Regulations banning smoking in BLS Ambulances

I would review your agencies policy regarding tobacco use. Specifically look at the infection control policy, which OSHA requires and must be reviewed yearly. Aside from the whole smoke, fire, pollutants issue, the act of putting something in your mouth with your hands in the pathogen loaded atmosphere of a rig is stupid!

What you have is someone who believes that the 'anti-smoking' crowd is unfairly jumping on him about something silly. and obviously has no respect for the rules of your organization or its reputation with the public. I would address the PR issues with your admin. If you put your concerns in writing, they will be kept as part of the legal records of your department. Also, talk to your infection control officer regarding a training on how stupid this is.
 
VentMedic said:
We have also had people in the ED who have lit high flow O2 devices and used them as weapons against the staff.
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Out of curiosity, what acts as the fuel in this case? The plastic of the device itself?
 
How absurd.

Just get out of the ambulance, walk a few feet away, and smoke in whatever parking lot you're parked in.

Shouldn't be smoking in an ambulance for a million different reasons.
 
MrConspiracy said:
Out of curiosity, what acts as the fuel in this case? The plastic of the device itself?
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There are many things in an ED that can be lit like sheets, alcohol, lighters and the oxygen permeated plastic tubing that the oxygen can accelerate the flames. If you put a flame near a nasal cannula with O2 running you will get a good flash flame. I see quite a few of my O2 wearing smokers that have tried that once or twice.
 
I have great respect for oxygen and the tanks it is stored in.

A quick internet search for oxygen related incidents:

Premature Boy Burned After Fire In Oxygen Hood

Jan 23, 2008 11:17 pm

http://wcco.com/local/newborn.injured.fire.2.635907.html

However, the fire dangers of oxygen in hospitals and other health care facilities are well known. Fires happen during surgery, and they even happen when patients who are on oxygen try to smoke.

The ECRI Institute, a nonprofit health research agency based in suburban Philadelphia, estimates that 50 to 100 fires annually ignite during surgeries performed in the U.S. Many surgical tools generate heat, and oxygen can build up in operating rooms, particularly under surgical drapes.

The institute says those fires kill one to two people annually, and 20 percent of the affected patients suffer serious injuries. The American Society of Anesthesiologists was developing guidelines for preventing surgical fires.
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Defibrillation in Oxygen-Enriched Environments

http://www.mdsr.ecri.org/summary/detail.aspx?doc_id=8126

Man escapes injury with oxygen tank fire
http://www.emtlife.com/showthread.php?t=4919

Fort Collins fire caused by candle, oxygen tube

http://www.reporterherald.com/news_story.asp?ID=13813

Deseret News | Patient on oxygen lights cigarette and ignites ER


http://deseretnews.com/article/1,5143,635178466,00.html


Woman Taken To Hospital With Serious Burns Monday Morning

http://www.lasvegasnevada.gov/Publications/7217.htm

Here's 108 articles from a tobacco website:
http://www.tobacco.org/articles/category/fires/?code=fires&pattern=oxygen
 
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alright, Ive been putting this off but i guess i'm just going to bit the bullet, take the heat and see if we can put this one to bed.

first, i know there are reasons not to smoke in an ambulance. its not fair to the patients or your partner, its presents an unclean image for the company and the industry etc etc etc. all of those i understand. but the safety risk is decidedly over hyped. i know this to be true. how? read on.

here's the part I'm going to catch hell on. I'm a smoker. have been since i was 15. Ive smoked in just about every ambulance Ive ever worked in. further, Ive smoked in a truck i know had a leaky regulator. never smoked with a patient on board, although i recognize that isn't worth much here. Ive probably smoked thousands of cigarettes in an ambulance and i have yet to blow up. mainly because for that to happen, the environment had to oxygen saturated which would be very difficult to accomplish with the windows open etc.

am i proud of this, no. but i hate myths and legends and scare tactics. don't smoke in an ambulance because its wrong in a lot of ways. but the safety hazard is overwhelmingly exaggerated.

now, feel free to commence beating me up over this. but those are my experiences.
 
