# Didn't Wear PPE - Should I worry ?



## RXMedic579 (Aug 6, 2013)

Last week when on a controlled bleeding call ( very small cut on elbow and minimal bleeding ) I used alcohol prep pads to clean up the semi dried up blood around the wound without wearing my gloves. I usually don't wear gloves unless I know the patient has a infectious disease or if there is a moderate to large amount of blood or other bodily fluid. With that said, I don't recall seeing any blood on me after cleaning the wound other than touching the alcohol pads, but I remembered I had scraped the top of my hand a couple days before. I'm somewhat worried wondering " what if they had Hepatitis C ". After patient care I immediately washed my hands using PAWS antiseptic hand wipes ( what we carry ) which is proven 99.9% effective against HIV, MRSA and a few other things. I also used a alcohol based hand sanitizer since a sink with soap and water were not readily available. My cuts were pretty much healed at the time, they weren't actively bleeding or anything but I did feel a small sting when using the hand sanitizer. Now you probably think I'm over reacting, but would you consider this a true exposure or would you just forget about it ? I know some of you will probably say I should know the answer to this as this stuff was taught in EMT school, but I second guess myself and would prefer a second opinion.

Is there any real potential of catching Hep C based on my story ?

Thanks in advance !


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## CodeBru1984 (Aug 6, 2013)

RXMedic579 said:


> Last week when on a controlled bleeding call ( very small cut on elbow and minimal bleeding ) I used alcohol prep pads to clean up the semi dried up blood around the wound without wearing my gloves. I usually don't wear gloves unless I know the patient has a infectious disease or if there is a moderate to large amount of blood or other bodily fluid. With that said, I don't recall seeing any blood on me after cleaning the wound other than touching the alcohol pads, but I remembered I had scraped the top of my hand a couple days before. I'm somewhat worried wondering " what if they had Hepatitis C ". After patient care I immediately washed my hands using PAWS antiseptic hand wipes ( what we carry ) which is proven 99.9% effective against HIV, MRSA and a few other things. I also used a alcohol based hand sanitizer since a sink with soap and water were not readily available. My cuts were pretty much healed at the time, they weren't actively bleeding or anything but I did feel a small sting when using the hand sanitizer. Now you probably think I'm over reacting, but would you consider this a true exposure or would you just forget about it ? I know some of you will probably say I should know the answer to this as this stuff was taught in EMT school, but I second guess myself and would prefer a second opinion.
> 
> Is there any real potential of catching Hep C based on my story ?
> 
> Thanks in advance !



Why weren't you using the proper PPE? If you are the least bit concerned, talk to your company's designated infection control officer and ask him/her.


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## Flight-LP (Aug 6, 2013)

You sure you want a second opinion? Odds are you will not care for the responses. 

Should you worry, yes.

In addition to exposing yourself to potentially infectious body fluids, you failed to set your personal protection as the highest priority. This in itself speaks volumes to dedication and commitment to an appropriate culture of safety and promotion of professionalism. Not to mention you violated OSHA's BBP standard and can be held individually accountable for your negligent actions. You also placed your agency at risk for potential regulatory involvement and inquiry if the exposure does turn out infectious. 

If you can't take the most basic premise, the one etched into your mind permanantly from EMT class and beyond, then one has to question your ability to avoid complacency in other job specific duties. 

As a manager, if this conversation was to occur with you as one of my employees, it would be concluding with a hand shake and a termination notice. Your actions based on your post are inexcusable.


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## ArkansasEMT (Aug 6, 2013)

*oh no you didn't!*

I remember during clinicals, one of the medics I rode with told me that if I EVER forgot to don the appropriate PPE before getting out of the truck when I was riding with him, he would drop me off at the next post or hospital and let me find my own way home.

No second chance with him when it came to safety.

kinda like real life, where there may be no second chance if you were to contract something from a patient because you were not wearing your PPE.

I'm not trying to be harsh or anything, but you should know better.

Peace.

ArkansasEMT


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## Handsome Robb (Aug 6, 2013)

I'm usually the last person to put gloves on and the first to take them off.

With that said, wear your PPE! 

You're probably fine but you need to report it to your company's OSHA/Infection control Officer and fill out an exposure report.

