Bsi

[bled12345]

Body substance isolation.... Kinda scary stuff when you think about it being a Paramedic.


Have you ever had any scary moments? get anything questionable into your eye/nose/mouth? had to get tested? Know of any EMS personnel that contract serious diseases from their line of work?

I was just reading up on a report talking about chronic care workers dealing with citizens in high risk TB areas had a fairly high rate of contracting the disease themselves...

whats your guyses opinion on this? have any stories to share? I know when I go on my practicum I will be wearing glasses for EVERY call.

 

[FF/EMT Sam]

We have two frequent flyer AIDS patients. One of them reminds us as soon as we walk into his house every single time. The other one has been known to try to bite us.

 

[Airwaygoddess]

Good for you for wearing eye gear, remember, when running your calls, get to know what is going on in that service area, look at how the seasons change, you will notice a pattern of illness that go with the seasons. Also, when things are starting to fly wear a mask. You need to protect yourself so you can take care of others!

 

[bled12345]

We have two frequent flyer AIDS patients. One of them reminds us as soon as we walk into his house every single time. The other one has been known to try to bite us.

thats pretty scary about the biting.... one of the teachers at my school told us a story about one of her EMT buddies, almost exactly like what you were saying, frequent flyer HIV+ freaked out and got combatative and started screaming about how his life was bull :censored::censored::censored::censored:, the EMT tried to calm him down, and he was freaking out yelling about how having HIV was bull :censored::censored::censored::censored:, and then out of nowhere the patient bit this EMT drawing blood,and with alot of spite said "See how you like it!"


scary story.. luckily, after 6 months of understandable :censored::censored::censored::censored:tiness, he finally was able to test HIV negative, but still, that would be so horrible. He had a wife and kids, I could only IMAGINE the stress it caused for him and his family.

 

[Ridryder911]

What most do not realize anytime you get blood, piss, puke, sweat or any other patients body excrements you have potentially exposed to anything the patient has. So everyday I don't know a medic that does not get "exposed" to anything.

I have been bitten, sprayed, splashed, stuck with a needle... etc.. over the past years. Enough, they know me by first name in the lab. I have to admit the first time I was bit, was in the mid 80's when HIV had just came into light and it was an AID's patient that had an attitude as well. This was at the time AID's had a 100% fatality and no exposure med.'s were out yet... it does make one thing about a lot of things!

The re-draw every 3 years, is becoming a habit. At least you know your status..

Most EMS are not well equipped for true BSI situations. As well as most medics are not prepared. The problem is we never know the underlying cause, as well many never follow up. If you depend on another source to inform you if you were exposed.... good luck. Be sure to make documentation and follow local company policies ASAP.

Hep B, C, MRSA and all the other critters out there is just as bad. Most health care workers are carriers and do not even realize it since over time some immune have become resistant. That is why it is important to have base line test, so if resistance becomes impaired .. you do not become active.
T.B. is very active in my state and we are tested at least 2-3 times a year. The problem is unless you wear a particulate masks, it will penetrate through regular surgical masks. This is if the masks are properly worn.

Which I will asks the question .. how many time(s) a year does your service perform "fit testing" for the particulate masks, and if you have a "no facial hair" policy ?

R/r 911

 

[Recycled Words]

I'm a relative newbie to EMS (only been riding for five months) so I haven't seen nearly as much as most people have. I have had two AIDS patients, though. The first told us the second we walked in, gave us his list of meds, etc. The second one didn't offer any information, but the sores and track marks led my partner to ask and, after a long pause, he 'fessed up.

 

[Alexakat]

A few years ago, my PPD came back positive. I've worked in hospitals (non-clinical area) for many, many years & one year it was positive (before ever working in EMS). It really scared me as I was under-educated about it & thought I "had" TB. My CXR was clear & has been ever since. I underwent prophylactic treatment, but still worry that perhaps I'm a little more susceptible to getting TB if exposed to it. It's always in the back of my mind when I have a cough. One of our crews had a TB+ patient recently. Apparently, they weren't informed until they'd already been in the home & been face-to-face with the patient. Ugh. SCARY as we have to depend on people being forthcoming about their medical history.

I was in an Infection Control meeting last week & they were talking about MRSA & how the IHI (Institute for Healthcare Improvement) is now recommending MRSA nasal swabbing for health care workers. One of the physicians in attendance commented "I bet every one of us, if we were swabbed, would have MRSA in our nares." YIKES!

We had an HIV+ patient several months ago & a Hep C+ patient several weeks ago. Both were very forthcoming as soon as we pulled up...it was the first thing they told us, which I appreciate. Never had a spiteful one, but I'm sure it's just a matter of time.

There are some nasty bugs out there...e gads...

 

[Recycled Words]

One of our crews had a TB+ patient recently. Apparently, they weren't informed until they'd already been in the home & been face-to-face with the patient. Ugh. SCARY as we have to depend on people being forthcoming about their medical history.

From their point of view, it's easy to understand why they wouldn't be quick to offer the information. They could be embarressed, they could be afraid of being denied treatment, they could be pre-occupied with whatever made them call 911. There could be dozens of reasons for them to not offer their history. It's obviously not ideal, but we have to live with that

 

[JSainte]

Scary

I'm new to the forum, and have yet to start my EMT-B course (which is a stepping stone to PA school). Of course I've always realized that working in health care is going to expose you to all sorts of risks, it is really scary to think about some of them... particularly HIV/AIDS.

Out of curiousity, does anyone know what the odds are on that? I wonder how many EMTs, nurses, docs, etc. have had that happen, particularly the ones who weren't so lucky.

