EMT Recommended Pen?

[JesterEMS]

Why would you be picky about handwashing and not about proper disinfectant procedures for equipment?

Alcohol is not sporocidal, doesn't penetrate protein rich material, and it evaporates quickly making it a poor choice for equipment, especially if just using a prep pad as opposed to a drenched cloth or immersion.

How many of us do disinfect our pens... how about our stethoscopes... how about our smart phones?

Isn't one thing we definitely should disinfect is our stethescope??

 

[MonkeyArrow]

How many of us disinfect our uniforms? Or ourselves at the end of a shift before getting in your car? If you're going to be worried about getting sick from your pen, well, never mind. The "germs" that w encounter in the back of the rig are no more bad than what's floating around for the common patient to catch (unless dealing with a truly extraordinary situation like ebola).

 

[JesterEMS]

@MonkeyArrow
So we shouldn't wash our uniforms????

 

[StCEMT]

Why would you be picky about handwashing and not about proper disinfectant procedures for equipment?

Alcohol is not sporocidal, doesn't penetrate protein rich material, and it evaporates quickly making it a poor choice for equipment, especially if just using a prep pad as opposed to a drenched cloth or immersion.

How many of us do disinfect our pens... how about our stethoscopes... how about our smart phones?

I'm lucky if I don't lose a pen before I even am worried about going that far. My pen isn't really any worse off than some other things in the back if the truck. I don't disinfect the stretcher after every single call and we grab those all the time. Unless it's a really nasty person, I am just not worried about the general things I could potentially get sick from. If mawmaw Betty tripped and fell, I probably wouldn't go crazy with thr wipes on my pen, stretcher, etc. Stethoscope I will go over with cavicide from time to time though.

 

[Summit]

@JesterEMS Absolutely! Stethoscope are as contaminated as hands and gloves.

See here: http://www.sciencedirect.com/science/article/pii/S0025619613010847

Cell phones can also be a hangout for the bacteria that cause nosocomial infections: http://jidc.org/index.php/journal/article/viewFile/19801807/291

How many of us disinfect our uniforms? Or ourselves at the end of a shift before getting in your car? If you're going to be worried about getting sick from your pen, well, never mind. The "germs" that w encounter in the back of the rig are no more bad than what's floating around for the common patient to catch (unless dealing with a truly extraordinary situation like ebola).

I am talking about all of these things because it is your job to make sure you aren't spreading bacteria that can cause infection to your patient.

It is about you too. And you colleagues.

 

[StCEMT]

@MonkeyArrow
So we shouldn't wash our uniforms????

Nowhere in his post did he say that.

 

[Summit]

I don't disinfect the stretcher after every single call and we grab those all the time.

You should...

Stethoscope I will go over with cavicide from time to time though.

What about your patients? They deserve a disinfected stethoscope. Every time!

 

[OnceAnEMT]

Second, third, and fourth the recommendation of Pilot G2. More specifically, the 0.5mm Extra Fine in black. You'll never look back. Buy in bulk (packs of 12 to 20) to save big money.

In ER our notes are on the back of patient label paper, sticky notes, or paper towels. Some of the doctors have spiral notebooks, some have notepads, some drag their computer around.

In SAR we use tape on the patient and personal notepads. Can't say I've ever seen anyone tape their own legs to be a notepad. Maybe forearm, but not legs...

 

[ViolynEMT]

A cheap pen that you don't care about losing. You should probably have three or four. Things are going to get "icky". It's pretty tough to avoid that.

 

[DesertMedic66]

To everyone who is not using a Pilot G2 0.7mm in black, you are all wrong and need serious help.

0.5mm? I'm not trying to poke holes in the paper or my hand. 1mm? Might as well be finger painting.

Only in black. My black tactical pen needs to color match my black tactical uniform so I can use a stealth approach on those diabetic patients

 

[StCEMT]

You should...



What about your patients? They deserve a disinfected stethoscope. Every time!

But not every patient requires the use of my Stethoscope....

 

[NomadicMedic]

How about the pen that your waitress gives you to sign the check with?
How about the PIN pad on the checkout at the grocery store?
How about the door handle on the way into Starbucks?

Also, there's big differences between icky and Infectious. Sticking my finger into a cup of urine may well be icky, but if I have intact skin, it's most likely not infectious. Don't sweat the small stuff, just wash your hands frequently. Good hand hygiene is the most importnat thing in preventing casual transmission.

 

[Summit]

How about the pen that your waitress gives you to sign the check with?
How about the PIN pad on the checkout at the grocery store?
How about the door handle on the way into Starbucks?

Also, there's big differences between Icy and Infectious. Sticking my finger into a cup of urine may well be icky, but if I have intact skin, it's most likely not infectious. Don't sweat the small stuff, just wash your hands frequently. Good hand hygiene is the most importnat thing in preventing casual transmission.

Let me preface this response by saying I like you and respect you as a provider based on your past posts. I say that because it is going to sound harsh, but it is more of a generalized commentary.