How can you "know" if someone has something infectious or not? Basing it on what they tell you? Ever watched House? "Everyone lies" isn't limited to that TV show. You'd be surprised how many people don't know they have HIV/AIDS or Hepatitis or they're embarrassed about it and won't tell you or they're a :censored::censored::censored::censored:head and don't care and won't tell you. What if they're altered? Gonna take their word for it?

Are you seeing my point? Is it worth putting yourself, your family and your friends at that risk? You're gonna be the sick one but they're going to have to deal with it and cope with it.


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## VFlutter (Aug 6, 2013)

I have forgot my PPE during codes before. It should not happen but it does. There is little you can do about it now except learn from it and do not let it happen again.


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## CALEMT (Aug 6, 2013)

I've had the phrase "all the gear all the time" drilled into my head. No matter what the c/c is I always wear gloves... but then again I'm also a germaphobe. If I were you yes I would be worried because you don't know what creepy crawlies the pt has.


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## cprted (Aug 6, 2013)

RXMedic579 said:


> *I usually don't wear gloves unless I know the patient has a infectious disease or if there is a moderate to large amount of blood or other bodily fluid.*


And how exactly do you know if a person has an infectious disease or not?  What if the patient has something they don't know about yet?  What if the patient simply lies to you?

I'll admit to not wearing gloves all the time, but I never go anywhere near bodily fluids of any kind without PPE.


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## teedubbyaw (Aug 6, 2013)

You have aids.


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## Flight-LP (Aug 6, 2013)

Yes he does have aids, gloves being the best ones!

And you thought you were being humorous...........


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## Bullets (Aug 6, 2013)

Apparently a lot of people werent paying attention in their BBP/RTK updates

Pop Quiz: What is the most effective barrier to bloodborne pathogens


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## JPINFV (Aug 6, 2013)

Bullets said:


> Apparently a lot of people werent paying attention in their BBP/RTK updates
> 
> Pop Quiz: What is the most effective barrier to bloodborne pathogens



Having someone else touch the thing that is wet, sticky, and not yours?


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## JPINFV (Aug 6, 2013)

Flight-LP said:


> Yes he does have aids, gloves being the best ones!
> 
> And you thought you were being humorous...........




Now see, if it was me that posted that, I'd at least have posted the Family Guy "You've got AIDs" song.


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## Bullets (Aug 7, 2013)

JPINFV said:


> Having someone else touch the thing that is wet, sticky, and not yours?



Negatory, the correct answer is....Unbroken Skin

So if your skin is healthy, you got nothing to worry about. As a bunch of medical people, sometimes we forget that the human body has this under control as long as we let it do its thing. It when we start messing around is when we get messed up


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## JPINFV (Aug 7, 2013)

Bullets said:


> Negatory, the correct answer is....Unbroken Skin
> 
> So if your skin is healthy, you got nothing to worry about. As a bunch of medical people, sometimes we forget that the human body has this under control as long as we let it do its thing. It when we start messing around is when we get messed up




I have yet to catch something that my partner touched that I haven't.


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## JPINFV (Aug 7, 2013)

Oh, and to the OP...








I've also just had a run of couplets.


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## Achilles (Aug 7, 2013)

Bullets said:


> Apparently a lot of people werent paying attention in their BBP/RTK updates
> 
> Pop Quiz: What is the most effective barrier to bloodborne pathogens








Bullets said:


> Negatory, the correct answer is....Unbroken Skin
> 
> So if your skin is healthy, you got nothing to worry about. As a bunch of medical people, sometimes we forget that the human body has this under control as long as we let it do its thing. It when we start messing around is when we get messed up


It is actually hand washing. 
Just because your skin isn't broken, doesn't mean things can't get inside you. (Giggity)
Under your nails for example


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## Bullets (Aug 7, 2013)

Achilles said:


> It is actually hand washing.
> Just because your skin isn't broken, doesn't mean things can't get inside you. (Giggity)
> Under your nails for example



Handwashing is the way to prevent spreading the BBP, but unbroken skin is the most effective barrier. The human body knows what its doing, we just screw it up by putting our hands in our mouth


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## DesertMedic66 (Aug 7, 2013)

Bullets said:


> Handwashing is the way to prevent spreading the BBP, but unbroken skin is the most effective barrier. The human body knows what its doing, we just screw it up by putting our hands in our mouth



Or other places...


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## Bullets (Aug 7, 2013)

DesertEMT66 said:


> Or other places...



Trying to keep it PG here....

