Should People With Infectious Diseases Be Allowed in EMS?

[DwayneEMTP]

As I mentioned before...

The only reason this conversation is continuing with such vigor is that you continue to ignore ccmedoc’s pertinent question and continue to say the same things over and over...

And you have ignored Vent's posts completely. That is always a mistake in my book.

If you insist on continuing to rant about "You know how EMS is! Every day we climb through wreckage, and sling our blood over everyone near!" then you'll continue to have a point.

If you step back into the realities of EMS, the diseases involved (with the exception of TB), and the science involved in the transmission risks, then you're simply back to imitating Chicken Little and screaming about the sky falling.

I truly want to hear what you have to say, but you simply keep repeating the same things over and over and they appear to me to be based in panic, fear, and ignorance. (Lone, it's my hope that you'll read this as an attempt to be clear, not insulting)

If you want to win this argument on logic instead of brute force, then you have to address the posts by Vent and ccmedoc. No one here has missed the fact that you have been careful to dodge them and their logical contribution to the question.

Good discussion though!

Dwayne

[Lone Star]

Where do you draw the line between 'acceptable risk' and 'unacceptable risk' when it comes to the possibility of passing an infectious disease on to your patient?

[DwayneEMTP]

...Do not chastise Ruff for this...

:shock: What! Then what am I supposed to do with the rest of my day?!?

Yeah, Ruff got a little pissed during this conversation. I'd hoped that showing him the error of his ways would make him feel better...

But he's full grown, doesn't need us to defend him, and will be itching to get back into the fray at the first opportunity.

Chin up ol'man! It's all just sparring, no good guys, or bad guys, just shared opinions to learn from....

Dwayne

[katgrl2003]

My biggest beef with the whole argument isn't the specific diseases listed. HIV and HepB/C are all horrible diseases and anyone that contracts them is pretty much given a death sentence.

Woah! Death sentence? News to me.

Hep B

About 30% of persons have no signs or symptoms. Signs and symptoms are less common in children than adults.

Chronic infection occurs in:

90% of infants infected at birth

30% of children infected at age 1–5 years

6% of persons infected after age 5 years

Death from chronic liver disease occurs in:

15%–25% of chronically infected persons

Hep C

80% of persons have no signs or symptoms.

Chronic infection: 75%-85% of infected persons

Cirrhosis: 20% of chronically infected persons

Deaths from chronic liver disease: 1%-5% of infected persons may die

Leading indication for liver transplant

*All info taken from cdc.gov*

Quite a few people keep saying HBV/HCV infected persons shouldn't be working in ems. From what I just found, most people won't even know that they are infected. Here's another thought: How many people were exposed years ago, before mandatory testing, and now are afraid to get tested? We really don't know how many are infected.

-Kat

[DwayneEMTP]

Where do you draw the line between 'acceptable risk' and 'unacceptable risk' when it comes to the possibility of passing an infectious disease on to your patient?

It's simply that as many have stated here, almost certainly we're killing many people simply by breathing on them.

I can't figure out how you are comfortable suggesting that people with the above diseases be removed from EMS when they pose an astronomically small risk to patients, yet do not demand that all EMS workers wear complete BSI (Masks, gowns) to eliminate the very obvious HUGE risk of contaminating weak patients with the everyday viral/bacterial illnesses that we know will kill many of them?

It's as if you're attacking the murder rate in the US. You are demanding that poisons all be removed from possible use, but saying that guns are ok. See what I mean? If infection is truly your issue, why get so worked up saving the (theoretically) one person a year that might be effected yet ignore the 10,000 that we KNOW will be effected?

Dwayne

[tniuqs]

*All info taken from cdc.gov*

Quite a few people keep saying HBV/HCV infected persons shouldn't be working in ems. From what I just found, most people won't even know that they are infected. Here's another thought: How many people were exposed years ago, before mandatory testing, and now are afraid to get tested? We really don't know how many are infected.

-Kat

Excellent point's all and backed by very realistic stats, damn I sure hope I am not infected with ................................................................................

