Gimme the flu vaccine, or I won't play EMT!

[Quakefire]

What type of thermometers are you using disposable ?... As that was found to be the focus/ fomite / vector in an ICU when we had a huge break out of MRSA in ICU, non disposable btw ... the ones found on the wall blue cover for rectal, red for oral ... was the entire attached wire and device that was swabbed to find the cleaning staff were told not to wash them.

Wow I would freak out at that hospital, but here blue is oral and red is rectal, then again the only difference is taste.....

Regardless of volunteer or paid, at least the laws here, if you are on call and you are dispatched and refused you are abandoning the patient even without contact. There is no reason this person should be allowed to practice, they have no dedication to the profession, and have no right to be allowed anywhere near a patient

Edited November 1, 2009 by Quakefire

[tniuqs]

'Quakefire' date='31 October 2009 - 11:22 PM' timestamp='1257052931' post='228170']

Wow I would freak out at that hospital, but here blue is oral and red is rectal, then again the only difference is taste.....

- 5 for a very very old joke, ok maybe - 3 as I have used it myself, point being an unknown unidentified vector in my post.

Regardless of volunteer or paid, at least the laws here, if you are on call and you are dispatched and refused you are abandoning the patient even without contact. There is no reason this person should be allowed to practice, they have no dedication to the profession, and have no right to be allowed anywhere near a patient

Where do you practice where there is no regulations to refuse unsafe work, (ps I already know where you live, btw)

So what if you are not trained to do a job or lack personal protection equipment (ie would you respond to a nuclear spill because of a man down ?) fortunately here the due diligence laws would be stacked in your favour, in fact if a fellow worker was not stopped to prevent a foreseeable injury or died, well your ass would be grass but yes an extreme example agreed.

Oddly flu type symptoms for example lately a patient triaged in Texas, well now one could see a taxi show up at that patients door, we are not talking refusal of a life threatening type emergency call in this situation at all.

Don't you have a duty to protect ?

cheers

[Dustdevil]

Regardless of volunteer or paid, at least the laws here, if you are on call and you are dispatched and refused you are abandoning the patient even without contact.

Dude, get real. Do you have a right to refuse a scene with an active shooter? What about a burning building? Do these "laws" require you to dive into freezing, alligator infested water too?

[tniuqs]

Do you have a right to refuse a scene with an active shooter?

Wouldn't that depend on the contract er contractor ? LMFAO

[JPINFV]

And your source of information would be ????

Not being a smart ass, lets talk evidence based medicine too many myths not enough tangible information ....

Basic immunology. The first time it your body is exposed to a specific antigen (note: antigens may change as an organism mutates. This is why the flu shot doesn't always work to prevent the flu) for your body to switch from the innate immune response (macrophages, natural killer cells, etc) to the adaptive immune response (B cells, T cells, antibodies). During this time, the receptors are undergoing somatic hypermutation to find the exact fit for the receptors and the antigen and the cells are undergoing clonal expansion to essentially gear up for battle. While the innate immunity is doing it's best to control an infection, the adaptive immunity is able to target specifically the antigens on the invading organism and bring heavier weapons to bear. It is this process that produces memory B cells. Once the memory B cells are produced, they tend to stick around for an extremely long time. Additionally, since they are able to recognize the antigen, your body is able to kick in an adaptive response in a day or two (no need for somatic hypermutation. Able to release some antibodies immediately as the cells start clonal expansion. Earlier response means the infection has less time to grow) instead of the week timeline.

On a side note, this is why you don't have an allergic reaction to the first exposure, but do to the second. During your first exposure to, say, bee venom, you're body doesn't immediately recognize it as bad and overreact. The second time, it knows that the venom is bad and already has cells that can respond to it.

[tniuqs]

Basic immunology. The first time it your body is exposed to a specific antigen (note: antigens may change as an organism mutates. This is why the flu shot doesn't always work to prevent the flu) for your body to switch from the innate immune response (macrophages, natural killer cells, etc) to the adaptive immune response (B cells, T cells, antibodies). During this time, the receptors are undergoing somatic hypermutation to find the exact fit for the receptors and the antigen and the cells are undergoing clonal expansion to essentially gear up for battle. While the innate immunity is doing it's best to control an infection, the adaptive immunity is able to target specifically the antigens on the invading organism and bring heavier weapons to bear. It is this process that produces memory B cells. Once the memory B cells are produced, they tend to stick around for an extremely long time. Additionally, since they are able to recognize the antigen, your body is able to kick in an adaptive response in a day or two (no need for somatic hypermutation. Able to release some antibodies immediately as the cells start clonal expansion. Earlier response means the infection has less time to grow) instead of the week timeline.

On a side note, this is why you don't have an allergic reaction to the first exposure, but do to the second. During your first exposure to, say, bee venom, you're body doesn't immediately recognize it as bad and overreact. The second time, it knows that the venom is bad and already has cells that can respond to it.

Most excellent information and a GREAT post, following that my next query would be (and I tell you I have searched extensively) In the ferret vaccination and non adjuvant H1N1, a study I did not bookmark sorry in advance, it took up to 14 days for the vaccine to achieve in most cases a majority of immunity. That said what is the expected immunity response and time frame for the human model with condition being that H1N1 was contracted and not vaccinated.

