Should People With Infectious Diseases Be Allowed in EMS?

[itku2er]

I have been reading this thread and trying to figure out what I want to say about it but no matter what i typed it all came down to this simple question

If someone you loved more than life itself was laying there dying would you turn away a person with HIV and let them die?

[mrmeaner]

I still maintain that proceeding down this road could open a can of unintended consequences that will only complicate the problem and cause additional problems.

That is probably true.

Why would we disclose it to the patient? Yes, your employer should know, but why should the patient? My hepatitis status has nothing to do with my treatment of a patient. What possible effect would sharing this information have, other than scaring them?

Sorry, but it comes back to my belief that the patient should have the right to decide whether or not your disease is significant to him.

I have an immediate family memeber who had to face the decision on whether to work or not because of the risk he posed to others due to a medical condition. I understand the dilemma and the pain this causes. I still believe the best decison is to walk away.

[mrmeaner]

I can see that Mr. 9 posts to his name has not come back and made any more comments. To me that speaks volumes to his credibility and I will treat that credibility for what's it worth, NOTHING> .

Kind of disappointing really.

If someone you loved more than life itself was laying there dying would you turn away a person with HIV and let them die?

No, I don't believe anyone would if they truly believed they were going to die. But, I think a closer question would be, "If someone you loved more than life itself was having severe abdominal pain, would you turn away a person with HIV and take them to the ER yourself?"

[katgrl2003]

No, I don't believe anyone would if they truly believed they were going to die. But, I think a closer question would be, "If someone you loved more than life itself was having severe abdominal pain, would you turn away a person with HIV and take them to the ER yourself?"

I really don't see a difference. So it's ok to risk transmission if you know they're dying, but not in any other circumstance? Patients can die on us anytime, anywhere. Correct me if I'm wrong, but by your line of reasoning I can only work codes from now on, since they're going to die anyways.

-Kat

[tniuqs]

That is something to think about. What if the patient finds out later that the medic that had treated him had/has some specific disease? When the patient finds out is freaks, "That medic had WHAT???". Will he want to sue? Be tested time and time again? Who knows what kind of legal action he may want to pursue.

Perhaps we should put signs on WE of EMS ?

1- I have been tested and it all good, well last month.

2- I have not been tested.

Perhaps preface ones introduction to your patient , Hi my name is Paramedic squint and I have HIV ... can I help you today ?

Can one see how preposterous these arguments are getting to be ?

I say there's a pretty good chance there would be a lawsuit. Not that anyone but the lawyers would win unless there was an actual transmission of the disease.

Even attempting to try to determine WHEN an individual was infected : Look to the patho once again, any Lawyer would be pissin in the wind, as no ID expert out there would stand up on this one and point fingers, just my guess.

mrmeaner

Sorry, but it comes back to my belief that the patient should have the right to decide whether or not your disease is significant to him.

I have an immediate family memeber who had to face the decision on whether to work or not because of the risk he posed to others due to a medical condition. I understand the dilemma and the pain this causes. I still believe the best decison is to walk away.

Ok try this example / tangent on for a minute, Your family member is a highly respected Cardiac Surgeon still the same answer ? I doubt it, but following some of the very irrational logic here, best he retrain as a plumber perhaps ?

[mrmeaner]

I really don't see a difference. So it's ok to risk transmission if you know they're dying, but not in any other circumstance? Patients can die on us anytime, anywhere. Correct me if I'm wrong, but by your line of reasoning I can only work codes from now on, since they're going to die anyways.

I'm sorry, but if that's what you got out of it you missed the point by a long shot. The point is that most people will chose to mitigate risk whenever possible.

[Dustdevil]

If someone you loved more than life itself was laying there dying would you turn away a person with HIV and let them die?

That's not even a remotely valid question, with respect to the current discussion. The valid question would be, if someone you loved more than life itself was laying there dying, and you had a choice of a healthy, disease free paramedic and an HIV positive paramedic treating them, which would you choose? After all, we're talking about whether or not those people should be in the field in the first place.