But seriously, wash your hands and take care of your skin, regular moisturizer will prevent cracks. Especially if you plan on inserting fingers in orifices, whomever they may belong to


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## Mariemt (Aug 7, 2013)

Bullets said:


> Trying to keep it PG here....
> 
> But seriously, wash your hands and take care of your skin, regular moisturizer will prevent cracks. Especially if you plan on inserting fingers in orifices, whomever they may belong to



Lol I don't think he meant R rated, but people do rub their eyes and noses.
Eyes are a big route of exposure


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## DesertMedic66 (Aug 7, 2013)

Mariemt said:


> Lol I don't think he meant R rated, but people do rub their eyes and noses.
> Eyes are a big route of exposure



I meant whatever way people may think R rated or G rated haha


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## Handsome Robb (Aug 7, 2013)

Bullets said:


> Trying to keep it PG here....
> 
> But seriously, wash your hands and take care of your skin, regular moisturizer will prevent cracks. Especially if you plan on inserting fingers in orifices, whomever they may belong to



Didn't know you were a mod...

Nose and eyes like someone already mentioned...get your mind out of the gutter!


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## MrJones (Aug 7, 2013)

ArkansasEMT said:


> I remember during clinicals, one of the medics I rode with told me that if I EVER forgot to don the appropriate PPE before getting out of the truck when I was riding with him, he would drop me off at the next post or hospital and let me find my own way home.
> 
> No second chance with him when it came to safety.
> 
> ...



Before getting out of the truck? That might protect you, but I feel sorry for the patient who is the recipient of every nasty little thing you pick up from the various and sundry surfaces you touch from the time you leave the truck until you start your hands-on assessment and treatment.


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## ThadeusJ (Aug 7, 2013)

MrJones said:


> Before getting out of the truck? That might protect you, but I feel sorry for the patient who is the recipient of every nasty little thing you pick up from the various and sundry surfaces you touch from the time you leave the truck until you start your hands-on assessment and treatment.



We were always taught to make it obvious to the patient that you were putting on fresh gloves (or gloves at all) while you were explaining the procedure to the patient as it adds to the professionalism of the experience.


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## MSDeltaFlt (Aug 7, 2013)

I've been in the healthcare industry since 1988 coming into contact with blood and body fluids including contact and airborne.  And no, I have not always worn or always wear PPE.  And the absolute worse infection I've received so far was a bad 24hr stomach bug I got from a local NH after picking up multiple residents with the exact same problem.  You'll be fine.


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## Tigger (Aug 7, 2013)

MrJones said:


> Before getting out of the truck? That might protect you, but I feel sorry for the patient who is the recipient of every nasty little thing you pick up from the various and sundry surfaces you touch from the time you leave the truck until you start your hands-on assessment and treatment.



I clean my ambulance every shift for starters. Anything that get's touched get's wiped down, door handles, steering wheel, radio mike, as much as I can think of.

Not to mention that the gloves aren't really there for the patient's protection (if they were they would be sterile), they are for mine. Obviously I am not going to go touch every nasty thing I can find before touching the patient, but I sincerely doubt that putting gloves on as I exit the truck is putting the patient at unnecessary risk. If the ambulance is clean, then anything I touch on the way in is nothing that the patient has not touched before me, without gloves I might add.


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## Bullets (Aug 7, 2013)

ArkansasEMT said:


> I remember during clinicals, one of the medics I rode with told me that if I EVER forgot to don the appropriate PPE before getting out of the truck when I was riding with him, he would drop me off at the next post or hospital and let me find my own way home.
> 
> No second chance with him when it came to safety.
> 
> ...



How do you know what appropriate PPE is before you see the patient?


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## DesertMedic66 (Aug 7, 2013)

Bullets said:


> How do you know what appropriate PPE is before you see the patient?



Well if everyone at my work did exactly as policy states we should have gloves on, eye protection on, and a N95 mask in a pouch on our belt. So the only "PPE" we don't have when we enter a house is a gown and the little shoe cover things.


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## neoclassicaljazz (Aug 7, 2013)

Do you guys usually wear some kind of long sleeve shirt or specific clothing too? Wondering for if you've got a patient who is bleeding and maybe you get a little bit of blood on your arm or something. Something to worry about or no?


