Systems For Touching Gurney/Clipboard/Pens without Gloves?

[Lithium]

I know I'll probably get flack over this, but I rarely write anything down while on scene or in the back of an ambulance.

For one, the laws in Ontario are very grey regarding what is admissable into court (yes, it's happened that gloves with scribbled vitals on the backside have been entered as evidence) that if I don't write anything down, I don't have to worry about it.

I believe in using my short term memory for things such as patient allergies, medications (and usually, all pill bottles are brought with us to the ER so I can just look at the label) past history and events leading up to the call. Vitals are easy to remember, as it's very rare that they change drastically. Then, all this information is present when reporting to triage or the MD. Same thing for patching. I hated looking down at my glove when giving reports initially, so I dropped the habit. Plus, it's better interpersonal skills and body language if you're looking the person you're talking to in the eyes rather then looking down. Then, after the patient care has been transferred, I grab a cup of java and go write my form. No gloves involved!

As you do more calls and develop your own routine, you'll find you can pick up certain things quickly. When I first started out, I'd forget the patients name right after they told me, and the reason being, I wasn't really paying attention. I was too concerned about other things then I was the patient. That quickly stopped, and now my full focus is on them and what they tell me. Plus, I'll usually repeat it multiple times during assessment/procedures (okay Jane, we're going to take your blood pressure, Jane we're going to move to our stretcher, Jane Jane Jane Jane Jane Jane .... repetition builds memory).

If that doesn't work for you (using your memory) then ask the FD on scene with you to be YOUR recorder. There's no reason why they can't stay an extra two minutes to write down patients name, contact information, meds etc etc and hand that sheet to you which you can place in your pocket. Same thing for vitals ... have them write down your first set, even on the back of a 6 or 10 second strip!

With regards to gloves, I only use them when in direct contact with patients. As far as everythin else, I try and use a glove free environment. Using the stretcher, switches in the back of the ambulance, driving, talking on the radio ... none of that requires the use of gloves, and is easily cleaned with wipes after the call. Don't let your dispatch push you back into service if you feel you aren't ready. If you need an extra 5 or 10 minutes to wipe down your vehicle, then take it. It's your work environment, you need to feel comfortable in it otherwise stress will build up.

peace

[JakeEMTP]

Soooo.... how do you remember your vital signs until it is time to do your electronic PCR?

.

I write the baseline V/S on my gloves. :wink:

[PRPGfirerescuetech]

Am I the only one who carries a notepad?

[whit72]

I also carry a pad, I used to be able remember three sets of vitals. Not any more. I can barely remember the address when its toned out.

[Eydawn]

Definitely always have the little memo pad in the back pocket. They're cheap, so if they get gunky well, out they go! Good for writing hx, things you thought looked funny, vitals, drunken quotes... you name it.. and don't worry about the pen. Wash your hands. The handle on the bathroom faucet in the Arby's is a much, much scarier thing to touch.

Wendy

CO EMT-B

MI EMT-B

[noahmedic]

I try to be diligent with gloves when I'm working with a patient, but there are times I just work with my bare hands, like doing a quick BP or taking a pulse. My skin comes in contact with far more people on the subway on the way to work than when I'm actually at work. I don't mind getting my hands dirty, but I am sure to get them clean right after wards, if all else fails I do a quick rub down with alcohol preps. If there's bodily fluids around, you should have gloves on, that's common sense, but I'd say be more diligent about washing your hands then making sure your gloves are on at all times. We have these extra thick rubber gloves that are good if you are banging around, they are very hard to tear, but doing delicate procedures with them is a real challenge. Our IV start kits come with a pair of sterile gloves, and when I'm doing an IV I always change into them before proceeding, not to fool myself into thinking that I'm going to be doing a sterile procedure, but at least they are cleaner than the other gloves I was using, and they are much easier to work in. This brings to mind a question I was debating with my partner. Say you have a long sleeve uniform shirt on and you are working on an actively bleeding patient. I have a tendency to pull my sleeves up to keep them out of the way of anything oozing. Now, my partner asserts its better to get it on your uniform shirt then your bare arms, but me, I honestly think that if you clean it off quickly its better to get it on your forearms than your uniform. If you get it on your uniform, especially a dark one like mine, you may not notice. In addition, if it seeps through, it is trapped by the cloth next to your skin for a prolonged period, unless you want to do a strip tease in the back. I don't mind getting blood on me. Yes, I ideally, I should be wearing a disposable gown if the person has a bleed, but falling short of that, which do you think is better, on the uniform or on your arms?

On your arms, definitely. As long as there are no open cuts your fine. I feel the same way, but I always wore white uniform shirt, so if I got stuff on it, it was just gross looking.

Noah

[AnthonyM83]

So, I decided not to wear gloves except when in direct patient care yesterday.

Just my luck I got two small cuts (lac and abrasion) somehow when lifting the gurney when overweight pt started freaking out.

But really it's much easier than worrying about gloves every second. Thanks guys.

[emtpsaveu911]

Two pens? One dirty, one clean. I cant even make it through a shift, hell usually a call without losing my one pen.

A little trick i use for taking down vitals if notepad is not available, is a strip of 3 inch tape on your thigh. Good for multiple patients / or messy scene.

[Dustdevil]

A little trick i use for taking down vitals if notepad is not available, is a strip of 3 inch tape on your thigh. Good for multiple patients / or messy scene.

I do that on every single patient. It's the only way to avoid having to handle that piece of paper, keep it handy, and not end up wondering where that little piece of EKG strip with all my vitals on it went.

I don't even touch the clipboard until I have already delivered the patient to the ER and washed my hands.

[emtpsaveu911]

I do that on every single patient. It's the only way to avoid having to handle that piece of paper, keep it handy, and not end up wondering where that little piece of EKG strip with all my vitals on it went.

I don't even touch the clipboard until I have already delivered the patient to the ER and washed my hands.

Yes ---I used to do the write on the back of glove thing but i quickly learned how messy that could get trying to handle my used glove after ive washed my hands, bad habit to start and unsanitary. I usually lost that little strip of EKG paper before i got to ER, and someone else mentioned having FD write down stuff for you on scene, but unless they ride in with you they usually wander off and forget to give you the notes they took for you. So, I found 3 inch strip of tape on the thigh is the best way to go. :wink: