Would You Tell

[BossyCow]

That was my point. But, as Rid and others continually point out... EMT Class isn't long enough to teach decent A&P or anything else...

I don't know about your system, but ours includes continual training. We get yearly training on infection control plus I review our infection control policy on a yearly basis and go over all updates with our EMTs. In addition to that, once a year we have the infection control director of the local hospital come in and do a presentation.

BSI doesn't mean putting on the magical nitrile shields of protection and be forever clean. BSI means practicing safe behavior around pts and their ickies. This is a matter of setting a standard within your agency and then training your staff and holding them to that standard. Initial EMT training deficits cannot be held responsible for lax practice in the field if the field supervisors allow risky behavior to continue.

 

[AnthonyM83]

If first on-scene, my gloves come on as I exit the ambulance and walk to the back or sometimes as I pull out the gurney (that way not touching dirty ambulance outside door handles with gloves that will be touching a patient).

If FD is already there, I carry gloves in my hands, because 2 to 6 EMTs/Medics are already surrounding the patient. No surprise ambushes. Also, a lot of these calls will be canceled as we walk up.

If I know it's something I'm not going to need gloves for sure, I'll abandon the 2nd on-scene rule (CPR in progress, injury, etc).

Only times I put on gloves while en-route are traumas where there's potential of a bloody someone running up to me as I exit the ambulance or where I'd need to hurry (GSW's, auto versus pedestrian, stabbings, assaults, drownings, etc)


THERE IS NOTHING WRONG WITH WEARING GLOVES INSIDE SOMEONE'S HOUSE.
Patients don't even think twice about it. It's standard for EMTs to wear gloves.
IT'S LESS OFFENSIVE if you come in wearing them then suddenly put them on before you touch them.

 

[firecoins]

I put them on when necessary. Its not hard to put on gloves without making a big deal about it in front of a patient. I have yet to have a patinet be offended. Don't run if your not being chased.

 

[AnthonyM83]

They're not going to say anything. I've had patients give facial expressions and even made a friendly comment or two. And I have actually been offended (I wouldn't be now that I'm working in EMS, but previously when in a car accident...even though it was reasonable for them to put on gloves because I had freaking blood on me).

But my point was that if the original poster's problem though gloves shouldn't be on inside the house perhaps because of offending them, I wanted to point out it would be less offensive then to put them on right before touching the patient...IF we were going that route of worrying that much about it.

 

[para82frame]

Is it ok to wear two pairs of gloves? Won't the rubbing of the gloves between each other compromise them in some manner?

My understanding is that wearing 2 pairs of gloves doee not cause failure like umm, wearing 2 "protective devices" as the activity done while wearing gloves is not as vigorus, so the friction doesn't brake the gloves down like it would a condom.

 

[firemedic7982]

I think you would be wise to make it practice to wear gloves on every call. Im all about pt. compassion, but my safety, and my partners safety supercede the pt's feelings.

I have yet to have someone get offended by me wearing gloves on a call. It is my services policy that all personnell will wear not only gloves, but eye protection on every pt. contact.

Im not one to make fun, or belittle someone but to the original poster ... Your partner who got mad at you for wearing gloves is an idiot, and I would have told them wear to put it. Thats rediculous to get angry over protecting yourself, you have no idea what condition that pt. is in. Remember... people often lie, stretch the truth, and conveniently omit facts. Is that pt. infact in as good of health as they say they are???

 

[BossyCow]

The whole idea of a pt being offended at PPE is ridiculous! I use PPE to protect myself from getting something nasty. We see a lot of really sick people in our ambulance and I'm not going to assume that first they know everything they are infected with, and second that they will be willing to share that information with me.

Universal precautions means just that! It doesn't mean being careful when you know there is something that can get you, but the assumption that every patient has everything that can infect you. Waiting until we see a need to use PPE is too late in many cases. Yes, the skin is a wonderful barrier device but there's another organ we have to use to its highest purpose as well, the brain. My brain tells me that we are creatures of habit, and the habit of wearing clean gloves for each patient and taking them off when they get icky, or before we touch something clean is the best way to avoid contamination of the clean, with the dirty.

No, my doctor doesn't put gloves on before he treats me for my annual asthma meds update. But then, I am not bleeding, puking, losing control of my bladder, bowels or other bodily functions in his office. I have had patients do all of the above in my ambulance. My dentist wears gloves and a mask, as does his dental hygenist and my optometrist washes his hands when he enters the exam room before examining me. I do not find this offensive, but rather proof that they are vigilant in their dedication to avoid the spread of disease from one patient to another.

If a patient is 'offended' by my putting on gloves, tough beans! What are they going to think when I put on a face shield, hepa filter mask or get out a big red bio-hazard bag to put their stinky effects in?

 

[medic8613]

In my opinion if someone tells you to take your gloves off you can tell them to f*** off. The most important thing is your safety, and the absence of bodily fluids does not mean that there is nothing you need protection from. There is never a situation in which you can be faulted for wearing gloves (well...maybe if there is heat or fire involved that could cause them to melt.)

I put gloves into the same category as reflective jackets, Kevlar vests, and steel toe boots. You don't need an excuse to wear them. They exist only for your protection and are to be used at your discretion, however there are situations that require their use.

 

[medic8613]

I waited more than 15 minutes to edit, so I have to add this way:

As for sweaty hands, I carry a pair of large gloves and a pair of extra large. Once I take off the large ones and my hands are sweaty, the XLs are easier to put on.

