic. In fact, while bleach is a good disinfectant, it is safer to use it in solution and never to co-mingle it with other cleaning agents.

USed to use a handwash called Hibistat (chlorhexidine gluconate in an alcohol and emolient mixture), not cheap, some folsk react to it, but it is antiseptic and to some extent bacteriostatic.


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## Jon (Aug 20, 2012)

Asclepius911 said:


> Dumb fact---H2O2 hydrogen peroxide is pretty bad stuff,  its a free radical after propogation stage it makes your skin possibly age quicker or can cause cancer (take multi vitamins  especially C and E and you will rarely get sick)



There are some people that swear by daily intake of H2O2 in some way, though. Different strokes, different folks.




Veneficus said:


> ...I hear that there were recent bans on the RT forum which corresponds to an increase in posting here.



And if people won't play nice here, they can go find a DIFFERENT forum to be miserable on.


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## Doczilla (Aug 20, 2012)

Daily intake? Maybe as a diluted mouthwash? 

Gotta be careful with even that... You'll predispose yourself to fungal infections. Oral thrush definately does not help with the ladies.


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## Veneficus (Aug 20, 2012)

Doczilla said:


> Daily intake? Maybe as a diluted mouthwash?
> 
> Gotta be careful with even that... You'll predispose yourself to fungal infections. Oral thrush definately does not help with the ladies.



Some people swear by a spoon full ingested per day.

Not sure I buy that since that is how poison control used to suggest for people induce vomiting back in the 80s.


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## NYMedic828 (Aug 20, 2012)

Veneficus said:


> I actually saw a patient who did that.
> 
> *But I hear that there were recent bans on the RT forum which corresponds to an increase in posting here.*



:lol::lol::lol:


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## mycrofft (Aug 20, 2012)

Oh, yeah. H2O2 has a definite boomerang effect. 30 ml mixed with canned cat food can make any garbage eating dog bring it back for analysis. Had a pt take his peroxide at pill call and before we could tell him it was for oral rinse (resolving exudative tonsilar tissue) he chugged it, his eyes widened, then ....


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## firetender (Aug 20, 2012)

*From the EMS graveyard*

The last thing I should do here is post something as stupid as this, but from about 1973 to 1985 or so, during my career as a medic, the ONLY thing that was adhered to religiously was hand-washing after each call and change of highly contaminated clothing. 

Other than the obvious -- like mouth-to-mouth on a premie whose mother likely had syphyllus (discovered later) -- *worries* about contamination were almost non-existent except with those medics who today would probably have to use disposable full-body condoms with every call!

Remember, we were exposed to Hepatitis and most of the other things you face today. And then came AIDS and our AWARENESS and SENSITIVITY to the issue changed. 

(I finished out my career around the same time it was becoming mandatory to use gloves, and I'm happy I left then. A tactile experience of the patient was key to my way of doing business.)

Now, this consciousness of contamination permeates a lot of your experience as medics today with almost as much passion as you see in talk of guns! It feels like an added burden; the worrying part. Educate yourself, sure, and do what you can, but relax!

Considering the almost unheard of transmission of maladies through my career through routine patient contact, I have to say "What, Me Worry?"

What I wonder is, statistically, how has the transmission of disease from patient to caregiver to caregiver's intimates increased (or decreased since we have so much to combat it with, like FebreezeTM.) between then and now?


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## JakeEMTP (Aug 20, 2012)

mycrofft said:


> Maybe if you bathed in it, daily. Petri dish or patch tests, maybe. It's a bleach, not for the eyes or left in contact indefinitely anywhere. (WHo invented this hydrogen peroxide gel I see once in a while?).



H2O2 has been declining in popularity in the hospitals, including the ER, for many years now. It is an irritant and is frowned upon now by surgeons for some wound cleaning.

Some of the advice given on these forums should be checked with your medical director and the infection control liason before doing something which could be harmful to you or your patients.


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## JakeEMTP (Aug 20, 2012)

Jon said:


> And if people won't play nice here, they can go find a DIFFERENT forum to be miserable on.



A quick internet search shows how many forums Veneficus has been on.


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## Veneficus (Aug 21, 2012)

JakeEMTP said:


> A quick internet search shows how many forums Veneficus has been on.



7 if my count is correct.

1 I stopped frequenting about 2 years after I got out of highschool. (which had nothing to do with anything even remotely to do with EMS.

2 medical related forums which got very boring because it became socially unacceptable for anyone but the most senior members to post there.

3 EMS forums, 2 I left because they were overrun with what I describe as protocol monkies because they can't have a discussion outside of protocol. 

and I play diabloIII and occasionally post to that forum.

