Systems For Touching Gurney/Clipboard/Pens without Gloves?

[EmergencyMedicalTigger]

There's nothing wrong w/having different pens. When I worked for a service that still required handwritten reports, I carried a pen to use on calls for pts to sign forms and a pen that I didn't let anyone else touch for finishing reports after calls.

[Dustdevil]

When I worked for a service that still required handwritten reports, I carried a pen to use on calls for pts to sign forms and a pen that I didn't let anyone else touch for finishing reports after calls.

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

Even if a system utilises EPCRs, the same dilemma exists. You still have to write sometimes. And then there is the matter of disinfecting the tablet or computer. How often do you disinfect the keyboard on the computer at the station? You say it's not in the ambulance, so it doesn't matter? Think again. How anal are the other people who use that computer about washing their hands? Would you bet your life on it?

That is the big problem with gloves. It makes people feel like they don't have to wash their hands as often. Or at all.

Another cut and dried argument for mandatory microbiology prerequisites for EMT and Paramedic school.

[Timmy]

I don't wear gloves' date=' unless it is a sterile procedure or there is some other clearly visible source of concern, like messy wounds, or I will be sticking me fingers into someone's arse.[list']

That’s crazy, we have to wear gloves even if were giving out pararcetamol.

No gloves, No patient contact is there little saying.

[EmergencyMedicalTigger]

Dust, good points. My partner and I try to keep our work areas as clean as possible, so we wipe down our computer at the beginning of our shift-I don't know about the other crews. We usually print code summaries off the LifePak for our vitals, times, etc. I prefer to write stuff on a small notebook I keep w/me, such as pt info or manual vitals and just refer to it later. Most of the time I have them sign a separate acknowledgement/refusal card instead of trying to get them to electronically sign on the computer correctly.

I'm not perfect w/it comes to keeping everything germ free, but I'm better than most. I'm a big proponent of hand washing even if gloves were worn.

[Asysin2leads]

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?

[Timmy]

My service makes us wear gloves as they can’t guarantee the safety of its members. It’s more of a big insurance thing all about infection control. They can’t guarantee that the patients don’t have infectious disease, vis-versa with the staff treating a patient. We even have to wear goggles when a patient is vomiting or bleeding anything more than a minor laceration.

Normally one member treats the patients w/ gloves on and the other does the paper work or gets the equipment. Otherwise I treat the patient, control the bleeding or bodily fluids then remove my gloves and fill out the paper work. You could double glove if you wanted to…

[akflightmedic]

Here is the solution to your pen issue Anthony.

There were many times I found myself with only one pen in my pocket and "uh oh!" I had to get a signature from an icky patient.

Many times I have either A: asked the pt to put on a glove and sign or B: Put a glove on the pen and asked them to sign.

Not once have I ever had a complaint or negative comment. They usually say ok cause I tell them straight up I dont want your blood on my pen as I use this one over and over.

[JPINFV]

For the gurney makeup, my company's culture (it's not really set in stone or anything) is a fitted blue sheet over the mattress (it can be used as a draw sheet in a pinch and it doesn't normally get changed), a regular blue sheet tied at both ends that covers the mattress (always gets changed), and another regular blue sheet that is used to cover the patient (always gets changed). We have the patient (non-critical or transfers) raise their hands, cover them with the blue sheet, seat belt, double the sheet back over the belt, then let them lower it (lots of steps, but generally takes less then 5 seconds). Now the patient's arms aren't seatbelted in (comfortable and the attendant is able to take BPs) while the gurney is covered.

For decon, I got in the habit before I started driving (most of our units are single driver) of deconing everything after the first call before clearing or at the first posting spot (and by deconing, I mean wiping ever surface down). Now that I'm a driver, I have no problems helping my partner decon the back (I've had other partners just sit and watch me when I was attending).

I've also gotten in the habit of changing gloves like a mad man (helped me out in lab class, stupid upperclass men who were taking notes during rabbit/sheep brain dissections without removing their gloves). I've never taken vitals IN the ER on a transport. The latest I'll take a set of vitals manually on a non-critical patient is in the bay before removing the patient. If the patient is critical and being transported BLS due to short transport times then I'll grab the second set off of the monitor in the ER and document appropriately (last V/S via machine @ PRC, for example).

For clipboard location, a good location if the person is seated up is behind the back of the gurney between the hydraulic support bar and the gurney. At worst, that place should be dusty. Also a common place (I personally don't like it, though) is between the mattress and the gurney.

AK, if your partner is putting on their gloves WHILE driving, please smack them. Smack them for extreme wackerdom (because they have NO time between getting out of the unit and walking to the back to get equipment/gurney?) and putting everyone's life at risk by operating an emergency vehicle in a dangerous manner.

[PRPGfirerescuetech]

I solve this problem with this easy three-step plan that has worked for me for over thirty years:

• 1. I don't wear gloves, unless it is a sterile procedure or there is some other clearly visible source of concern, like messy wounds, or I will be sticking me fingers into someone's arse.

2. I wash my hands as if I owned stock in the surgical scrub manufacturer.

3. I decon everything in between every patient.

TAKE HEED IN THIS. THERE IS NO REASON TO DO ANYTHING BEYOND THIS...

[Dustdevil]

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?

I'm with you on this one. Better on the arms than on the shirt. I am always disgusted when I get undressed at the end of a shift and find a big bloody patch on my skin that I didn't know about because it was on dark clothing. And I still carry a spare uniform on the ambo with me, just in case.