MariB

When we walk into a house on a 911 call, we don't always know what we are seeing, the patient fell? OK well they didn't mention the blood all over the place. Or the pt not feeling well that just had the mrsa scrapped from their knee yesterday. Its unknown.

On a inter facility transfer, with no open wounds or body fluids present, there is no reason to treat them any differently that anyone you just shook hands with, even if they do have HIV or hep c.

No the op said we don't wear gloves everywhere we go, every time we go in public. Etc

It appears he/she is anxiety stricken and is trying to reason with themselves. I mean the posts here and the other place surely show concern and then to go and say you need repeated exposure to broken skin etc... well if that was the case, he wouldn't have been nervous.

No we don't wear gloves in public to open doors etc, but we aren't cleaning open wounds while we do that. The blood on door handles if any are micro scopic, I wouldn't touch a door with blood on it without gloves!

We are talking about his mental health, not whether he will mess up or not.

There is no need to wear gloves on every call. Do you wear gloves to touch door handles or shake a persons hand where maybe there was dried blood or infectious bodily fluid without you even seeing or knowing it was there? No you don't. You just wash your hands throughout the day. Its the same thing for patient care. Anyone can become a patient. Just because there riding in the ambulance dosn't mean there infected and need gloves to take a BP or pulse .etc. If there is visible contamination or the patient tells your they have something, by all means glove up and I do. As for my situation, I have been told by several doctors and nurses that my non intact skin proves no exposure to hep c. CDC and many other places show that non intact skin is not a risk for contracting hep c. It only becomes a risk when your non intact skin is repeatedly exposed to the virus. I don't know where you guys are getting your information from, but maybe you all can use a little bloodborne pathogen refresher. You don't need a body condom to be near people.

Oh my goodness

I'm truly speechless

/> We have had our share of scary diseases or symptoms that are just too close to not be a believer in universal precautions. If you live in an area with a busy international airport, you have to be suspicious sometimes.

Someone mentioned carrying gloves in their pocket. Do not do this. Your clothes rubbing against the gloves along with body heat can make these gloves worthless and you might even be aware of it. Consider it like a defective condom which you discover after the fact. Also, every time you reach to your pocket for a clean set, you risk contaminating your pocket. This seemed to be a learned thing passed on from one person to another as a neat shortcut until a whole ambulance service was carrying gloves in their pockets. Some EMTs did end up with nasty infections to their eyes and skin. A staph infection is also nothing to laugh at.

I am a volly an have a vest, my pocket is not up against me and I keep those for switching out old for new to carry out equipment etc. Its a designated pocket just for that purpose. You don't have to dig around to grab one, you can pull one out at a time. With bare hands, not gloved hands.

Gloves are kept on us, a few pair at a time because we have responded to scene from home. It is a little bit of a different situation as these gloves are grabbed with bare hands for equipment, and not kept in clothing pockets.

However the advice is good and should be noted for people who wear uniform.

Is it bad that I read that as, "I will disinfect my penis"?

bwahahahaha

Ouch, I think that would hurt.

I use gloves on every 911 call no matter what. However on transfers I may take them off depending on the situation. Closed skin fracture, heart pt etc with no nausea, I will take them off.

I will wear them the whole transfer if there is bleeding or vomiting etc. Then I will disinfect my pens, clipboard etc, anything the pt even touched.

And don't forget Ebola too

lol etc etc

Please remember you are number one in this business. Your health and safety come first and foremost. Hep C and HIV are not the only things you can catch from a patient. I keep gloves in my pockets to change them constantly. If I'm going to be grabbing our jump bag, k pop the used ones inside out and put new on etc as the straps are tough to clean. Cot straps will get removed and soaked in disinfectant after an exposure to any infectious fluid. Not just for future patients safety, but for ours too.

Remember gloves protect you from all sorts of viruses and infections including but not limited to MRSA, hepatitis, HIV, c diff, herpes sores etc.

You must not have liked the responses on the other site where you mentioned you don't always wear gloves if you know the person etc.

You were exposed, HIV exposure was small as it was dried and did not touch an open sore, but hep of all strains can live several days in dried form. Your exposure risk was low but it is there, you are hesitant to report it because you were in the wrong (I read the other thread) yes, you have exposed yourself.

Your safety always comes first and was the first thing you were taught. Our protocol has is wearing gloves before we even set foot out of the ambulance. Let this be your lesson and I hope everything turns out for you.

EMT,nursing and other health care professionals have the highest rate of non drug use or sexual contact hepatitis infection contraction rates there is. PPE is a must. Keep safety glasses , gloves and a face shield near you at all times.

I am thinking of you and hope things are OK!

Since you are obviously new to EMS we'll go easy on you.

Yes it was an exposure

probably not an exposure worth worrying about unless you know the pt is positive.

You should have been required to take an OSHA bloodborne pathogens course before you were allowed to respond to calls. this is mandatory, which would have explained the process and how to make determinations of exposure or not.

If you are a germaphobe then you might want to reconsider your life activities.

he has stated elsewhere he doesn't wear gloves unless he knows the pt has an infectious disease. I hope this changes his way of thinking.

If you have doubts, why not wait a bit for a later date? It isn't going anywhere.

I believe everyone has told him he needs to get this under control. Anxiety can be managed very well with meds, therapy or preferably both. Hopefully he will get the help he needs and has the desire to do so. People with GAD will be compulsive over anything, job related or not. He should fulfill his dreams and goals but everyone agrees he shouldn't be on an Ambulance until he has it controlled and he has time to get that done before he gets his certification.

Good luck to you Seth. Just remember your health, physical and mental are everything here. Someday, even someone without anxiety issues will run into that call where they wonder if there was something more they could have done. You want to be in the right mind set for that. Get a good psychiatrist and make sure he knows your intentions. Find a different medications and better coping skills. Hopefully you can achieve your dreams!

Actually, I think I do.

Funny how your post is gone now...did you delete it, or did admin?

no, you really don't.

Admin deleted it.

Certainly. Feel free to correct any and all spelling, punctuation and grammar errors you find.

Or you can accuse me and other posters of being high.

Or you can actually contribute something.

You obviously do not know the whole story about the "high" comment.

I was stating shivering was good brain function wise, not that she should be allowed to continue

Shivering is good.

Anorexic?

I would tone down the o2 a bit, post code patients should run around 94%.

The rest is out of my scope as I haven't learned to read EKG etc I will watch this one unfold.

I'll. Have to take some. Just broke it in. A couple firsts tonight. Had an emergent transfer by ground and my daughter was the driver. So since we had an EMT with a nurse in the back I was her trainer. She's been driving a while but only other emergent transport was in town. We very rarely run lights and sirens and this one was 68 miles.

Got my hands on it today. It is a nifty little gadget.

It works on all differet terrains and angles

It charges the battery in the cot

It has a manual override in case of power failure

Very easy to use

I give it a thumbs up.

We busted ass to get it many times having 3 lighter weight women on and lifting heavier patients. The cot has a 700 point limit as most power cots do but the rep said not to worry about the system itself.

I'm happy

I'd do a whole weekend at Bernie's if I had too

The people even in the service you work with may not even understand why that particular call hit you, but they should understand calls can bother anyone.

I'm so sorry you are going through this. I understand the small area thing. I hope you find relief.

I did think of that, but this is why I didn't go that way.

The patient is going to be able to breath easier in the original sitting position, moving them into the recovery position in a moving ambulance is unsafe for both the patient and myself, I would rather not pull over and take the time to do that if it means a delay to the ER , and if they code I am ready for that scenario.

I see.

It isn't so bad if you have to to loosen the straps and start wedging blankets under them to get them onto their side. However, it takes some practice. You can then pull them out to get them back on their back.

Well this is an interesting scenario. It's always great to call in ALS but alas I do not have that luxury. Since I'm so efficient I have all my equipment with me

As I am doing my initial assessment ABC's, I will ask my partner to get the O2 on, I am choosing a non-rebreather at 15 lts. and to get the cot ready.

As soon as this is done my patient is getting onto my cot ASAP in a sitting position unless he goes unconscious then supine it is.

In all reality getting this patient to the ER and getting notification to them ASAP is my priority.

I can help with the secretions with suction but I need to be careful not to get to suction happy or I can wipe with a gauze to help.

With the hx that has been given I am also suspecting a stint has dislodged from the infection, so that is going to tell me that there is a chance the air is not necessarily going into the lungs but the chest cavity. I think that using a BVM may be detrimental in this case as the pressure may cause more damage, but if I had to it would be very gentle.

I can only use a King if the patient codes, so if he goes unconscious I am more apt to try a nasal airway first.

I will continue to monitor and reassure this patient all the way to the hospital and stay, help in the ER and truly hope for the best.

What is air to Chair?

I think instead of supine, how about recovery position to help aid in letting secretions drain, then if you suction maybe you could suction his left cheek where it is draining and may not have to irritate the infected areas? I'm guessing his pharynx, tongue, and everything at this point may be affected at this point. .

O2 and cot

I'm applying diesel and hoping he makes it to the er. I would have my medic intercept, and call in ahead telling them we have a perforated trachea. This is a patient I don't want to see.

It is definitely a reason I want to go back to school. Bls is not going to save this guy of he loses his air way. I can give him an opa, NPA and a king airway, but he needs more than that.