KEVD18 said:
alright, Ive been putting this off but i guess i'm just going to bit the bullet, take the heat and see if we can put this one to bed.

first, i know there are reasons not to smoke in an ambulance. its not fair to the patients or your partner, its presents an unclean image for the company and the industry etc etc etc. all of those i understand. but the safety risk is decidedly over hyped. i know this to be true. how? read on.

here's the part I'm going to catch hell on. I'm a smoker. have been since i was 15. Ive smoked in just about every ambulance Ive ever worked in. further, Ive smoked in a truck i know had a leaky regulator. never smoked with a patient on board, although i recognize that isn't worth much here. Ive probably smoked thousands of cigarettes in an ambulance and i have yet to blow up. mainly because for that to happen, the environment had to oxygen saturated which would be very difficult to accomplish with the windows open etc.

am i proud of this, no. but i hate myths and legends and scare tactics. don't smoke in an ambulance because its wrong in a lot of ways. but the safety hazard is overwhelmingly exaggerated.

now, feel free to commence beating me up over this. but those are my experiences.
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Every partner I've had smoked too. I don't like it, but I deal. You know why? They're respectful and intelligent enough to simply walk a yard away from the ambulance before lighting up. It's so easy.
 
well i have to add that i only smoked in the rig when my partner was a smoker as well. otherwise, i went out side.

still no excuse, but eliminates that argument.
 
KEVD18 said:
well i have to add that i only smoked in the rig when my partner was a smoker as well. otherwise, i went out side.

still no excuse, but eliminates that argument.
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I meant a respect of the vehicle and of the patients that would eventually be riding in it. I was walking that yard with my partner to talk to them as they smoke. Never an excuse to smoke in the rig. Not when such little effort of walking a few feet away makes such a huge difference.
 
KEVD18 said:
here's the part I'm going to catch hell on. I'm a smoker. have been since i was 15. Ive smoked in just about every ambulance Ive ever worked in. further, Ive smoked in a truck i know had a leaky regulator. never smoked with a patient on board, although i recognize that isn't worth much here. Ive probably smoked thousands of cigarettes in an ambulance and i have yet to blow up. mainly because for that to happen, the environment had to oxygen saturated which would be very difficult to accomplish with the windows open etc.

am i proud of this, no. but i hate myths and legends and scare tactics. don't smoke in an ambulance because its wrong in a lot of ways. but the safety hazard is overwhelmingly exaggerated.

now, feel free to commence beating me up over this. but those are my experiences.
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Education, education, Education.

Myths? I guess this is where some FF training could be beneficial to you.

What you do to yourself is one thing. If it puts a patient or your partner in danger, that is something else.

Respiratory equipment is supposed to be regulated, checked and double checked. I'm sure the last thing on the minds of the RN and RRT in the nursery was giving a baby severe burns on their shifts.

I have seen O2 fires and they can have some very deadly results. Our county hospital has had more than its share even with the best of safety efforts. I have 2 patients in our BICU that were the result of smoking with O2. Neither have a good prognosis. The equipment I work with is constantly checked by us and by Biomed. Doing something stupid just because you think it can't happen to you is irresponsible if others are around or to the property of your company. I would rather not tempt fate by being in a closed ambulance with oxygen equipment running or things that have been exposed to large quantities of oxygen. Some transport ventilators can run at 60 L/min. That is why we advise single limb ventilator circuits to remain outside of the bedsheets to exhaust.

I personally would not want to be responsible for someone's burns by giving irresponsible advice. Respect the O2 and don't smoke around it. Do not advise patients who smoke that it is okay to do so with O2. Do not tell them the danger of O2 and smoking is a "myth". Do not play with fire and O2 just to disprove a "myth".
 