No, I don't believe anyone would if they truly believed they were going to die. But, I think a closer question would be, "If someone you loved more than life itself was having severe abdominal pain, would you turn away a person with HIV and take them to the ER yourself?"

Yep, like it or not, those are the kinds of concerns that the public has.

I really don't see a difference. So it's ok to risk transmission if you know they're dying, but not in any other circumstance? Patients can die on us anytime, anywhere. Correct me if I'm wrong, but by your line of reasoning I can only work codes from now on, since they're going to die anyways.

Kat, I can't even figure out what you are talking about. If you really don't see a difference, then you must have zero experience in emergency healthcare. What we reluctantly accept when our backs are against the wall, and desperate for lifesaving options, is indeed very different from what we prefer and demand on a day-to-day basis. Pragmatically weighing your options is simply part of human nature.

[mrmeaner]

Lets not forget one other small concern, a false positive ..... hmmm.

Good point.

Question: How long can HIV outside of the human body ? just wondering can anyone hazard a GUESS?

30 seconds if I remember correctly.

WHAT ? HIV and full blown AIDs is not a Pandemic ?

Perhaps look to the continent of Africa please if you get a minute.

I was referring to the transmission of HIV via HCP/pt. contact. Sorry if that was unclear.

Just about any type of blood bourne disease can be transmitted it does not have to be a "lac", a simple crack in a cuticle can and does lead to infection, but staph and strep are far more likely on the hit parade, besides was she wearing "just" nitrile gloves ... very poor PPE cleaning sharp metal edges I would be so bold to suggest.

I believe she was cleaning the cot when she was cut but I can't say for sure. Nothing was being cleaned that would have been expected to lacerate the skin.

Even attempting to try to determine WHEN an individual was infected : Look to the patho once again, any Lawyer would be pissin in the wind, as no ID expert out there would stand up on this one and point fingers, just my guess.

A patient who believed he/she was infected by a HCP would only need to file the lawsuit for the service and the HCP to make the news. That would be enough to run hell through the department.

However you are correct, it would be difficult to convince a jury the infection came from the HCP. I light of this, let me refine my statement: Not that anyone but the lawyers would win[s:78a0118804] unless there was an actual transmission of the disease[/s:78a0118804].

Ok try this example / tangent on for a minute, Your family member is a highly respected Cardiac Surgeon still the same answer ? I doubt it, but following some of the very irrational logic here, best he retrain as a plumber perhaps ?

If he believed he was a risk to the pt., yes. The world will not end due to one less Cardiac Surgeon, plumber, or EMT. Should he be highly respected, I would assume that it's due to not only his skill as a surgeon, but also due to his intellect, patient care and integrity. All three of which can be utilized outside the OR and without touching the pt.

[ccmedoc]

You're working a MVA with a patient who has one of the infectious diseases that we've been talking about (not the contagious ones that got thrown in).

You know, of all the comments made in this discussion, most of them valid, this one sticks out in my mind for some reason. I have a question and, given the topic, I think it has legitimacy..

Do we know the difference between infectious and contagious and do we know where the diseases we are talking about would be classified?

Just some food for thought...

"...all contagious diseases are also infectious, but it does not follow that all infectious diseases are contagious" -- W. A. Hagan

[Lone Star]

You know, of all the comments made in this discussion, most of them valid, this one sticks out in my mind for some reason. I have a question and, given the topic, I think it has legitimacy..

Do we know the difference between infectious and contagious and do we know where the diseases we are talking about would be classified?

Just some food for thought...

"...all contagious diseases are also infectious, but it does not follow that all infectious diseases are contagious" -- W. A. Hagan

When I started this thread, I listed 5 speciffic infectious diseases, but somewhere along the line, everything from the common cold on up has been thrown in the mix.

I've also noticed that the question hasn't been answered by anyone since I posted it.....