:unsure:

 

[MMiz]

I took a job working for a highly regarded private service (oxymoron right?). I was absolutely disgusted at what I found when I would arrive for my shift. I was always wiping dried blood off of the grab bars on the ceiling, and the steering wheel and door handles were absolutely disgusting. In general I'm absolutely amazed by the lack of cleanliness and regard for disease control in EMS.

I had one patient who had a whole bunch of things. It was years ago, but I want to say HIV and a HEP ABCDEFLMNO. She had an uncontrollable nose bleed, and I saw what was coming. My partner in the back refused to put a mask or NRB on her because she didn't want one. As I was pulling the cot out of the back, and as he stood by her side ready to grab the wheels, she sneezed far too much blood all over him and us. That was my last regular shift in EMS.

 

[Alexakat]

I took a job working for a highly regarded private service (oxymoron right?). I was absolutely disgusted at what I found when I would arrive for my shift. I was always wiping dried blood off of the grab bars on the ceiling, and the steering wheel and door handles were absolutely disgusting. In general I'm absolutely amazed by the lack of cleanliness and regard for disease control in EMS.

I had one patient who had a whole bunch of things. It was years ago, but I want to say HIV and a HEP ABCDEFLMNO. She had an uncontrollable nose bleed, and I saw what was coming. My partner in the back refused to put a mask or NRB on her because she didn't want one. As I was pulling the cot out of the back, and as he stood by her side ready to grab the wheels, she sneezed far too much blood all over him and us. That was my last regular shift in EMS.

I agree, Miz. I always wipe down the inside of the truck with antimicrobial wipes when I do my equipment check-off. The grab-bars, the cabinet doors, the benches, all surfaces...it makes everything smell nice & clean too!

 

[JSainte]

Follow-up to my post

Interesting article I found while 'Googling' some things. Goes with my previous post.

http://www.medicalnewstoday.com/medicalnews.php?newsid=64503

 

[fm_emt]

I agree, Miz. I always wipe down the inside of the truck with antimicrobial wipes when I do my equipment check-off. The grab-bars, the cabinet doors, the benches, all surfaces...it makes everything smell nice & clean too!

Our rig checkout sheets basically tell us to Lysol the crap out of the inside rig before we leave quarters. Oh, and we're supposed to wash it too.
My partner & I go through and pick out all of the trash and clean the rig out pretty good before our Saturday 24 hr shift. It doesn't take more than 5 minutes to spray everything with Lysol and wipe it down.

 

[Recycled Words]

I took a job working for a highly regarded private service (oxymoron right?). I was absolutely disgusted at what I found when I would arrive for my shift. I was always wiping dried blood off of the grab bars on the ceiling, and the steering wheel and door handles were absolutely disgusting. In general I'm absolutely amazed by the lack of cleanliness and regard for disease control in EMS.

I completely agree. Generally people will clean up if there's blood or vomit, but otherwise, they don't bother. When I do rig checks at the start of my shift, the well is FULL of used gloves, towels, NRBs, 4x4 wrappers, etc. I make a note of tossing all of it, but....

 

[VentMedic]

There is a really good article about EMS workers in Infection Control Today magazine.

http://www.infectioncontroltoday.com/articles/291feat2.html

There are some good articles in the related categories of that magazine also.

 

[JSainte]

Great article, thanks for the link.

There is a really good article about EMS workers in Infection Control Today magazine.

http://www.infectioncontroltoday.com/articles/291feat2.html

There are some good articles in the related categories of that magazine also.

 

[VentMedic]

There are alot of reasons for practicing safe BSI technique. Most of mine live in my house. My family is the biggest reason I try to be careful. I have never worn my work clothes home either as a medic or RT. Nobody hugs me until after I have a shower. I may sound paranoid but I know what I have been exposed to all shift. My patients also depend on me keeping them safe from other patients' germs. I also worry about my immunosuppressed co-workers (HIV, cancer, COPD-steroid therapy, etc). I watch how they protect themselves and learn. Influenza can be a death sentence for some. I wear a mask or keep the 3 - 5 foot rule if possible when giving nebulized meds. The particles are small and can go great distances. Even pseudomonas can bring havoc to even the healthiest.

 

[JSainte]

This thread has really helped open my eyes to all the risks that health care providers are exposed to.

As someone who is a compulsive hand-washer, and very weird about germs, I plan to take every precaution there is, as an EMT-B, and as a PA.

Thanks for that last link, the site is very informative.

 

[BossyCow]

Why Lysol? We use Virex which is an antiviral and we have an extremely specific policy about its use. Everything that touches a patient must be Virexed after each call as well as the walls, floors and ceiling of the rig. The stretcher is also Virexed from head to foot after each call. I've added one more for me. One day while heading back into the ER through the outside doors, without gloves since my patient care was done, I looked at the security keypad that I keyed on my way in wearing pt dirty gloves and since then I use an antiviral wipe on that as well.

What about the steering wheel? The outside door latches? How many things to we touch with our gloved hands that we then touch without them? Universal precautions means do it universally.

 

[JSainte]

Great point BossCow. I thought about that, too. You touch so many things, it's hard to tell. I thought, "Steering wheel, door handles, keys, etc, etc..."

I'm starting to feel like most of my EMT-B work will be hands-on cleaning experience. When do you have time for patients? How long does it take to do all this procedural cleaning after a patient?

Why Lysol? We use Virex which is an antiviral and we have an extremely specific policy about its use. Everything that touches a patient must be Virexed after each call as well as the walls, floors and ceiling of the rig. The stretcher is also Virexed from head to foot after each call. I've added one more for me. One day while heading back into the ER through the outside doors, without gloves since my patient care was done, I looked at the security keypad that I keyed on my way in wearing pt dirty gloves and since then I use an antiviral wipe on that as well.

What about the steering wheel? The outside door latches? How many things to we touch with our gloved hands that we then touch without them? Universal precautions means do it universally.