How well are we cleaning our rigs?

bigbaldguy

bigbaldguy

Former medic seven years 911 service in houston
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Ours are taken out of service once a month for an OSHA cleaning, if we suspect bedbugs we can have the rig pulled from the streets and cooked, and after most pts we clean the gross contaminants up.

If our rig got absolutely destroyed by somebody we'd be out of service until we got it clean again.
 
Some practices I've read about here:
1. FEBREEZE/other deodorants: not disinfectant, actually leaves a non-bacteriostatic residue which continues to release stink that covers the real stink of stuff that needs to be cleaned up properly and disinfected. Some folks react to strong smells like Febreeze also.
2. WIPES: May leave a bacteriostatic residue, but that can't be depended upon to supplant actually getting in there and cleaning the bugs and debris out. Microbes in substrate (dried blood or mucus, mud, secretions and excretions, tissues) have to be gotten out, and small particles can protect then carry lots of microbes.

Watch your cleaning instruments; that mop may have been slogging through lots of ambulances that day without being taken out, decontaminated or discarded, etc. as needed.

Good lighting assists good cleaning, too.

I didn't read the article, but I have read similar titles through the years. Often the fomite carrying the bugs is the patient, so unless we start stripping and decontaminating patients, it's going to keep happening.

Studies culturing MD's hands and housekeeping tools (and nurses' scissors!) in-house are sobering too.
 
Last edited by a moderator:
We have hygiene plans, on which everyone must keep. In our plans is also regulated at which infection runs the disinfector is to consult. The documentation of the cleaning and disinfection measures is dealt in regulations and laws.

We conduct daily, weekly and monthly by disinfection measures.

After an infection trip, we have to put our ambulance for an hour for the disinfection out of the service. The same for the Weekly and Monathly disinfection. Equipment that have been used in applications, are immediately to disinfected after the Use.

The hygiene Supervisor or disinfector controlled vehicles here without an appointment.



Daily disinfection:
- Driver's room
- Patient Room: handles, stretcher, contact surfaces, shelves, carrying chair
- The outside of bags and cases
- Uniforms

weekly disinfection
- Driver's room
- the patient's room from the ceiling to the floor, Complete
- stretcher
- carrying chair
- ECG machine, complete
- Ventilators complete with accessories
- suction Unit
- Blood Pressure Equipment
- pulse oximeter
- Cases and bags, completely

Monathly disinfection
- driver"s room
- the patient's room from the ceiling to the floor, Complete
- stretcher
- carring chair
- Drawers, cupboards and compartments inside
- Case and bags from inside and outside
- ECG machine, complete
- Ventilators complete with accessories
- suction Unit
- Blood Pressure Equipment
- pulse oximeter
- scoop stretcher
- vacuum mattress
- Spine Board
- ruffs
- K.E.D system
- Sam splints
- vacuum splint
- pneumatic splint
- carry Slings
- EMS Jackets
 
Rettsani said:
We have hygiene plans, on which everyone must keep. In our plans is also regulated at which infection runs the disinfector is to consult. The documentation of the cleaning and disinfection measures is dealt in regulations and laws.

We conduct daily, weekly and monthly by disinfection measures.

After an infection trip, we have to put our ambulance for an hour for the disinfection out of the service. The same for the Weekly and Monathly disinfection. Equipment that have been used in applications, are immediately to disinfected after the Use.

The hygiene Supervisor or disinfector controlled vehicles here without an appointment.



Daily disinfection:
- Driver's room
- Patient Room: handles, stretcher, contact surfaces, shelves, carrying chair
- The outside of bags and cases
- Uniforms

weekly disinfection
- Driver's room
- the patient's room from the ceiling to the floor, Complete
- stretcher
- carrying chair
- ECG machine, complete
- Ventilators complete with accessories
- suction Unit
- Blood Pressure Equipment
- pulse oximeter
- Cases and bags, completely

Monathly disinfection
- driver"s room
- the patient's room from the ceiling to the floor, Complete
- stretcher
- carring chair
- Drawers, cupboards and compartments inside
- Case and bags from inside and outside
- ECG machine, complete
- Ventilators complete with accessories
- suction Unit
- Blood Pressure Equipment
- pulse oximeter
- scoop stretcher
- vacuum mattress
- Spine Board
- ruffs
- K.E.D system
- Sam splints
- vacuum splint
- pneumatic splint
- carry Slings
- EMS Jackets
Click to expand...


yea....we dont clean our stuff very well in America.

