when is it necessary to...

[Sasha]

So all you smarty pants are telling me that not only do you know what a ickies patient may or may not have immediatly, but you also know there's nothing on your hands that you could've picked up somewhere and are now bringing to an immunosupressed patient?

Gloves are not just for your protection, but the protection of the patient as well.

They take two seconds, why not wear them even when they aren't needed? It's just another safe guard between you and the patient to benefit both of you.

 

[medic417]

smarty .

ummmmmmm smarties!!!!!!!!!!!!!!!

 

[Sasha]

Ooooh candy!!!

 

[JPINFV]

So all you smarty pants are telling me that not only do you know what a ickies patient may or may not have immediatly, but you also know there's nothing on your hands that you could've picked up somewhere and are now bringing to an immunosupressed patient?

Gloves are not just for your protection, but the protection of the patient as well.

They take two seconds, why not wear them even when they aren't needed? It's just another safe guard between you and the patient to benefit both of you.

It's a question of balance and thought. Does your physician know what you have/don't have when he comes in and shakes your hand at the beginning of an office visit? Now, sure, I'm all for wearing gloves pending an evaluation of the situation, but after an evaluation is done based on the ickyness of the patient (hopefully the provider is practicing good hygiene), a decision about gloves could be made on an informed level.

For additional thought, I'll post the same survey I posted in a thread about hygiene and osteopathic manipulation lab on SDN.

Quick survey.

1. T/F Our bodies have an entire army devoted to killing tiny weeny bad guys?

2. Y/N I wash my hands between paying for fast food and sitting down to eat.

3. Y/N When getting drive through, I always wash my hands between paying and eating.

4. Y/N I understand that money, and by connection my wallet, are very dirty thing.

5. T/F I don't live in a plastic bubble insulating myself from the outside world.



The really is an option between 'never wear gloves' and the nuclear option of 'always wear gloves.'

 

[Sasha]

1. T/F Our bodies have an entire army devoted to killing tiny weeny bad guys? My body does, but how do I know my patient's has a normal immune system? How do I know that they are not immunosupressed and the icky I just picked up from the ambulance door handle is not going to land them a lengthy hospital stay?

2. Y/N I wash my hands between paying for fast food and sitting down to eat. Yup. I wash or sanitize my hands prior to eating.

3. Y/N When getting drive through, I always wash my hands between paying and eating. Yes sir, I do. I have hand sanitizer if I am eating on the go. But was that not covered in the previous question?

4. Y/N I understand that money, and by connection my wallet, are very dirty thing. You are getting redundant, my dear friend. Can you not think of better arguments? I understand all of the above.

5. T/F I don't live in a plastic bubble insulating myself from the outside world. You don't have to live in a plastic bubble to understand that gloves are not only for your protection but the protection of the patients. We are not talking about a doctor's office visit where there is a chart and a history presented to you, we are talking about emergent or urgent situations.

There is a good middle, and I'm not talking about using gloves for everything from pushing the stretcher to opening doors etc. I am talking about direct patient care. Gloves are such a simplisitc device and an additional safeguard between you and your patient, it takes a few seconds to put them on. So why on earth would you argue against them?

 

[NEMed2]

How I love the debates about gloves & PPE.
I generally put my gloves on as I am walking up to the pt. That being said, do I wear them every time? No. Do I sometimes take them off after I get into the ambulace, only to take a bp or provide some care that doesn't require my touching body fluids. Sure. But I also use hand sanitizer before I touch a pt without gloves on. And I wash my hands after every call. I'm not going to ride around wearing gloves 24/7 just in case I get a pt that is ucky. Who knows what I touched after putting my gloves on but before I get to the pt. Is it ideal to wear gloves every time you have pt contact? Yes. Is that reality for most? Not even close.

Seaglass- Is is possible that now your partner isn't as conscious of grabbing a pair of gloves, knowing that you have a spare in your pocket that you will hand him if the pt is ucky? Try having a conversation with them, again, about it. Make it a topic that can't be avoided. Maybe they don't know how you feel about it and would take it into consideration. Or, maybe your partner will think your still a little green and laugh it off. At least then you will know.

It is necessary to... report another EMT if they are more f-ed up than your pt. Sorry, but if you're coming to work hammered or after what looks like a week long moon shine bender, you are asking to be reported, disciplined/fired, and lose your cert. I have a thing against someone consciously endangering their partner, pt and innocent bystanders. There are a ton other reasons to report someone, but that is my little pet peeve.

 

[harkj]

I prefer to wear gloves when its needed but not all the time and germs are everywhere whether your working or not

 

[PinkEMT23]

Gloves

I agree with harkj and ventmedic. When you are shopping at the store pushing a buggy around you don't wear gloves. We go on many calls where gloves aren't needed because you may never even get close enough to the patient to need them. That is unless you force every pt you come in contact with to go to the hospital. I never said I didn't think gloves should be worn. I don't always wear them but I don't put them on until I know they are needed. With that said don't worry what your partner does. Protect yourself. No matter what anyone says about the crew's safety comes first. You come before your partner. If you don't protect yourself how can you protect your partner or anyone else. I mostly have a tendency to not wear gloves with little kids. I don't know about you but when I was a child going to the doctor scared the crap out of me so I try to make kids as comfortable as possible. Not scare them with gloves. But once again like I said before....BSI is very important but if you are going to choose not to wear them on every call, for the entire call make sure you use good judgment.

