HIV and EMS co-worker

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VentMedic

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After reading through some of the BSI posts, I have to ask these questions;

What are your thoughts on having an EMS partner who is HIV+?

Do you consider yourself open enough for your EMS partner to tell you he/she is HIV+?

If you found out in the healthcare setting that your friend's EMS co-worker was HIV+, would you disclose it to your friend?

What about the Hep C partner?

I'm just curious to see if attitudes have changed over the past 20+ years.
 
I have several friends who have Hep C and have lost friends to AIDS. I don't think anything about a co-workers health is any of my business unless it impacts their ability to perform their job.

I think I might be more concerned with the co-worker who has the flu or bad cold and is hacking germs into the air around me than I am in the blood borne pathogens. Higher likelyhood of my contracting the illness with the second than the first.

But, I'm one of those tree hugging Washington State liberals you hear so much about.
 
I would advise anyone with HIV to better get another job. With the exposure and potential of the virus going into full blown AIDS, is a great potential and being exposed to any other viruses, bacteria is suicidal. Worked at a place in the late eighties with many medics with AIDS, and it was only a short time before they caught something.

It is not so much they would infect someone rather they get infected by a patient.

Hep C is very hard as well on someone in the field. Chances are they too would be too ill to work, especially in a stressful position. Many healthcare workers get exposed and receive Hep C from exposures. It makes them feel like they have bad flu like symptoms all the time and very. very weak .. Some attempt to tx. with interferon chemo..injections, which helps place Hep C in remission but makes one very sick from the chemo tx...

R.r 911
 
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:sad: Oh Ridryder911, we used that "it's for your own good" argument in the 90s after the government would no longer let us just fire people with HIV.

This isn't the 80s anymore.

People with HIV are now living 15 - 20+ years now with HIV without ever being defined as having AIDS. This is partly due to them keeping their jobs which they enjoy working at, sense of worth and esteem, INSURANCE, medical leave benefits, etc.

The HIV era has made us more aware of the need for better BSI for all types of viruses and bacteria for protection and to protect. Prior to that, I remember having to "borrow" from the hospital masks and gowns because the ambulance companies didn't supply them. Even the hospitals weren't into Universal Precautions in the 80s. I have attended alot less funerals for coworkers with HIV/AIDS in the last 10 years. The ones I have attended have been for something else; COPD, MVCs, etc. A person with HIV in the healthcare profession will usually take that extra step to be cautious where the non-HIV person doesn't. The non-HIV person may then find themselves going for an unplanned PPD test or out with the flu.

Healthcare workers who are cancer survivors, organ transplant recipients, COPD, autoimmune diseases, etc still try to maintain active careers providing to the sick and injured. I have seen many more healthcare workers with some form of COPD being put out of work and/or die from a flu bug. If we eliminated all of the immunosuppressed healthcare workers from the industry, we would truly see a shortage.

Peace and Health for all.
 
It didn't sound to me like Rid was intimating those with HepC or HIV be fired 'for their own good' or even fired at all. He makes a valid point though about the stress and exposure to infection that is dangerous to a compromized immune system. While HepC can take some time to become debilitating, it does eventually and the treatment can be equally difficult. What we do is a high stress job and stress will exacerbate symptoms on any disease.

Sounded to me like Rid was giving a caution to someone infected considering working in this line of work rather than steps to be taken by the workplace. I know if I got sick with something that nasty I would definitely take a break from work. But it should be a personal decision, absolutely.
 
Please don't flame me, because in no way do I mean this to sound derogatory, but if EMS workers are at increased risk to accidental exposure from HIV positive patients, doesn't it stand to reason that it goes both ways, and the patients are at increased risk for accidental exposure from an HIV+ EMS worker? Universal precautions have come a LONG way, but there are always unfortunate and unplanned for incidents (ambulances wreck, accidental needle sticks, pt seizes and stuff goes flying, pt suddenly gets violent......)
 
Medic's wife... I understand your point, but I don't see a great potential for blood-to-blood contact with a patient... for an accidental needlestick, it would have to stick ME and then the PATIENT... that's a lot of sticking.


As for VentMedic's questions:

If I found out from a PATIENT that they were HIV+, and they happened to be a co-worker of mine, or a co-worker of a friend, then HIPPA and other laws cover that... I cannot say anything about it.