ATMs and pens at a restaurant are examples that indicate you are only thinking in terms of protecting yourself, not the patient.

You have an ethical imperative to protect your patients from contact transmission from yourself and previous patients... patients with weakened immune systems, open wounds, and more. You cannot see human pathogens or potential drug resistance with your naked eye.

The pen the waitress gives you AFTER your meal was not handled by gloves that were touching who knows what patient in their house (or hands that touched a surface that was just touched by those gloves) or the potentially drug resistant colonized bodies of your patients coming from a nursing home or hospital.

This nonchalant attitude about infection prevention interventions the rest of healthcare has been focusing on reminds me of the old school EMS people who used to say that gloves were overkill. I've presented both scientific evidence and ethical reasoning. You have to come up with a better response than "no biggie."

Responses about infection prevention in this thread are a screaming reminder that the vast majority of EMS personnel do not taken College Biology much less Microbiology. You understand and see concepts that would make you think about your actions.

It also is a reminder that EMS doesn't see the patients who get nosocomial infections and MDRO infections and what happens to them because EMS only sees their patients for a few minutes.

Even a good CNA program will use an invisible dye that fluoresces under UV as a lab exercise to demonstrate just how wild and wide contact transmission is along with the difficulty of proper equipment disinfection/hand hygiene. I've never seen an EMS program that does this...

 

[NomadicMedic]

Summit, I also respect you and don't think that your post wasn't harsh in the least. It's obviously a point that you're passionate about.

However, after reading your interpetation of my statement, I should reprashe to be a bit more clear as to my point; The OP seemed worried about getting cooties from his/her pen. This was followed by much talk about things getting icky... and my statement was made to reiterate that there are many possible vectors of disease transmission that should be as forefront as the everr popular "EMS pen".

And how do you know that the pen that waitress just handed you wan't contaminated by a sick person? When was the last time that pen saw a cavicide wipe? How do you know that the waitress hereslf isn't colonized by a drug resistant bug? How do you know the Pin Pad at the ATM wasn't just operated by a person with Impetigo and those weeping sores? Do you wash your hands before and after each use of the ATM? Does anyone?

Does the waitress have a imperative to protect me from the pathogens that may be on the pen or the menu? Does the restaurant owner?

Yes, I agree. I think EMS hand hygiene, and infection control as a whole, is atrocious. But, that's where it needs to start. Not by scaring EMS providers into throwing away pens because every patient that signs will give them MRSA. If EMS really wanted to be relevenat in the world of infection control, we would we wearing a uniform that was discarded after each patient contact, use fully disposable equipment and have a full on decon procedure for the vehicle and fixed assests after each patient encounter. I don't see ANYONE doing that. Or anything close.

Barring all that, I think a base education other than, "if its wet and sticky and not yours, don't touch it" and a solid hand hygiene program is a good start.

"...handwashing is the single most important public health practice to prevent the spread of disease from person-to-person in instances in which respiratory droplets are not the vehicle of transmission."

Y Nigam and J Cutter. A preliminary investigation into bacterial contamination of Welsh emergency ambulances. Emerg. Med. J., Sep 2003; 20: 479 - 482.

 

[NomadicMedic]

Summit, I also respect you and don't think that your post wasn't harsh in the least. It's obviously a point that you're passionate about.

However, after reading your interpetation of my statement, I should reprashe to be a bit more clear as to my point; The OP seemed worried about getting cooties from his/her pen. This was followed by much talk about things getting icky... and my statement was made to reiterate that there are many possible vectors of disease transmission that should be as forefront as the everr popular "EMS pen".

And how do you know that the pen that waitress just handed you wan't contaminated by a sick person? When was the last time that pen saw a cavicide wipe? How do you know that the waitress hereslf isn't colonized by a drug resistant bug? How do you know the Pin Pad at the ATM wasn't just operated by a person with Impetigo and those weeping sores? Do you wash your hands before and after each use of the ATM? Does anyone?

Does the waitress have a imperative to protect me from the patogens that may be on the pen or the menu? Does the restaurant owner?

Yes, I agree. I think EMS hand hygiene, and infection control as a whole, is atrocious. But, that's where it needs to start. Not by scaring EMS providers into throwing away pens because every patient that signs will give them MRSA. If EMS really wanted to be relevenat in the world of infection control, we would we wearing a uniform that was discarded after each patient contact, use fully disposable equipment and have a full on decon procedure for the vehicle and fixed assests after each patient encounter. I don't see ANYONE doing that. Or anything close.

Barring all that, I think a base education other than, "if its wet and sticky and not yours, don't touch it" and a solid hand hygiene program is a good start.

"...handwashing is the single most important public health practice to prevent the spread of disease from person-to-person in instances in which respiratory droplets are not the vehicle of transmission."

Y Nigam and J Cutter. A preliminary investigation into bacterial contamination of Welsh emergency ambulances. Emerg. Med. J., Sep 2003; 20: 479 - 482.

And here's the Paramedic CE class on infection control that I took last year. http://www.ems-ceu.com/courses/485/index_ems.html