Have we missed the boat with PPE?

I would always wear gloves, but that's because my hands dry up really bad, and I occasionally have cracks like in the picture I below that I took like 10 minutes ago for this post. Circled it to make it more distinguishable since the picture quality is kind bad.

lthand.jpg


I use lotion too. I usually survive the summer, but when it's winter, I dry up like crazy. :(
 
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I've put those gowns on a couple of times for calls we knew were bloody, maybe 2-3 times in seven years?

Thinking about it though, how often do you see hospital staff wearing them? The only time I see them are on "known" MRSA et al. patients. I put "known" in quotes since not doing isolation percautions it is based off of a pt history that may or may not be accurate.

What concerns me more than PPE is the ambulance as a whole. They gurney, BP cuff, radio, etc. I would love and hate to see cultures done in an amb.
 
I guess I'm going to be known as a germaphobe at the station. I wash my hands, glove up, and wipe down the truck and stretcher coming on shift. Then before checking off the truck and bags I wash again. Gloves on with every patient, off and on for the ride/drop-off at ER, staying on for stretcher cleaning and post run clean-up. Then a wipe down of all my personal stuff halfway thru each shift and at the end of the night.

But I've only seen maybe two other people doing anything close to this. I'm sure we are spreading a lot of critters as a result.
 
I've noticed a huge variation in cleaning and PPE usage depending on who you are working with. Some will check off the truck and go to bed. Others will check off the truck and then start cleaning. I think it's crazy not to clean when you come on shift, because you have no idea what was going on before you arrived. :glare:
 
Aprz said:
I would always wear gloves, but that's because my hands dry up really bad, and I occasionally have cracks like in the picture I below that I took like 10 minutes ago for this post. Circled it to make it more distinguishable since the picture quality is kind bad.

lthand.jpg


I use lotion too. I usually survive the summer, but when it's winter, I dry up like crazy. :(
Click to expand...

My mom had the same problem, its from her thyroid, she swears by utter cream, the only thing that works for her
 
You know wearing gloves halves your chance of infection from an accidental needle stick. Just wear the gloves in contact with the patient, take them off when your not in contact. Quite easy if you ask me.
 
This wasn't started as an anti-glove, thread more of a pro-appropriate use of PPE thread. Gloves for instance, can develop microtears from the moment of donning, thereby reducing their effectiveness. So if your putting them on while going to the call, your starting off in the hole. I'm not saying do a barehanded trach change, but on initial interview and physical exam of the conscious and alert patient you probably don't need a full body condom, or even gloves for that matter. Using your head is the point that needs to be driven home, not the "BSI and scene safe" mantra that gets repeated verbatim at National Registry test nationwide everyday, and does not take into account evolving circumstances/need for greater or lesser levels of protection as the call progresses.

At my part time FD job we do BLS first response. We're also allowed to wear shorts during the summer, but have the appropriate cover garments to protect against glass, ect on accidents. I once had a coworker state I was "stupid" for wearing shorts because of the "danger" I was putting myself in for exposing my legs to blood. I asked him how blood on my bare leg was different than blood that soaked through his pants. I was met with 1). a blank stare, 2). a switch in the conversation to how unprofessional shorts looked. I also used to work with a guy who was afraid to touch our Toughbooks without wearing gloves, but would then set said computer on the kitchen table to finish what he was doing, put away the computer and EAT OFF THE SAME TABLE! It's not PPE I'm opposed to. It's the misunderstanding of it's application that's driving me bonkers lately.
 
1 pair from truck to pt, doing interventions, ect,
1 pair for handling whatever moving equipment we use
1 pair for treatment in back of truck
1 pair up arrival at hospital for pt transfer
1 pair to clean up

5 pairs of gloves minimum, i usually wear 2 pairs at a time, so i can peel off the top layer and have a fresh pair on underneath
 
Were it up to me, equipment used during any call would have its handles, buttons, and other commonly touched surfaces quickly run over with antibacterial wipes between calls.
 
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