Every MSDS lists compressed medical oxygen as NonFlammable with No Flashpoint

Granted Oxygen is required for combustion, and the richer the atmosphere the higher the chances of a *boom*. The O2 tanks we use are compressed oxygen, while the latent atmosphere is mostly nitrogen.....Small enclosed space with an O2 tank opened up will create the potential for an explosion if there is the slightest accelerant in the richer atmosphere compared to that of 'simply the air we breath'


Edit: A gasoline soaked rag in a shed with a spark from a lighter 10 feet away will not cause an explosion.......same room, same rag, same spark with an O2 tank opened up and a huge BOOM
 
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VentMedic said:
That is correct but it supports combustion. Why do you think it is a popular gas for welding?
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it does more than support combustion, its required. speaking of being educated in fire science, oxygen is sort of a huge part of the fire tetrahedron. way more than a support role.

again, i'm not trying to defend my actions. i know it wrong. but for this issue to be an imminent safety risk, you need an oxygen rich environment. a person that's on 2l all day every day, their facial hair, nose hair, hair hair, clothing can be saturated. if you leave a cannula running sitting on clothes or sheets, they become saturated. but a vehicle in motion, with a forced ventilation system, passive vents in the walls and open windows is pretty well impossible to saturate.

for their to be a significant fire from smoking in the bus, you have to close all the openings, release the o2 into the vehicle and then light a butt. i don't know about your services, but when i was working we're in and out of the truck a hundred times a day and i don't remember ever duct taping the vents shut.

that's what i mean earlier by a myth. sure, you can get jacked up smoking in an o2 rich environment, but you actually have to try to make it happen. its not just a random occurrence.
 
Thanks for everyone's input. I will have to go through the OSHA regulations again.

KEVD18 said:
one more thing: can anyone explain to me the difference between a bls ambulance and an als ambulance as it pertains to this discussion?
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I mentioned we are BLS because while reading through some NJ regulations, there was different sections; one covered basic transport services, another covered BLS ambulances, and another covered ALS ambulances. I just wanted to make sure, if necessary, the right regulation was presented.
 
BossyCow said:
I would review your agencies policy regarding tobacco use. Specifically look at the infection control policy, which OSHA requires and must be reviewed yearly. Aside from the whole smoke, fire, pollutants issue, the act of putting something in your mouth with your hands in the pathogen loaded atmosphere of a rig is stupid!

What you have is someone who believes that the 'anti-smoking' crowd is unfairly jumping on him about something silly. and obviously has no respect for the rules of your organization or its reputation with the public. I would address the PR issues with your admin. If you put your concerns in writing, they will be kept as part of the legal records of your department. Also, talk to your infection control officer regarding a training on how stupid this is.
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I did read through our SOPs and bylaws. It was stated in one section that there is to be no smoking or tobacco use inside the building. It did not say anything about the ambulances. Another section put the responsibility of making sure no one smokes inside the ambulance on the crew members (not worded exactly like this, but nonetheless it prevents tobacco use in the rig). I will have to find out where our infection control policy is and have a look through that.

We did put our concerns in writing to the board of trustees. I also think making an amendment banning smoking in the ambulances to the SOPs and/or bylaws would help us discourage people from smoking in the ambulances.
 
ConcernedEMT said:
We did put our concerns in writing to the board of trustees. I also think making an amendment banning smoking in the ambulances to the SOPs and/or bylaws would help us discourage people from smoking in the ambulances.
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It might discourage some but there will always be those will do it anyways. Getting caught smoking in an ambulance is pretty much an insta-fire (suspension until board finalizes your termination) at most of the services I have worked for.

(For the record, I am a smoker but don't smoke in an ambulance due to the 'insta-fire' policies)
 
How will we ever be considered professional with garbage like this. Smoking in an ambulance? Are you fvcking kidding me?
 
This is New Jersey. Why are we acting so shocked.

I mean, we don't even require 2 EMTs on 911 ambulances if you do it for free. Why should we not allow smoking....:blink::blink:
 
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