Infection control in ambulances is indeed deplorable. We transport many patients with infections diseases, some that are difficult to treat (MRSA, VRSA, VRE, c diff, etc), with none of the standard precautions that hospitals employ (gowns, masks, etc). Despite my own best efforts to decontaminate, I have come to accept that my stretcher and truck are dirty.
With all of that said, I do try some different things for patients who are immunocompromised. I like to do a wrap for them on the stretcher (open a sheet/blanket fully, place patient on, then wrap around patient). This minimizes their contact with the stretcher and straps, and is often more comfortable. If they are stable, and I need a set of vitals, I get a set while they are still in their hospital room (these patients tend to have their own bp cuff and scope, to minimize cross contamination). If I do use my own cuff and scope, I make sure to wipe it with the decon wipes thoroughly first (I just this week learned that the surfaces need to stay wet for more then 1 min, in order to be effective). If the nurse recommends, it, I have the patient wear a surgical mask throughout the transport, and consider using the exhaust fan during transport, to make sure air is flowing around.
Otherwise, there really isnt much we can do... its unfortunate.
