Should People With Infectious Diseases Be Allowed in EMS?

[DwayneEMTP]

It was very plain, but for the level of conversation, way too simple in my opinion.

I would be interested in your opinion as opposed to you simply raising your hand and yelling..."Yeah! What he said!"

See what I mean?

Dwayne

[brentoli]

If you have HIV, would you want to work in an environment that exposes you to infectious diseases everyday? With your compromised immune system?

[ccmedoc]

Three things...First, I think when operating from your perspective you should feel obligated to answer the above question.

Fair enough..

I am not sure where I was going with the last bit I wrote, to be honest. I don't think I have any Prejudices or fears concerning this subject, either. I do, however, think that anyone with a disease such as hepatitis or HIV, given they take proper precautions, should not be prevented from practicing medicine..EMT, Paramedic, Nurse, Physician, etc.., if they don't mind putting themselves at risk. I believe the risk is greater to them than their patients.

Where TB is concerned, I believe that with the proper treatment, and being away from patients until cleared with the three clear sputum cultures, a previously infected person should be allowed to practice.

I think what I was saying was that a person most likely would not be held responsible for transmitting the flu or common cold to an immunocompromised patient prehospital, and it would be far easier to do this than transmit Hep or HIV. I just worded it a bit retarded..I read Ventmedic's posts and agree with most of those also..

And to answer the second question...I most likely have gone insane..It comes and goes, I'm just ridin the manic wave at the moment.. :wink:

If we still disagree I'm sorry, but I think people can work with these illnesses when proper precautions are taken..thats all..

[VentMedic]

If you have HIV, would you want to work in an environment that exposes you to infectious diseases everyday? With your compromised immune system?

That would depend on the person's CD4 and viral load count.

I have just one more comment about getting cut while on scene. Commonsense should prevail here regardless of one's infectious status. Hopefully one would feel themselves getting cut. Take a minute to utilize your basic first-aid training to clean yourself up, bandage and glove. This is again important for a couple of reasons:

1. It is just not polite or in bad form to bleed on everything or everyone regardless of your health status.

2. You need to take care of yourself and cover the wound before you do pick up something either from the patient or a dirty environment.

I do agree with ccmedoc on passing the flu and other common ailments to immunosuppressed patients. In the hospital, if the pt is neutropenic, WE mask even when we are healthy. If we feel like we are getting a cold, WE mask regardless of pt dx. Right now several employees have had the flu. We would rather they stay home. PERIOD. Elderly people do die from the flu.

Pts with TB are isolated until their sputum is clear which is 3 - 7 days usually. They will continue to be treated for several weeks or possibly months after that. If the patient is seriously non-compliant, we still have a TB hospital (A.G. Holley) in South Florida.

It has some good links on its web page if you want more info.

http://www.doh.state.fl.us/AGHolley/index.html

[DwayneEMTP]

Fair enough..

I am not sure where I was going with the last bit I wrote, to be honest. I don't think I have any Prejudices or fears concerning this subject, either. I do, however, think that anyone with a disease such as hepatitis or HIV, given they take proper precautions, should not be prevented from practicing medicine..EMT, Paramedic, Nurse, Physician, etc.., if they don't mind putting themselves at risk. I believe the risk is greater to them than their patients.

Where TB is concerned, I believe that with the proper treatment, and being away from patients until cleared with the three clear sputum cultures, a previously infected person should be allowed to practice.

I think what I was saying was that a person most likely would not be held responsible for transmitting the flu or common cold to an immunocompromised patient prehospital, and it would be far easier to do this than transmit Hep or HIV. I just worded it a bit retarded..I read Ventmedic's posts and agree with most of those also..

And to answer the second question...I most likely have gone insane..It comes and goes, I'm just ridin the manic wave at the moment.. :wink:

If we still disagree I'm sorry, but I think people can work with these illnesses when proper precautions are taken..thats all..

My apologies ccmedic for the misunderstanding. I had quoted your question as the one to be answered, my post was to Lone Star or others of the ...misguided camp... :wink: Though I can see now as I look back at it that I failed to make that clear.

I have a lot of respect for you opinions, and quoted you as I believed you had made this one very clear as well as posed one of the most, if not the most relevent question in this thread.

Thanks for taking the time to respond!

Dwayne

[UMSTUDENT]

While I understand that as a patient there must be significant fear of infection, I also can understand how devastating it might be for a person with one of these diseases to loose their practice.

As for the provider passing one of these diseases, I think we should all worry more about passing MRSA or some other bacteria from person-to-person. When was the last time anyone here took extra special care to practice aseptic technique? I've probably yelled at several providers in the last week about using gloves when they set-up an IV bag. Insuring the line NEVER touches the floor. Properly removing extension lines from wrapping so that a minimum level of exposure is had. Do you all wash your hands after every call? Scrub your ambulance top-to-bottom? Has anyone here seen the studies on the cultures done from the back of ambulances?

Many of the diseases mentioned here, minus TB, require direct blood-to-blood contact or saliva-to-blood contact. Even then, some of these diseases require a significant viral load. I understand both sides of the argument, but also know that people fear things- sometimes irrationally. I see few instances where a person with HIV, as a paramedic, can easily pass the disease to their patient. I see our patients bleeding on us more than the other way around.

Remember tolerance. It would be a shame to take a very skilled person off the street for fear only. I don't think this is generally a black and white answer.

[ccmedoc]

Thanks for taking the time to respond!Dwayne

No problem..I must have read the posts a dozen times trying to find the problem with them...8-[

Thanks for making me think I was (am) crazy...Jeesh!

[EMTrocker]

Simply put, NO!. Take your stinky DNA elseware. No HIV or Hep, MRSA,SPCA or PAPD for me!

[courageheartx]

This is pretty cut and dry. No, someone with a communicable disease or (even congenital or heriditary)*some conditions* should not be allowed in the industry. as mentioned before, first do no harm. also refer to hippocrates oath. anything in society can be looked at as discrimination,but when it boils down to it, a patient's safety and wealth shouldn't be jeopardized even more because of a providers current illness or disease. the public utilizes the EMS system when they are ill or an emergency has arisen. as providers as a whole we need to be in shape,healthy and able to preform our duties. if were not,what are we really doing for our patients?

good topic brett.

[VentMedic]

This is pretty cut and dry. No, someone with a communicable disease or (even congenital or heriditary)*some conditions* should not be allowed in the industry. as mentioned before, first do no harm. also refer to hippocrates oath. anything in society can be looked at as discrimination,but when it boils down to it, a patient's safety and wealth shouldn't be jeopardized even more because of a providers current illness or disease. the public utilizes the EMS system when they are ill or an emergency has arisen. as providers as a whole we need to be in shape,healthy and able to preform our duties. if were not,what are we really doing for our patients?

good topic brett.

Simply put, NO!. Take your stinky DNA elseware. No HIV or Hep, MRSA,SPCA or PAPD for me!.

Wow! I feel like I'm back in 1986 as FFs and Paramedics made the same comments as they watched the family home of the Ray brothers (hemophiliacs with HIV) burn due to arson. The FFs were not about to fight the fire because "you know that HIV stuff could be in the smoke". The house was also burned for the good of the community.

One could get away with those comments and the fear in 1986 since HIV was still relatively new. But, this is 2008.