..................................... or a respiratory viral infection that in itself can kill.

cheers

[mrmeaner]

I can't figure out how you are comfortable suggesting that people with the above diseases be removed from EMS when they pose an astronomically small risk to patients, yet do not demand that all EMS workers wear complete BSI (Masks, gowns) to eliminate the very obvious HUGE risk of contaminating weak patients with the everyday viral/bacterial illnesses that we know will kill many of them?

As one of the "misguided", I'd agree that is a valid concern. The immuno-comprimised patients should be protected. Actually, all patients should be protected with appropriate BSI, equipment cleaning, and infection control.

[Lone Star]

It's simply that as many have stated here, almost certainly we're killing many people simply by breathing on them.

I can't figure out how you are comfortable suggesting that people with the above diseases be removed from EMS when they pose an astronomically small risk to patients, yet do not demand that all EMS workers wear complete BSI (Masks, gowns) to eliminate the very obvious HUGE risk of contaminating weak patients with the everyday viral/bacterial illnesses that we know will kill many of them?

It's as if you're attacking the murder rate in the US. You are demanding that poisons all be removed from possible use, but saying that guns are ok. See what I mean? If infection is truly your issue, why get so worked up saving the (theoretically) one person a year that might be effected yet ignore the 10,000 that we KNOW will be effected?

Dwayne

First off, lets not confuse 'contagious' with 'infectious'. To even draw a correlation between the two, shows that the line between them has been blurred.

In none of my posts have I mentioned anything about influenza, mrsa/vrsa, the common cold, etc.

My initial topic was the infectious diseases such as HIV, Hepatitis A-C, TB....

I'm currently working through the CDC in Atlanta on this issue. I've got some 'reccomended reading' to do, but from what I've seen so far, it does not apply to EMS personnel, but rather to clinicians such as surgeons and dentists/oral surgeons. As I obtain the information that is relevant to this topic and I've had a chance to read it; I'll post my findings.

Furthermore, the CDC reccomended that I also contact OSHA, and see what they have to say about the whole mess as well.

[DwayneEMTP]

Fair enough all...

I just can't get a handle on your logic. That certainly doesn't mean it doesn't apply, I just don't see it.

Michael once cautioned that I sometimes make partial arguments based on the belief that the logic that preceeded my thoughts is "So obvious that it shouldn't really need to be explained to anyone." I just can't seem to find the key to this one that would show the "obviousness" that jumps out at me.

I do understand that to be one of my many weaknesses.

Would I have issues with someone with HIV/AIDS, Hep, etc working on my son, who I adore above all else? None. With the data available, if I did, I would also be forced to be ever vigilant that he's not attacked by Bigfoot, or abducted by aliens, or possesed by demons.

Again, with the exception of TB, which in my mind doesn't seem to belong in the same catergory as the others. And even then, would I run screaming from the room if I knew that the properly masked/washed nurse taking his vitals or giving his injections had TB. Of course not. The SCIENCE tells me that would be silly.

So I'm grateful that you all have taken the time to share your opinions. Some people much smarter than me have ended up on the 'misguided' side of this discussion. Thank goodness some terribly smart people have landed on my side as well.

For me though, you might just as well argue that the sky is orange with polka dots. My logic says it's blue (in general of course), all of the scientific data suggests that it's blue, common sense says that it appears to be blue. I'm going to be a while getting on board with the "polka dot" crowd.

Have a great day all! Great discussion!

Dwayne

Edited for minor grammar and spelling errors. No changes in content/context.

[firedoc5]

I'm not exactly sure how to respond to this question. As others have said you have a knee jerk reflex of saying no way. But after thinking about it for a little bit I'd say it would depend on the disease and how it is transmitted. The main issue I have would be HIV and would say NO way. Also, depending on what the disease may be, is what stage would it be in? I worked and taught with a who had contracted malaria as a POW in VietNam. About every nine to twelve months he would have to go to St.Louis for I guess what would be treatment for what would be considered a flare up. It was my understanding that as long as he wasn't having a flare up he was not contagious. Is that something to consider too.

This is something I'm going to have to think about and read up on.