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## DesertMedic66 (Aug 7, 2013)

neoclassicaljazz said:


> Do you guys usually wear some kind of long sleeve shirt or specific clothing too? Wondering for if you've got a patient who is bleeding and maybe you get a little bit of blood on your arm or something. Something to worry about or no?



Some do and some don't wear them. As long as you don't have any damaged skin and remember to wipe and disinfect the area before you touch anything you "should" be fine.


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## Mariemt (Aug 7, 2013)

neoclassicaljazz said:


> Do you guys usually wear some kind of long sleeve shirt or specific clothing too? Wondering for if you've got a patient who is bleeding and maybe you get a little bit of blood on your arm or something. Something to worry about or no?



If someone is bleeding enough you may get it on you, you should wear a gown.


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## JPINFV (Aug 7, 2013)

Bullets said:


> Trying to keep it PG here....
> 
> But seriously, wash your hands and take care of your skin, regular moisturizer will prevent cracks. Especially if you plan on inserting fingers in orifices, whomever they may belong to



Any time I stick an appendage into any orifice, I live by the motto, "No glove, no love."


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## medicsb (Aug 7, 2013)

As long as your skin was intact, you'll be fine (ok, there is an extremely remote chance of getting some sort of cooties).  

What you did would not count as an exposure by my service/hospital.

Really, you could dip your hands in a bucket of AIDS blood and you'd most likely be fine as long as you had intact skin and washed them hands afterwards (not that I recommend you try).

Needle sticks and blood on mucus membranes or open wounds are the true exposures.  

I've had blood on my skin more times than I can count, but I do recall being a little freaked out the first time (that guy had hep c, IIRC).


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## Bullets (Aug 8, 2013)

medicsb said:


> As long as your skin was intact, you'll be fine (ok, there is an extremely remote chance of getting some sort of cooties).
> 
> What you did would not count as an exposure by my service/hospital.
> 
> ...



Actually needle sticks have statistically low infection rates


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## NomadicMedic (Aug 8, 2013)

Bullets said:


> Actually needle sticks have statistically low infection rates



That doesn't make you feel any better when they're drawing a rapid HIV and Hep. I knew I wasn't gonna be sick from the needle stick I got, but I was still FREAKED out. Not something I want to repeat.


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## rwik123 (Aug 8, 2013)

medicsb said:


> As long as your skin was intact, you'll be fine (ok, there is an extremely remote chance of getting some sort of cooties).
> 
> What you did would not count as an exposure by my service/hospital.
> 
> ...



This. Open wound being the key word. I've seen people freaked out over, dry skin, paper cuts, torn up cuticles, ect. Essentially it would have to be a deep wound that is actively bleeding and even then, it's remotely low in risk compared to other more high risk routes.


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## shyandroid (Aug 9, 2013)

RXMedic579 said:


> Last week when on a controlled bleeding call ( very small cut on elbow and minimal bleeding ) I used alcohol prep pads to clean up the semi dried up blood around the wound without wearing my gloves. *I usually don't wear gloves unless I know the patient has a infectious disease or if there is a moderate to large amount of blood or other bodily fluid. *With that said, I don't recall seeing any blood on me after cleaning the wound other than touching the alcohol pads, but I remembered I had scraped the top of my hand a couple days before. I'm somewhat worried wondering " what if they had Hepatitis C ". After patient care I immediately washed my hands using PAWS antiseptic hand wipes ( what we carry ) which is proven 99.9% effective against HIV, MRSA and a few other things. I also used a alcohol based hand sanitizer since a sink with soap and water were not readily available. My cuts were pretty much healed at the time, they weren't actively bleeding or anything but I did feel a small sting when using the hand sanitizer. Now you probably think I'm over reacting, but would you consider this a true exposure or would you just forget about it ? I know some of you will probably say I should know the answer to this as this stuff was taught in EMT school, but I second guess myself and would prefer a second opinion.
> 
> Is there any real potential of catching Hep C based on my story ?
> 
> Thanks in advance !



I stopped reading after the bolded comment above.  If you do contract any communicable diseases it's nobodies fault but your own.  

Always wear PPE, every call, every time.  No excuses.


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## firetender (Aug 9, 2013)

The only question I have -- and you all as professionals should at least have the answers available to you -- is "What are the odds?" You have access to the data.

How many contacts with patient's blood by a medic with unbroken skin result in getting some sort of vile infection or pathogen transfer?