 

[HotelCo]

Remind your physician to wear gloves during the entire exam next time you go for a check up. Make sure to tell him that your fire captain said to always wear gloves when dealing with patients.

I make my doctor wear gloves during an examination. If he touches me without them, chances are he does it with other patients.

 

[BruceD]

Physician would be a bit of a different scenario

In addition to having prior medical information on almost every patient encountered, they have the facilities & time to wash/sanitize hands before and after every patient and are also seeing patients (for the most part) in very controlled environments where sudden surprises like kneeling down in a puddle of fluids are not as likely.

Just a thought...
-B

 

[JPINFV]

How often are you kneeling down in blood? Seriously now. Not every call (in fact a very small minority) are multisystem traumas with puddles of blood that you're sloshing around. Regardless, there's still those moments between being able to see the scene and actually ariving at the patients side that would give you the opertunity to decide on a proper course of action in terms of PPE.

Besides, where are you going that lacks proper hand washing facilities. Every emergency room, nursing home, assisted living facility, and every other care facility I've ever been to has had a sink. Every ambulance I've been on have had some sort of hand sanitizer.

 

[PinkEMT23]

I don' t know what podunk town you live in but mva's, shootings, stabbings, etc happen where I work at least 5 of every 10 calls. One year where I work counts as 3 years experience anywhere else due to the high call volume and all the trauma we have. My towns first homicide happened while I was sleeping at the station across the street so dancing around in blood is nothing uncommon around here. That said, I wear my gloves and always bring extra uniforms with me. I wouldn't want my family getting into an ambulance or being handled by a medic or emt that is nasty. This all boils down to you do what you have to do to protect yourself and your patient. If your partner don't want to comply that's his or her problem not yours . You did your job by trying to help but if they don't want to listen, you can tell them till your blue in the face and they aren't going to do it until they want to themselves.

 

[medic417]

I don' t know what podunk town you live in but mva's, shootings, stabbings, etc happen where I work at least 5 of every 10 calls. .

I have to throw the BS flag. There is no system in the USA that at least 50% of their calls are serious trauma as you are claiming yours are. You may have a busy system that gets a lot of calls for serious trauma but I bet you are probably just like everyone else that gets 90% of calls that the patients could and probably should have gone by private car to the ER and probably just to a clinic for most of them.

Until you provide documentation flag stays in place.

 

[JPINFV]

I don' t know what podunk town you live in but mva's, shootings, stabbings, etc happen where I work at least 5 of every 10 calls. One year where I work counts as 3 years experience anywhere else due to the high call volume and all the trauma we have. My towns first homicide happened while I was sleeping at the station across the street so dancing around in blood is nothing uncommon around here. That said, I wear my gloves and always bring extra uniforms with me. I wouldn't want my family getting into an ambulance or being handled by a medic or emt that is nasty. This all boils down to you do what you have to do to protect yourself and your patient. If your partner don't want to comply that's his or her problem not yours . You did your job by trying to help but if they don't want to listen, you can tell them till your blue in the face and they aren't going to do it until they want to themselves.

Let's assume that number is right. What do those calls come in as, elderly patient fall down/go boom? I highly doubt that you come rolling up to a massive traumas most of the time thinking it's something simple, especially gun and knife club patients. The only thing I'm advocating is using your brain, not sticking a carrot in your ear and going, "Durr, I'm frail, all of my patients are bleeding out and have Hep C, HIV, MRSA, and every other assorted disease possible." There's a middle ground where people who choose the nuclear option generally fail to see. It's exactly the same issue with people who are against selective spinal immobilization and want to back board everyone with trauma.

 

[Sasha]

Besides, where are you going that lacks proper hand washing facilities. Every emergency room, nursing home, assisted living facility, and every other care facility I've ever been to has had a sink. Every ambulance I've been on have had some sort of hand sanitizer

Why would you even need to wash your hands if nothing on your hand was a danger to the patient and nothing on them is a danger to you?

"Durr, I'm frail, all of my patients are bleeding out and have Hep C, HIV, MRSA, and every other assorted disease possible."

I think you are failing to see gloves are not just for your protection but the patient's as well.

 

[HotelCo]

If you don't wear gloves when touching a patient, you're a fool. End of story.

 

[JPINFV]

You wash your hands because of simple hygene. Patients touch everything in a facility. Does anyone wear gloves the entire time they are in a health care facility? Patients aren't confined to their rooms, so the entire facility is going to be cross contaminated with patient germs, so for the entire 'gloves every patient, every time,' argument to be truely valid, then gloves need to be worn from before you enter a facility until you leave the facility.


Yes, gloves protect the patient, but the vast majority of patients have immune systems also and aren't living in negative pressure isolation rooms. They are going to be exposed to the same things everyone else is just by simply walking around their facility. Healthcare facilities may be 'clean,' but the vast majority of facility patient care space is anything but sterile.

 

[JPINFV]

If you don't wear gloves when touching a patient, you're a fool. End of story.

How about we keep this to a logical discussion and not revert to name calling? Mmmkay?

 

[HotelCo]

How about we keep this to a logical discussion and not revert to name calling? Mmmkay?

It's the way I view the subject, so I said it.

 

[JPINFV]

Then the logical conclusion is that anyone who doesn't wear gloves in public is a fool too. 'Healthy' people have germs too afterall.