Should People With Infectious Diseases Be Allowed in EMS?

[DwayneEMTP]

isn't it about time to let this thread ride off into the sunset and retire?

I'm not sure...there are still some interesting questions to be answered...

Unfortunately they tend to be ignored...like the one above...

Dwayne

[Lone Star]

I'm not sure...there are still some interesting questions to be answered...

Unfortunately they tend to be ignored...like the one above...

Dwayne

It's society's nature to go to the knee jerk reactions, easy questions and not deal with the 'tough stuff', because it will be dealt with by someone else......

[VentMedic]

boneknuckleskin,

I'm going to ask you the same question that I've asked everyone else taking part in this thread....where do you draw the line between 'acceptable risk' and unacceptable risk'?

Is the risk only acceptable because its a patient's life we're talking about? Would the same 'its only a minor risk' mentality be as prevalent if it were you as the patient?

It's society's nature to go to the knee jerk reactions, easy questions and not deal with the 'tough stuff', because it will be dealt with by someone else......

Some choose to answer questions with knee jerk responses to incite fear. Others choose to use education.

You honestly can not say these questions have not been answered. It implies that you have not read your own P&P or have taken any type of education to inform yourself about what has been done to protect the patient and the provider.

These questions have been answered by state and Federal laws that have been passed on as guidelines for policies and procedures in individual agencies. As I mentioned earlier, your HR and employee rights form can provide a lot of answers for you as well as additional resources.

Everyday there are meetings concerning the next pandemic or the next AIDS or SARS at all levels of government and individual departments. So no, the "tough stuff" is not being avoided.

Have you been involved in healthcare at all since 1984? Have you read your P&P manual? Have you taken any infectious disease continuing education? Have you participated in any infection control planning committees at any level? What have you done to either educate yourself or to formally express your opinion to those that make the laws and policies?

There are alot of things in EMS that truly can be be harmful if not deadly to patients that need an ambulance. There is little education in EMS concerning those things either. I would say there is more chance of dying from a botched intubation by a poorly trained provider or in an ambulance accident caused by an impaired or reckless EMS driver than that very slim chance of an EMT dripping his blood directly into your open wound.

It also amazes me that some EMT(P)s would even want to do any advanced skills like IVs, Intubation or CPAP with the chances of being exposed to more pathogens from the patients. If you are in health care, there are risks. There are risks for the patients in every procedure performed on them regardless of the situation. Education and improved training reduces the risks. Not scare tactics based on "what if" scenarios. Many of these "what if" cases have similar situations that are addressed in many eduation programs.

If you are still asking the same question over and over, talk to your training officer, medical director or chaplan. There may be other issues simmering in the background that continues to muddy any reasonable answers or logic for you. It seems you have an overbearing need to have people agree with your view regardless if it is right or wrong. Not everybody works in your situation and your views may not apply. People that work in more modern BLS and ALS systems may have access to better education and equipment thus reducing the risks.

If you can not keep current with safer techniques, the latest laws, statutes and policies that pertain to your job to keep the public and provider safe, find another profession because healthcare is constantly changing. There will be always be new risks as different disease processes are discovered or develop into resistant strains.

[DwayneEMTP]

Again LS, I'm going to follow your logic here and restate something...

If no risk is acceptable, then you, as someone that's been injured, historically will be at a much higher risk to be injured again, perhaps during lifting, or moving a pt, than someone that hasn't been injured in the past. (Anecdotal from a doc, I don't have documents to support it. Besides, the logic stands without docs.)

So are you in fact prepared to flush your knowledge and experience down the drain,(or as your argument suggests, should have already done), for the good of the patient?

You could become re injured and drop a critical patient at a catastrophic moment, or be unable to help the stroke or cardiac patient be carried down the stairs to immediate transport, or unable to adjust an airway at a critical time, right?

Have you in fact shredded your EMS certs and moved on to your next career? It is, after all, the only responsible thing to do. Isn't it?

And I still maintain that I would have no issue with an HIV+ person treating me or my family for the reasons stated, ad nauseum, before this. Nothing to do with being PC, or sensitive to the plight of those infected. It's simply good science.

Dwayne

LS, address this question/statement and I promise to run as far away from this conversation as possible and never come back.

I've asked this at least twice, and perhaps as many as four times (No time to explore it) in this thread yet you continue to ignore it.

It's a simple question really. Have you shredded your certs and moved on to another career?

I have a lot of respect for your opinion on many things and am curious to see your logical answer...This is my last shot...then I'll assume you've chosen to stick to the easy questions...

Dwayne

[Scaramedic]

As a nurse working around so many people everyday, I agree that People with any infectuous disease should not be in the health care field at all, if its a danger to them, obviously it will be a danger to not only us, but pts.

I would think as an RN you would be better educated than to make a blanket statement like that. But then again I notice that all 3 of your posts were within 8 minutes of each other so Welcome to chat.

The basic fact is you are all arguing over something you will NEVER have any control over. You might as well argue over super string theory. The AIDS Lobby, The Mental Illness Lobby, etc, have made it so it impossible for employers to screen for this stuff. We are at the bottom of the food chain here people, the real decisions are being made by highly overpaid public servants wining and dining with the lobbyist crowd.