I think it's important for each of you to personally decide what is caution and what is paranoia. I hear a lot of paranoia here, unsupported by fact, especially considering the OP didn't have broken skin.


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## Clipper1 (Aug 9, 2013)

firetender said:


> The only question I have -- and you all as professionals should at least have the answers available to you -- is "What are the odds?" You have access to the data.
> 
> How many contacts with patient's blood by a medic with unbroken skin result in getting some sort of vile infection or pathogen transfer?
> 
> I think it's important for each of you to personally decide what is caution and what is paranoia. I hear a lot of paranoia here, unsupported by fact, especially considering the OP didn't have broken skin.



Blood borne pathogens are not the only things you are protecting yourself against. There are many other infectious diseases including bacterial, viral and spore which can give you a world of hurt. Gloves also add a little protection from the provider...especially one like the OP who does not believe anyone or anything is contaminated unless visibly dirty.


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## Aidey (Aug 10, 2013)

dryaridnod said:


> I stopped reading after the bolded comment above.  If you do contract any communicable diseases it's nobodies fault but your own.
> 
> Always wear PPE, every call, every time.  No excuses.



Observe the PPE habits of the ED staff the next time you are in the hospital. They do not wear gloves every time they get near a patient. Unless you wear PPE to go out in public it is a bit hypocritical to say that gloves are mandatory on every call, period.


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## NomadicMedic (Aug 10, 2013)

Aidey said:


> Observe the PPE habits of the ED staff the next time you are in the hospital. They do not wear gloves every time they get near a patient. Unless you wear PPE to go out in public it is a bit hypocritical to say that gloves are mandatory on every call, period.



Great point. There's a big difference between "icky" and infectious. I don't like to touch either, but I could place my hand in a fresh bucket of urine and not really worry about exposure. 

I also don't put gloves on just shake someone's hand, feel their pulse and skin temp or put EKG electrodes on.


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## Aidey (Aug 10, 2013)

DEmedic said:


> Great point. There's a big difference between "icky" and infectious. I don't like to touch either, but I could place my hand in a fresh bucket of urine and not really worry about exposure.
> 
> I also don't put gloves on just shake someone's hand, feel their pulse and skin temp or put EKG electrodes on.



Exactly. We're probably exposed to nastier bugs on shopping cart handles and gym equipment than we get exposed to from our pts.


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## NomadicMedic (Aug 10, 2013)

Aidey said:


> Exactly. We're probably exposed to nastier bugs on shopping cart handles and gym equipment than we get exposed to from our pts.



That's not to say I don't practice almost obsessive hand washing, but I usually don't wear gloves unless its messy or I'm doing something invasive with the potential for contamination. 

But, YMMV and your service may have specific rules about when to don PPE.


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## Aidey (Aug 10, 2013)

DEmedic said:


> That's not to say I don't practice almost obsessive hand washing, but I usually don't wear gloves unless its messy or I'm doing something invasive with the potential for contamination.
> .



I'm basically the same way. Personally I think the OP will be fine, didn't do anything outrageous and people need to take off their tinfoil gloves.


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## Mariemt (Aug 10, 2013)

Personally, I wear gloves to every call, on every patient until I see there is no body fluids present. 
You can be dispatched to a syncope patient where it isn't mentioned they have a head wound or GI bleed. Etc.
On long transfers with no fluids present I don't want the patient to feel they are some freak or anything, I don't mind removing them without any obvious blood or other fluids present.  I still always wash my hands before and after touching my patients though


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## Kevinf (Aug 11, 2013)

Aidey said:


> Observe the PPE habits of the ED staff the next time you are in the hospital. They do not wear gloves every time they get near a patient. Unless you wear PPE to go out in public it is a bit hypocritical to say that gloves are mandatory on every call, period.



The ED staff also has easy access to sinks with running water and soap, which they'll use after contact with a patient. We don't always have that luxury.


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## RocketMedic (Aug 11, 2013)

Yesterday, I held an old lady's hand bare-handed! OOOOHHHHH!


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## Clipper1 (Aug 11, 2013)

Aidey said:


> Exactly. We're probably exposed to nastier bugs on shopping cart handles and gym equipment than we get exposed to from our pts.