If my partner confides in me that they are HIV+.... I wouldn't care.... there should be VERY little chance for me to become infected by their blood or OPIM... I'd be MUCH more likely to get infected by a patient. Same goes for Hep C.

If the partner was healthy and OK, I'd have absoloutly NO problem working with them. If they continually played the "I'm a weakling with AIDS" card, I'd tell them they probably need a new line of work, because I'm not comfotable not having a partner I could depend on.

As was said, these days, with the triple coctail, many folks live moderatly normal lives as HIV+ people.

Jon
 
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Medic's Wife,
Your post is exactly what I was hoping for. My questions where about how you would feel if....

You asked the questions that can open lines of communication even if not on this forum. These are questions that YOU have a concern for. The only way to get answers to alleviate or justify your concerns is through honest expression. Someone with HIV, or not, may appreciate your frank concerns because then they can now give you answers from their prospective. There are probably several here that share the same concerns or very similar. Even with all the education and information available, it is natural to still have concerns about the "what if?".
 
Well, Jon did have a good point about the needle stick scenario being highly unlikely. It's just that from my experience in life, there is always the possibility of the unexpected that you cannot take into account and prepare for, kwim? That's how accidents happen. Take my hubby for example. He likes to sleep in until the last possible moment, then drive an hour to work on country roads at 90 MPH. Yes, he's had all the classes, yes, he's had years of experience in ambulances, and yes, he's a good driver. But what drives me nuts is that he never takes into account that element of unsuspected events, like going around a sharp corner only to find a cow standing in the middle of your lane, and a semi truck in the oncoming lane. And in our neck of the woods, that's a distinct possibility, lol!

There are just things in life that you can never anticipate and prepare for, and I think that element is hightened in EMS, because you are always working in different, sometimes less than stable environments, with medically and/or emotionally unstable people. To me, that just ups the risk factor all around.

Now personally, if I had a partner that was competent and trustworthy, I would probably not have any issues. I'd be more likely to be endangered from a patient than I would be from someone educated in universal precautions. However, if the person in question had shown a pattern of poor judgement in the past, I might be a little more leery. I guess to me it's more of a character/common sense issue than it is a HIV status issue.

As far as risk to the patient goes, it is feasible that a patient could bite an EMS worker hard enough to draw blood. What then?
 
Medic's Wife said:
As far as risk to the patient goes, it is feasible that a patient could bite an EMS worker hard enough to draw blood. What then?
Click to expand...

Well, that would just serve them right!:P
 
Bite me hard enough to draw blood and you will have to gum your food for life. Keeping in the vein of this thread though, I worry more about hepatitis, or one of the exotics than HIV transmission. My partner's health status is only important to me if it directly impacts his ability to work or is harmful to a patient.
 
oldschoolmedic said:
......or is harmful to a patient.
Click to expand...

Ok, I'm playing devil's advocate a bit here, but wouldn't the patient biting and drawing blood from a HIV+ worker harm the patient? There is definite exposure, and risk of contracting. Is there a possibility that an incident like that could open up the HIV+ worker and the ambulance service to a lawsuit?
 
As a vector for infection a bite is not a good route of transmission. Casual contact with the blood of an hiv positive patient, though not recommended, is not dangerous. The infectious capacity of hiv is severely limited by the fragility of the cells involved. The tissue of the mouth while thin, heals rapidly, and the passing of the virus would have to occur without light, heat, and minimal saliva present, while this "perfect situation" happens during oral sex, a bite by its very nature is violent and transient. There would have to be an open wound in the mouth with direct contact on the newly created wound of the victim. I don't know anyone who is going to let another person just chew on them. While I would be worried about the possibility of infection and take yet another post-exposure pack of pills, I still understand it to be a poor route of transmission. HIV requires intimate contact to spread. Hepatitis on the other hand can be spread through casual contact. One study cultured viable hepatitis on a disinfected surface 210 days post exposure, and don't get me started on prions which can withstand being autoclaved. That's scary stuff.

As to your second point about the liability of the service,no. As long as universal precautions were observed, and there is no deviation from the standard of care, there is almost no chance of cross-infection or risk to the patient. As a service director I would be far more frightened about firing an employee based on their health status. The check I would have to write to the terminated employee would have to be extra-long for all of the zeroes that came after the one. The ADA and ACLU, along with activist groups would quickly turn your service into a national nightmare, as an example of what not to do. The last thing any ems director wants to see sitting in his parking space when he shows up to work in the morning is a satellite truck from NBC.
 
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