We have CNA's working in nursing homes who do not speak English do you really think that nursing home cares if their HIV positive?

[ccmedoc]

As a nurse working around so many people everyday, I agree that People with any infectuous disease should not be in the health care field at all, if its a danger to them, obviously it will be a danger to not only us, but pts.

This argument is fruitless..Do you go to work when you don't feel well?

As a nurse, working around people all day, do you think you come into contact with immunocompromised individuals everyday, the elderly, the young, those that have no clue that they are,indeed,at risk? If you are sick with strep or another virus, or the common cold, do you think these could lead to complications quickly leading to death....certainly. There is probably a greater risk of these, droplet and airborne viruses and bacteria, infecting your patient than hepatitis or HIV..

And yes, the seemingly inane microbes and viruses are indeed infectious disease. They are also contagious...Which risk is more acceptable? Are we better than the health care worker with HIV that never infects anyone even though we infect many others daily when we are sick? Is HIV more contagious than influenza? Given that you are most likely contagious before you show symptoms...

You can , and probably do (especially nurses), carry MRSA on your skin all day long..You are contagious..

If you can not keep current with safer techniques, the latest laws, statutes and policies that pertain to your job to keep the public and provider safe, find another profession because healthcare is constantly changing. There will be always be new risks as different disease processes are discovered or develop into resistant strains.

I think we should just agree to not agree....we should be seeing some better arguments though, not just "because I say so"...

[Lone Star]

LS, address this question/statement and I promise to run as far away from this conversation as possible and never come back.

I've asked this at least twice, and perhaps as many as four times (No time to explore it) in this thread yet you continue to ignore it.

It's a simple question really. Have you shredded your certs and moved on to another career?

I have a lot of respect for your opinion on many things and am curious to see your logical answer...This is my last shot...then I'll assume you've chosen to stick to the easy questions...

Dwayne

Dwyane, my friend, you know me better than that! I do not 'stick to the easy questions'....I'm probably one of the more 'outspoken' ones here (not to be confused with the ONLY outspoken one)....

The injuries I have dealt with in the past do NOT include anything that I could pass along to any patient of mine, and while, yes its true that I am probably at a greater risk of being injured again; the bones I've broken shouldnt affect either my patient care or my job performance.

So, no, I do not fit the 'criteria' that I've used to base my opinion on for this thread. I will however, turn in my stethescope and take my certificates down off the wall the day that I feel I can no longer perform the duties required of me in either the EMS field or the field of Firefighting. IF in the event that I should contract some infectious disease, as we've covered here, then I would be more than willing to end my career in both the Fire service and EMS as a 'self imposed "precaution"' to insure that there is no way that any of my patients would have to deal with it.

I'm not sure what information about my past medical history you're basing this question on, but I would be more than willing to discuss it with you, either in PM, or in a thread.

[DwayneEMTP]

...and while, yes its true that I am probably at a greater risk of being injured again; /

...I will however, turn in my stethescope and take my certificates down off the wall the day that I feel I can no longer perform the duties required of me in either the EMS field or the field of Firefighting.

Ah, but see LS, there's the rub. It makes no difference how you feel about it. It only matters if an uneducated public would choose to be cared for by someone that had never been injured over someone that has had a serious injury in the past.

That is what this thread has established above all, as it certainly hasn't established that there is any logical, mathematical, scientific reason for removing HIV/AIDS/HEP workers from the field.

You pose a larger risk than I do as I've gone several decades without a serious injury, so if there is .001% chance that you are a higher risk than I am, then you are morally and ethically obligated to remove yourself from the field.

Hasn't that been your argument? I mean disease is not the only danger to patients...right?

And many thanks for taking my comments in the spirit intended, to be direct and accurate, not demeaning or insulting.

Dwayne

[Lone Star]

My contention throughout this has been for the infection of the patient, not whether an EMT that has been injured in the past should remain in the field.

Logically, if you had an 'exposure incident' (even if the risk of becoming infected by a patient is at 0.005%), you would more than likely get 'checked out, just to be sure'..correct?

I know I would!

But if that 0.005% risk is enough to get you checked out, for your own safety and well being.....wouldn't it stand to reason that the patient would also like that option as well? After all, the risk is the same for the patient that it is for you.

That being said, now you can see why I asked the question about where to draw the line between 'acceptable risk' and that risk that is deemed 'unacceptable'. The risk of infection is still 0.005% in either direction (patient to EMT or EMT to patient)

(*DISCLAIMER* THE RISK PERCENTAGE IS ONLY A NUMBER I'VE PULLED OUT OF THIN AIR, NOT BASED ON ANY SCIENTIFFIC DATA)

Never have I included things like influenza, the common cold, hangnails, or broken bones. Again, there is nothing in MY past medical history that would include me in the same group as an EMT with HIV/AIDS, Hepatitis (A,B, or C), TB, MRSA/VRSA.

[ccmedoc]

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