The public is now becoming more aware of that which is why grocery stores and gyms have hand wipes available in plain view to wipe off the unknown nasties you might be touching.  This is all about educating the public. As someone being involved in health care you should already know the importance of protecting not only yourself but also the patient from all the nasty things you touched before getting to them.  But then I bet you might even go into a grocery store wearing the same uniform you were all shift after seeing many  patients. 

Hospital staff may not always wear gloves but all of them know the consequences not only for their own protection and that of the patient but also from an administrative action when they are viewed as lacking good judgment. We don't always know who is infectious which is why people are screened now prior to being admitted into the hospital for MRSA and the flu.  Health care workers are to wash or gel prior to touching a patient (ANY PATIENT) and immediately after before leaving that patient's space. This does minimalize the risk to others if they did touch the patient or the equipment with bare hands.

Hospitals have taken a lot of steps to minimalize risk for both the providers and the patients. It is sad to read where some throw caution out. Think about how many things you touch after the patient is your are using your bare hands and not washing or using gel right away. Also, remember there are things the gel is ineffective against like C. Diff.   

I've also heard some EMS providers will not wear gloves with kids because it would frighten them. Or, when talking about RSV some will just say "it's just a bad cold" and nothing to worry about. Or, kids don't have old people's diseases. 

Think about all the patients you come into contact with as well as yourself.  

Definitely a need for more and continuous education on the topic.


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## Clipper1 (Aug 11, 2013)

Rocketmedic40 said:


> Yesterday, I held an old lady's hand bare-handed! OOOOHHHHH!



Did you wash or gel immediately afterwards?  Or did your hands touch your uniform which your child might also touch to hug daddy?


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## Kevinf (Aug 15, 2013)

Why are we ridiculing best practices to safeguard ourselves and other patients from possible contaminants/contagions? ED staff have clean sinks and policies in place to wash before and after patient contact. We generally don't have that luxury, and gloves are the easiest way to replicate that.


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## shyandroid (Aug 15, 2013)

Aidey said:


> Observe the PPE habits of the ED staff the next time you are in the hospital. They do not wear gloves every time they get near a patient. Unless you wear PPE to go out in public it is a bit hypocritical to say that gloves are mandatory on every call, period.



In the contexts of the OP, this was a call out in public and I was not referring to those who work directly in ED.  EMS deals with too many unknown variables when working out in the field to not wear PPE during medical/trauma calls.  I would assume because the close access to a sink & antimicrobial soap ED staff are less stringent on PPE.

I have witnessed an internist was his hands prior and after contact with a pt in an outpatient care facility.  Granted this is was not in an emergency setting but to your point - I took no issue with what he did.


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## Rialaigh (Aug 15, 2013)

I wear gloves when I take care of acutely sick patients

I generally don't wear gloves when I take care of injured patients or patients that are chronically sick. 

There is a major difference between sick and injured, and acute and chronic.


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## VFlutter (Aug 15, 2013)

Rialaigh said:


> I wear gloves when I take care of acutely sick patients
> 
> I generally don't wear gloves when I take care of injured patients or patients that are chronically sick.
> 
> There is a major difference between sick and injured, and acute and chronic.



So chronic and injured patients do not have communicable diseases? 

Have you, or a coworker, ever picked up a MRSA infection from a chronic patient? We have had Nurses get all kinds of crazy infections from patients.


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## medicsb (Aug 15, 2013)

Are there services that do not supply ambulances/response vehicles with hand wipes?  

I'm pretty obsessive about "gelling" and hand-washing whether I'm in hospital or working as a medic.  I've never not had access to hand wipes on an ambulance.  So, even if I touch something nasty (like the moist candida infection on the underside of a boob), I have something close by to clean myself with.  The times when I've gotten blood on my hand/s, I've had wipes nearby to clean myself with until I could use soap and water.  

Anyhow, there is no recommendation that gloves be worn on every patient encounter.  But, hand washing or using water-less hand-sanitizers are recommended before and after every patient contact.  If you want to wear gloves always, fine.  But, realistically, it's not needed always.


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## Rialaigh (Aug 15, 2013)

Chase said:


> So chronic and injured patients do not have communicable diseases?
> 
> Have you, or a coworker, ever picked up a MRSA infection from a chronic patient? We have had Nurses get all kinds of crazy infections from patients.



Chronic and injured patients have communicable diseases via bodily fluids just like everyone else. Acutely sick patients are able to communicate things much more easily. Do I need to glove up to do an EKG on grandma who broke her hip, frankly I don't think so. Do I need to glove up to do an EKG on the guy throwing up with a 103 fever, maybe not but I prob will. 