BUt most of my "high level" discussions are directly between other researchers and myself, so there is really no need or want to talk about it on a forum. Facebook is also my prefered method of communication.

But stragely enough, I know people from all over the world. With people making demands on me from 3 continents. (I am working to get it up to all of them, but the person I knew in Antarctica went home.)


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## Veneficus (Aug 21, 2012)

8 forums.

In the interest of full disclosure, 

I also frequented a Harry Potter Book club forum for about 2 months.

I'd like to think I made some intelligent statements about identifying specific characters as being modeled on other popular characters from classical literature, which is one of my nonmedical interests.


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## PVC (Aug 21, 2012)

RookieRescue1 said:


> Looking for a decontamination spray to use on my uniform in between calls. I just started working as an EMT a week ago and I really concerned about spreading contaminates especially when I'm visiting my mom, who has weak lungs or my girlfriend, whose nephew is 3 years old. Any suggestions?
> 
> Also a decontamination spray for the gurney would be nice, one that doesn't contain bleach.



You might want to consider radiation instead of a spray.


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## mycrofft (Aug 21, 2012)

JakeEMTP said:


> Some of the advice given on these forums should be checked with your medical director and the infection control liason before doing something which could be harmful to you or your patients.



Absolutely. However, two observations:

1. Surgeons and most  doctors have no idea what works for dressing change, they delegate it to nurses.  They order things like telfa dressings (wound healing becomes maceration), or normal saline wet-to-dry dressings (the gauze is allowed to dry out, meaning you strip away everything that has adhered to it). I have seen a MD's order for a telfa wet to dry (??), and so many MD orders for "bandaid and triple antibiotic ointment" which degraded into messes that I could scroan. So, the MD in my experience hardly has a good idea what truly happens when peroxide is used professionally. It is a good cleaner for hard surfaces, but not bacteriostatic.

2. Peroxide is a cleaning agent and has to be used with disgression. I have never, in over twenty years, seen irritations etc caused primarily by peroxide unless it was abused, such as a peroxide wet dressing, or an overlong soak in the traditional "teryaki sauce" for finger wounds (NS with 1/3 again of peroxide and enough Betadine to turn it dark red). A peroxide soaked ambulance litter might be a bad thing, I wouldn't want to lie on it.

I have seen maceration reactions to chlorhexidine gluconate ("Hibiclens") where it is not rinsed off properly like under wedding rings or wristwatches.

Oh, a good cot spray? Lysol. But again, clean off the substrate/goop before you spray.

PS: NIH document showing peroxide to be effective against staph and strep.

http://www.ncbi.nlm.nih.gov/pubmed/16899706


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## Veneficus (Aug 21, 2012)

mycrofft said:


> 1. Surgeons and most  doctors have no idea what works for dressing change, they delegate it to nurses.  They order things like telfa dressings (wound healing becomes maceration), or normal saline wet-to-dry dressings (the gauze is allowed to dry out, meaning you strip away everything that has adhered to it). I have seen a MD's order for a telfa wet to dry (??), and so many MD orders for "bandaid and triple antibiotic ointment" which degraded into messes that I could scroan. So, the MD in my experience hardly has a good idea what truly happens when peroxide is used professionally. It is a good cleaner for hard surfaces, but not bacteriostatic.



Where do you find these people?

I get pissed at wound care nurses for not knowing simple things about wound care, like what early onset cellulitis from strep looks like before it becomes grossly inflammed.


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## Doczilla (Aug 21, 2012)

Before rubor/dolor/calor set in? Or is that nonspecific?


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## Veneficus (Aug 21, 2012)

Doczilla said:


> Before rubor/dolor/calor set in? Or is that nonspecific?



That is not specific inflammation.

Because strep species will break down hemidesmosomes you see closed blisters similar to partial thickness burns.

Or the remnants from when the pt purposefully or accidentally "pops" them.

You see it days before the redness and and local temperature change.


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## mycrofft (Aug 21, 2012)

You caught me on this before, V. !

My daughter came down with an indurated cellulitis starting with focal ulcers and her MD's note was "change dressings as needed". Period.

We rotated tx between QOD H2O2 then betadine, and QOD H2O2 then Hibiclens, GENTLE  cleanings followed each time by triple antibiotic and gauze dressings. Once she got compliant, and on day 1 of oral ABX, the lesions started to retreat...after draining copious green-yellow  purulent goop (or "substrate"). No irritation; however, the dead tissue sloughed promptly in concentric collars around the ulcers.

ANYWAY, disinfection/cleaning has to be done carefully and thoughtfully to be effective and avoid creating secondary problems.


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## Veneficus (Aug 21, 2012)

mycrofft said:


> You caught me on this before, V. !



But it is not you that I get angry with or have to educate after the patient needlessly suffers.


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