The textbook answer is always wear gloves during any patient encounter. I have also never heard the term "selective BSI," but this is essentialy what I do. I put my gloves on some time during the scene survey and general impression part of my assessment. If the scene or general impression indicates that gloves are reccomended then I put them on. The exceptions are children, where I wait to make contact with them before putting on gloves, and when dispatch says things like GSW, MVC, arrest, or childbirth. Then they go on before I leave the bus. Just be smart about it. If dispatch suggests that bodily fluids may be involved then put gloves on.

Are there flaws in the way I do it? Of course there are. I never know what I'm walking into, but this is just the habit I have gotten into. As for those who say putting on gloves after you walk in is a "delay in care," I disagree. Until protocols or laws specificly state when to put gloves on, it is up to the individual. Putting gloves on once you reach the patient is not a delay of care. It is simply changing your approach to the call by adding a measure of safety, just like putting on a mask after you notice that your patient is coughing up blood. If the 10 seconds it takes a reasonably intelligent person to put on a pair of gloves causes an adverse effect on the outcome, then the patient was already in trouble and having gloves on probably wouldn't have made a difference.

One department had a rule saying that its your fault if you should have been wearing PPE and you get exposed (for example: You start an IV without gloves on and you get the patient's blood in a cut. The expense of all testing and medications is on you because you were not following SOPs. However if you start an IV and blood shoots into your mouth, thats different. A mask is not considered necessary when starting an IV.)

 

[Jon]

As I said... I think my biggest problem is when a provider wears 1 set of gloves throughout the entire call... driving to the hospital/making a new stretcher, etc. Beyond that, I wouldn't tell someone else to take gloves off.

JOn

 

[LE-EMT]

This is kind of an odd topic to me. I guess I look at it like this. I could give a flying monkey's bahookie if it offends you when I walk in with gloves on or if I put them on before I touch you. YOU ARE DIRTY AND I AM DIRTY get over it. It is for your safety and mine. Hell I have been known to wear two or three pair when dealing with particularly dirty individuals.
When on scene would you NOT need gloves. when you aren't dirrect contact with the PT over in the corner picking your nose????
This is the way I look at all cases. I just walked into a contaminated house. Being as this is not my personal residence I do NOT know what is on the counter, the walls, the PT, hell in the air. Not to mention YOU ARE EMS so you were called for a reason the PT is sick in some way shape or form. I am not saying run into a persons house with your Haz-mat gear on. I am just saying better safe then sorry folks.

 

[TNEMT06]

I put them on before I get out of the unit.

 

[Buzz]

One of my instructors brought this topic up for discussion one day. Our book said use gloves at a minimum every time. The discussion was based on when to put them on. For the example he used, he said if we were responding to someone in a call in the classroom, when would we put the gloves on? Most everyone said as they were getting out the ambulance. He and a few other people said they would have put them on at the patient's side because the multitude of door handles that needed to be touched to even get up to the patient. You'd run the risk of bringing germs from every door handle you touched up to the patient.

I've personally gotten into the habit of wearing two pairs of gloves and removing the top set whenever it seems appropriate for the situation.

 

[Res1cue]

Without reading the multitude of replies to this topic, I will say this: always put on your gloves BEFORE exiting the unit. If you don't need them, take them off. If you DO need them, they're already there and won't delay patient care.

Why don't you directly ask your partner why he was so upset by you having gloves on?

 

[CFRBryan347768]

Without reading the multitude of replies to this topic, I will say this: always put on your gloves BEFORE exiting the unit. If you don't need them, take them off. If you DO need them, they're already there and won't delay patient care.

Why don't you directly ask your partner why he was so upset by you having gloves on?

After that i wanted nothing to do with him, since the original post he was asked to leave, didnt resign so he was fired.

 

[mdkemt]

I always put gloves on as soon as we hop into car. Just the way it is. You never know what is going to happen or what you will encounter. Better to be safe then sorry.

 

[Hightoweruk]

i always put gloves on before arriving on scene, normally o it when sat nav says 2 mins away so you have time to ge them on or change one if it tears, while also not giving your hands too much time to start sweating in there.

Ade

 

[KB1MZR]

Department Policy = Gloves on Every Call for Every pt. That means as soon as I get in the ambulance the gloves go on. They come off after the stretcher is disinfected in the ED and I'm ready to put new sheets on. If you want to wear gloves WEAR GLVOES

 

[CFRBryan347768]

Department Policy = Gloves on Every Call for Every pt. That means as soon as I get in the ambulance the gloves go on. They come off after the stretcher is disinfected in the ED and I'm ready to put new sheets on. If you want to wear gloves WEAR GLVOES

I Hope You Change Gloves In Between Settings, Load Strecher New Gloves, New Gloves When Taking PT Out And New Gloves When Moving Strecher To Re-Make

 

[KB1MZR]

I Hope You Change Gloves In Between Settings, Load Strecher New Gloves, New Gloves When Taking PT Out And New Gloves When Moving Strecher To Re-Make

Well, not being a driver (volly jr.) I am with the pt. from the initial contact until they are handed over to the ED. Then i pull the sheets off the stretcher throw em in the bin, wipe it down and then gloves off until the next call - and then another pair of gloves to go clean the pt. compartment before the stretcher goes back in - stretcher needs to be made first for purposes of a busy volly town with only 1 scheduled crew (scatter for 2nd calls) so we respond from the ED a lot.