Injured and chronically ill patients present a MUCH lower risk of transmission then acutely ill patients. 

And as far as MRSA goes...my wife is MRSA positive, my mother in law is, my little boy is...etc...etc.... I would venture at least 20% of all healthcare workers would test MRSA positive from a nasal swab (if not a lot higher).


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## PaddyWagon (Aug 15, 2013)

Heck, I've had mrsa twice acquired in the wild.  But the truth is that noscomial infections cost hospitals real money and for the inconvenience of gloves I think that safety is worth the trouble.  Where I did my clinicals it was always gloves in the ER for any patient contact.  The rig, too, for that matter.


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## Rialaigh (Aug 15, 2013)

Let me pose a comparison. 

If you know your hands are clean, you have no cuts, no open wounds, nothing of any kind - Then putting gloves on for every patient contact "just in case" is like wearing your seatbelt in your rig while parked in a parking lot "just in case" someone hit's you while your rigs in the parking lot and off. 

You CANNOT get anything if you have no entry points for exposure. Not without someone else creating an entry point. Just like you cannot get in a car wreck while your rig is off, unless someone else hits you. I for one don't wear my seatbelt the entire time the rig is off...


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## TheLocalMedic (Aug 15, 2013)

I carry two pairs of gloves on me, but I generally don't put a pair on until I deem it necessary.  They just aren't warranted on most calls!  Unbroken skin is a better barrier than gloves for BBP, and if I'm worried about the other stuff (scabies, MRSA, anything resembling a rash), then I can throw on gloves before I dive in.  

For example, on a chest pain call I'll go glove-free until it's time to pop in an IV, and afterwards the gloves come back off.  Easy peasy.  

I also find it hilarious when people show up at a hospital for an IFT and put gloves on as soon as they pull up.  They walk in, wait around, talk to a nurse, get report and then say hello to their patient...  WHILE WEARING GLOVES.  They haven't even touched the patient yet!  Are we so scared of the thought of big, bad infections that we have to wear gloves to even take a report about a patient?


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## Kevinf (Aug 15, 2013)

Hospitals are also famous for spreading infections around, let's not forget that.


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## Clipper1 (Aug 15, 2013)

Kevinf said:


> Hospitals are also famous for spreading infections around, let's not forget that.



But now we know despite the hospitals' efforts to stop infections, they can not stop the infections from being transferred by the ambulances and EMS providers. When there is a weak link in the patient care system as it now appears ambulances are, no matter how much the hospitals try, infections will still roll in. This definitely explains a lot especially in LTC where transfer by ambulance is so frequent.


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## Clipper1 (Aug 15, 2013)

Rialaigh said:


> And as far as MRSA goes...my wife is MRSA positive, my mother in law is, my little boy is...etc...etc.... I would venture at least 20% of all healthcare workers would test MRSA positive from a nasal swab (if not a lot higher).



That does not make you immune from getting another strain which will make you contagious or another disease which will weaken your or your son's immune system which could become a very serious and even deadly event.


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## Clipper1 (Aug 15, 2013)

TheLocalMedic said:


> I also find it hilarious when people show up at a hospital for an IFT and put gloves on as soon as they pull up.  They walk in, wait around, talk to a nurse, get report and then say hello to their patient...  WHILE WEARING GLOVES.  They haven't even touched the patient yet!  Are we so scared of the thought of big, bad infections that we have to wear gloves to even take a report about a patient?



Yet if a hospital worker is caught with gloves on outside of a patient room they are disciplined. This is just one example of not wanting to make waves with the EMS agencies or some have just given up telling them why they should not walk around a hospital with gloves on. When picking up a patient, you should wash or get and then put the gloves on before entering the patient room.


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## Bullets (Aug 15, 2013)

Chase said:


> So chronic and injured patients do not have communicable diseases?
> 
> Have you, or a coworker, ever picked up a MRSA infection from a chronic patient? We have had Nurses get all kinds of crazy infections from patients.



If youve worked in EMS longer than 10 minutes, you problably already carry MRSA.

While i carry a glove pouch with 6 pairs of gloves, i have noticed my glove wearing has gone down as my experience has risen...Though i still have an N95 and a pair of clear glasses on me at all times.

I also wash my hands every time im at the hospital


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