Decon. Decon

[Medic Tim]

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.

 

[Doczilla]

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.

 

[Veneficus]

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.

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.

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.

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.

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.

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.

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.

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.

 

[Tigger]

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.

 

[CANDawg]

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

 

[bigbaldguy]

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.

 

[mycrofft]

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.

 

[mycrofft]

BBG, ever hear of iatrogenic superinfections?

 

[bigbaldguy]

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.

 

[Jon]

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.

 

[JakeEMTP]

: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.



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.



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.



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.



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.



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.



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.



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.

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.

 

[Aidey]

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.

 

[Veneficus]

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.

 

[Asclepius911]

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)

 

[Veneficus]

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."

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

Yes, it is called an anecdote.

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.

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.

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.

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.

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.

 

[Doczilla]

How is there no emote for popcorn? :angry:

 

[CANDawg]

How is there no emote for popcorn? :angry:

 

[mycrofft]

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.

 

[Jon]

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.

...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.

 

[Doczilla]

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.