I try to wipe everything down with the "anti-bacterial" spray (I have theories about where it comes from, most likely it being mostly water). But we dont always get time. Even if we have time its usually visible surfaces maybe the monitor
 
Commonly overlooked areas I clean every shift:

C-MED radio
Grab rails, especially the ceiling one
Steering wheel

I don't care what the emergency is you should not be touching things with a bloody/contaminated glove. CHANGE YOUR DAMN GLOVES before touching equipment.
 
CLeaning patient care articles weekly instead of after each contact? I assume the probes and contact points are being cleaned after each use. But some like the pulseox probe won't stand for that very long.

Used to always find much UNDER the rails of the ambulance litter where we'd grab to lift it. We clean stuff we see.

BP cuffs?......
 
SliceOfLife said:
Commonly overlooked areas I clean every shift:

C-MED radio
Grab rails, especially the ceiling one
Steering wheel

I don't care what the emergency is you should not be touching things with a bloody/contaminated glove. CHANGE YOUR DAMN GLOVES before touching equipment.
Click to expand...

Since I usually ride third I stay behind while they take patient in and tryntomget every nook and crany in the back of the truck. Grab rails and steering well almost always have blood on them somewhere. Bottom of the captains seat is always awful. The levers that operate the seat are almost always contaminated with blood. Generally I find some on the handle pulls for the cabinets as well. All of this after the rig was supposedly already cleaned.
 
mycrofft said:
CLeaning patient care articles weekly instead of after each contact? I assume the probes and contact points are being cleaned after each use. But some like the pulseox probe won't stand for that very long.

Used to always find much UNDER the rails of the ambulance litter where we'd grab to lift it. We clean stuff we see.

BP cuffs?......
Click to expand...

I clean the BP cuff after every call, and everyone looks at me funny for doing it. I don't care, I do the same for my steth too. I try and wipe the cot down after every patient too but again, the culture is that "clean looking" dialysis patients only need new linen and not a wipe down. Sad. <_<
 
What if we put disposable covers on handles and pulls like dentists do? And should the interior be better designed for cleaning and staying clean?

I used to use 70% alcohol on everything, sometimes preceded by H2O2 to break up blood etc.

What are we taking home on our shoes?

(After volunteering around animals at the local shelter, we change clothes and drop the ones we wore into the washer before we walk into the house).
 
We clean very poorly. Our company is too cheap for wipes and we usually run out of spray.

I don't wear uniforms home and boots stay in the trunk. I'm very germophobic.
 
Yeah, I'm just waiting until the hospital figures out how many of their MRSA/C-Diff/VRE etc. infections were not hospital acquired but actually ambulance acquired.

Infection control has been a major part of hospital culture for years and it's been reinforced lately by Medicare rules that don't reimburse hospitals for hospital acquired infections. Once the hospitals start really coming down on transporting agencies that are infecting all kinds of patients we might see a culture change in EMS. That or EMS agencies will come up with rules saying that hospitals can't come after them for ambulance acquired infections (looking at you FDs).

Generally, the culture of EMS has been one of not cleaning. I think one poster described the general behavior of agencies in my area very well: a sheet change is enough if they weren't leaking anything, wipe down equipment if it gets gross contaminants, wash hands before eating EMS break room food... There are jump bags that I don't think have been wiped down since they were purchased, heck I don't think some of the pulse-ox's have been wiped down since they were purchased.

Is anyone's work starting to shift to one of cleanliness? I personally bring a bottle of hand sanitizer with me and clean my hands after the patient is loaded (if I'm driving) and after the call is done. I tend to wipe down the cot and everything that gets touched if the patient was old or gross. It's certainly something I would like to improve on a personal level, but the culture largely stands in the way ("Hey! why are you cleaning that? cavicide wipes don't grow on trees you know"... actually heard that from a senior employee at a place I worked once)
 
94H said:
yea....we dont clean our stuff very well in America.

I try to wipe everything down with the "anti-bacterial" spray (I have theories about where it comes from, most likely it being mostly water). But we dont always get time. Even if we have time its usually visible surfaces maybe the monitor
Click to expand...


If we do not disinfect our Ambulances very well, our businesses can during inspections by the authorities to be punished with fines of up to 25 000 euros and the loss of the concession.

Infected a patient proven, in our ambulance , then it is here, negligent injury dar. If he dies in consequence of the infection, even this is negligent homicide.

For the personnel, it can sometimes mean losing the professional certificate, or a lengthy punishment.

I personally see it so ..
Do your patient not on, what you don´t like to do with yourself .
Everyone has only one health and one life. This has to be protected and not permanently damage.

For us, the guiding principle:
We do not have to be protected from the patient but the patient before us.^_^
 
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