Should People With Infectious Diseases Be Allowed in EMS?

[DwayneEMTP]

But, as for me personally, I'd rather allow the risk of Varicella transmission than HIV transmission. That just seems to be a no-brainer to me. And only somebody who has never taken microbiology could possibly be so silly as to debate this.

As one with microbiology, and not offended by the comment, I just can't seem to get on the same page with you here. I have no idea what Varicella is, and don't have the time to research it now, so I'll address HIV only.

In this thread Vent and others have posted data to support the fact that the risks are extremely low, I believe that someone even posted a link claiming that the CDC is ok with HCW with HIV within given, though very broad parameters (I didn't go back and verify these things, I'm pulling from memory), many, as well as myself have claimed that their experience has shown the situations necessary to cause transmission are rare to unheard of...so what is the problem?

I know you are not prone to knee jerk reactions, panic in any form, or "jumping on the band wagon" ever...it just seems that in this case you've chosen to ignore the science, which your posting history makes impossible to believe.

What am I missing?

Dwayne

[Eydawn]

Dwayne, varicella = chicken pox. Bad for pregnant women and adults, may lead to the development of shingles as well as having (as I recall) teratogenic effects on the developing fetus. Kind of like Rubella (german measles) is bad for pregnant women to get....

Wendy

CO EMT-B

[Dustdevil]

What am I missing?

My point, which was that there is legal and medical precedent for excluding persons from the medical professions based upon their health status. In fact, it was never, ever even a question until AIDS began it's proliferation in society. Only after that did we suddenly decide that people with infectious diseases should be afforded a special protected legal status. My only point was to contradict those who maintain that we "can't" discriminate on that basis.

Nowhere in this thread have I advocated the practice. All I am doing is addressing specific points of the debate. Anything else is strictly an assumption.

[EMTBASIC_911_911]

I dont feel that anyone with an infectuous disease should work in the healt care field. Here In Illinois, I have had flu shots,TB tests,ect....and the nurses dont bother to wear gloves until I tell them too. How dumb is that? Who knows what they have been exposed to. But no I dont think that someone with an infectious disease should be in the healtcare field.

[Lone Star]

and if i got aids from a person,yuea i would be fucking pissed but im not going to blame it on the system.i knew the risks when i took the job and if i didnt take the neccisary prectaions then its my fault.and in all seriousness here,when was the last time we heard about anyone in ems getting THAT sick from a pt.if you use BSI and take take your time then your chances are lessened greatly.

and like i said,if your THAT scared then your in the wrong business.

This isn't an issue of the health care worker getting infected by a patient, but rather the health care worker INFECTING the patient....let's try to stick with the whole story here.

Secondly, show me CONCRETE proof that BSI precautions are 100% effective 100% of the time....I'm pretty sure that you can't do it.

I'm sure Im not the only person here that has either cut a glove while extracating a patient, or had a glove blow out (even while putting them on).

If BSI were so completely 'germ proof'...then whats the big deal about washing our hands all the time?

Furthermore, you dont have to be "THAT scared" to have concerns, not only for yourself, but for your patients as well!

[Dustdevil]

If BSI were so completely 'germ proof'...then whats the big deal about washing our hands all the time?

Furthermore, you dont have to be "THAT scared" to have concerns, not only for yourself, but for your patients as well!

Exactly. Believing you are safe because you are taking BSI precautions is about as smart as believing it's okay to run around during a gunfight because you're wearing body armour.

[DwayneEMTP]

My only point was to contradict those who maintain that we "can't" discriminate on that basis.

Nowhere in this thread have I advocated the practice. All I am doing is addressing specific points of the debate. Anything else is strictly an assumption.

Got it. It wasn't my intention to put words in your mouth, I was just having a difficult time figuring out which side of the issue you were coming down on. I see now that you weren't picking a side so much as debating individual misconceptions...

Dwayne

[Eydawn]

Really? Dust isn't taking a stand? I don't quite buy it... and here's why.... (no offense, Dusty, you know I love ya and respect ya...)

Here's what I'm going to do. I'm pulling quotes from multiple posts, and analyzing the language you used, and the effect it had on how I interpreted it. Feel free to show me where I read it wrong.

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.

I know this is in response to the statement of "if your loved one lay dying wouldn't you accept care from someone with HIV" but the way you say "prefer and demand on a day-to-day basis" indicates that you, given the choice, would prefer a HCW without HIV over one with HIV, regardless of other qualifications. Since you didn't clarify that other factors might play in, this is what I see here.

I'll tell you who calls 911: Desperate people with no choices and no options. The weakest and most vulnerable people in our society. The thought of giving them less than what they deserve simply because they are forced to accept it is repugnant to my moral reasoning.

Here, you seem to be indicating that our weakest and most vulnerable are getting less than they deserve when they encounter a HCW with HIV. And you state that it is morally repugnant! Tell me that "repugnant to MY moral reasoning" isn't claiming a position on HCW's with some sort of transmissible disease.

Tap dancing around the feelings of those with AIDS and TB is quite obviously not necessarily what is best for them or their patients.

Not quite sure where you were going with this quote, but you seem to be implying that by accomodating healthcare workers with diseases like AIDS and TB we are merely pandering to their emotional states, rather than evaluating risks, and thus endangering the individuals themselves and their patients. Looks like a position to me!

But society's biggest focus these days is not public health. It is indeed the feelings and rights of the infected, with public health being of only tertiary concern. That's not how I roll.

Here you seem to clarify and crystallize what I was seeing inferred before. Your stand is quite clear. The public health should not be a secondary or other lower concern; in your opinion, since the rights of infected HCW's are apparently being prioritized, it is a bad

thing. Because that's not how you roll.

But, as for me personally, I'd rather allow the risk of Varicella transmission than HIV transmission. That just seems to be a no-brainer to me. And only somebody who has never taken microbiology could possibly be so silly as to debate this.

Ok. So here you're saying that only people with a poor understanding of microbiology would even question the issues being raised here, and that to debate the issue is silly. Therefore, it is cut and dry. And you're also inferring that someone who's taken microbiology who disagrees is also silly.... see how tricky language is?

Ok... so what did I misread? The nature of internet communication is such that we must infer what we cannot get from vocal inflection or other communication, so we interpret based on what we know about a person and how they phrase things.

Wendy

CO EMT-B

*edited for a syntax problem*

[Lone Star]

Wendy,

I've read the same statements, and think I'm getting a different read on what Dust is saying. Keep in mind, its 0451 and I've been up for a whopping 15 minutes.....here goes:

Really? Dust isn't taking a stand? I don't quite buy it... and here's why.... (no offense, Dusty, you know I love ya and respect ya...)

Here's what I'm going to do. I'm pulling quotes from multiple posts, and analyzing the language you used, and the effect it had on how I interpreted it. Feel free to show me where I read it wrong.

What we reluctantly accept when our backs are against the wall' date=' 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. [/quote']

[UtProsim]

Show me, in the United States Constitution, where anyone is guaranteed by that document, or the Bill of Rights, or the amendments to the Bill of Rights, that we are guaranteed by our creator the unalienable right to gainful employment that just makes us all warm and fuzzy happy every day! (no, the 'persuit of happiness does NOT guarantee the career choice!)