H1N1A Exposure

[Tincanfireman]

Got a phone call this afternoon from the EMS director at my part-time agency. Seems that a patient I treated/transported last Friday came back as a positive for H1N1A; yup, I'm now a part of the whole national swine flu pandemic story. I had to go to talk to the doc at our workman's comp place, then get a prescription for Tamiflu. I have to take the medicine 1x per day x 5 days, just in case. The good news is that I'm currently asymptomatic for everything and they told me not to worry as long as I stay that way. The doctor told me since I have a healthy immune system I shouldn't have any problems. The pt. has multiple issues and an extensive hx and is essentially bedridden due to severe autism and contractions. He was feverish and dehydrated, so we had to lift him onto the cot because he couldn't walk due to his current condition. My partner started the line and rode the call, but my face was right next to his getting him on the cot (sigh). The fact I am fine after four days w/o any meds is a very good sign that I don't have anything to worry about. It was the first confirmed exposure at my EMS employer. Lucky me... =) Oh yeah, the patient? Currently on a ventilator in ICU. I have to give big kudos to my director; as soon as he received the notification he dropped everything and devoted the afternoon to making sure my partner and I were seen, treated and got our meds. OK, before anyone asks; yes, we transported the pt on a NRB @ 12LPM because he had absolutely cruddy lung sounds. We applied the mask almost immediately upon entering the room. No, I wasn't thinking H1N1, but I will next time I run into a patient with similar symptoms. Live and learn...

 

[timmy84]

We have had three patients who started off on my floor before coming back h1n1 and sent to the ICU for some vent time. Makes you think... how many people came in contact with them before they came to the hospital, even in the hospital. EMS/Family taking them to the ER, everyone in the ER, from the ER to the floor, on the floor and everyone taking care of them, from the floor to the ICU, everyone in the ICU. When I had them on the floor, they were rule out pneumonia so we took droplet precautions, but what about before then. Your right, it does make you think though.

 

[marineman]

Uh oh, the big bad flu's gonna getcha

 

[VentMedic]

Uh oh, the big bad flu's gonna getcha

It is definitely not a joke. We have had some very bad cases in the ICUs with patients requiring ventilators. Unfortunately most have been young pregnant women and children. Their lungs take a hard hit to where we've gone to High Frequency Oscillation Ventilaors and have used nitric oxide also with the HFOV for a few patients.

We swab everyone with flu symptoms to determine if it is Influenza A. We don't care what animal it is named after at that point. They get isolation.

 

[VentMedic]

anyone asks; yes, we transported the pt on a NRB @ 12LPM because he had absolutely cruddy lung sounds. We applied the mask almost immediately upon entering the room. No, I wasn't thinking H1N1, but I will next time I run into a patient with similar symptoms. Live and learn...

The NRBM will NOT offer protection to you from whatever the patient has.

Unfortunately this will be the easiest way to spread it. Hopefully everyone in that truck had an N95 mask on even though the flu is normally droplet precautions. Any device giving that amount of flow will aerosolize the droplet particles. In the hospital the patient MUST be in a negative flow room to have a NRB or BiPAP/CPAP through a single limb circuit.

 

[Hockey]

I got puked on by a patient who turns out to have Swine Flu


I'm still here

 

[VentMedic]

I got puked on by a patient who turns out to have Swine Flu


I'm still here

Vomit is not aerosol particles.

Seriously, learn the facts about exposure for the many different diseases. No one should call you paranoid for being informed.

I have yet to comment on the hideous uneducated statements made on the tattoo thread and probably won't since Rid did a nice job stating what needed to be said. Playing roulette with your health and those around you that you care about is never a good thing. Don't take this one incident as a chance to get cocky and believe you are invincible. This is how misinformation spreads and people let their guard down. Some EMT(P)s will hear "Hockey EMT got puked on and nothing happened". Then someone will say, "It can't be that bad so why do we need to be concerned"? Thus they blow off something that can be very serious.

We don't know why the flu is more prevalent in the young and in pregnant women. However, that doesn't mean others aren't testing positive for Influenza A. There are others that are also sick but aren't dying. As well, the initial tests for certain populations are not reliable such as those who are already immunosuppressed.

Here's an article of interest:

Officer Brings Swine Flu to San Francisco PD

Five officers show symptoms

Wednesday, July 29, 2009

http://www.emsresponder.com/article/article.jsp?id=10048&siteSection=1

A San Francisco police officer apparently brought swine flu back from a trip to Mexico and infected four other officers, a police spokesman said.
The five officers are stationed at the department's Northern Station on Fillmore Street and work the same shift, Capt. Al Casciato, head of the station, said.

Two days after one officer returned from Mexico, he and other officers started showing flu symptoms, Casciato said. When one of the officers went to the doctor he was tentatively diagnosed with the H1N1, the virus that causes what is generally known as swine flu.