My second query is the efficacy of ETOH based cleaners as there is now even more controversy in that regard, the public in general (many HCW as well) is very uninformed with the standard of effective use of soap and hot water hand washing actually quite deplorable in EMS, any input on that issue? in reference to the use of proper PPE that is, i guess thats a 2 part question.

A third question would be has there been a Titer developed (as in Hep B so far as H1N1 ?

Apologies in advance for rambling a bit a tad over tired as sleep patterns are a bit messed up lately.

cheers

[JPINFV]

Most excellent information and a GREAT post, following that my next query would be (and I tell you I have searched extensively) In the ferret vaccination and non adjuvant H1N1, a study I did not bookmark sorry in advance, it took up to 14 days for the vaccine to achieve in most cases a majority of immunity. That said what is the expected immunity response and time frame for the human model with condition being that H1N1 was contracted and not vaccinated.

Vaccinated vs contracted to the best of my knowledge shouldn't change. To be honest, the time line I presented wasn't for vaccination per say, but was the text book time line for dealing with an infection since, in essence, the difference between an outside infection and a vaccine is simply virulence and port of entry. A vaccine is either going to be a dead or extremely weakened sample since the important thing is getting the body to be able to recognize the antigens so that it can start an adapted response sooner.

My second query is the efficacy of ETOH based cleaners as there is now even more controversy in that regard, the public in general (many HCW as well) is very uninformed with the standard of effective use of soap and hot water hand washing actually quite deplorable in EMS, any input on that issue? in reference to the use of proper PPE that is, i guess thats a 2 part question.

My understanding is that flu like symptoms patients, regardless of type, should have the same precaution as any other droplet disease, as in gloves, mask, and gown. As always, hand washing is important. Alcohol hand sanitizers are good stop gap measures and more practical in some instances (like on ambulances), but shouldn't be the only source of hand cleaning. An important thing to remember with alcohol is that, unlike antibiotics, microorganisms won't become resistant to it. As such, use alcohol cleaners early and often and wash after every patient.

A third question would be has there been a Titer developed (as in Hep B so far as H1N1 ?

I honestly don't know.

[tom5706]

For the most part she can flap her gums and vent that she wont respond, BUT, until it actually happens, you got no case (IMHO) anyway

[tniuqs]

BEACH HAVEN - The captain of the Beach Haven First Aid Squad says she and her colleagues should not have to wait two days to receive the swine flu vaccine, but instead should be among the first to receive it.

Deborah Whitcraft, a former mayor and outspoken public figure, added that as a resident of Beach Haven and a taxpayer who funds the Long Beach Island Health Department, she should be able to receive a vaccination at the clinics.

Whitcraft said the department told her she could not make an appointment to receive the swine flu vaccine at the clinics today and Wednesday. Tim Hilferty, the department's director, said Whitcraft and other emergency personnel can receive the vaccine Thursday at Southern Regional High School.

But that's not soon enough for Whitcraft. She said she answers more than 200 first aid calls per year along a 10-mile stretch of Long Beach Island and that she will not be so quick to take calls anymore after being denied a vaccination.

"If there are flu symptoms on a call, I just won't answer the call," the 10-year volunteer said.

Hilferty said that because of the limited supply of vaccine, the department and the Ocean County Health Department had to establish two sub-tiers of priority cases. The local and county departments are waiting for more vaccine to arrive every day, Hilferty said.

Whitcraft said that is all the more reason to vaccinate emergency medical personnel immediately.

"We started with pregnant women and young children. It was determined that those populations we were seeing were having the most complications from the flu. This is the population that is most vulnerable," Hilferty said.

LBI Health Department employees are not even vaccinated yet, he added.

Whitcraft referred to areas around the country that are using their vaccinations on emergency medical workers.

So back on thread a link FYI: http://en.wikipedia.org/wiki/Pandemic_H1N1/09_virus

Please put into perspective that some of this information is changing almost daily

That said:

The priority groups have now been again redefined:

1:Highest risk group(s)

Pregnant women

Children 6 months to less than 5 years of age

Persons residing in remote and isolated settings or communities

Health care workers HCW (all health care system workers involved with the pandemic response or delivery of essential health services*)

Rationale: prevent HCW spread to vulnerable patients, prevent outbreaks, protect HCW (reciprocity) and protect essential health infrastructure

All health care workers involved with the pandemic response or delivery of essential health services:

Those who provide direct patient care as well as those who support the provision of health care services

Includes full-time staff, part-time staff, students, regular visitors and volunteers i.e. all persons carrying out the health care function

Settings include acute care, chronic care, ambulatory/community care, emergency medical services, laboratory, public health departments, pharmacies etc.

Household contacts and care providers of:

2. Others Who Will Benefit From Immunization

Children 5 to 18 (inclusive) years of age

First responders (police, firefighters)

Rationale: frequently attend emergency health situations with Emergency Medical Services (EMS)

Now this thread was started because this LEADER in EMS dared to make a public statement to make an impact and educate, I must COMMEND Captian Deborah Whitcraft for doing her duty and her JOB, following known following evidence based medicine and best practice medicine .

For those that would disagree and want her head are you not feeling just a little bit silly ... best stop pointing a finger because 3 of them are pointing back at you

[JPINFV]

For those that would disagree and want her head are you not feeling just a little bit silly ... best stop pointing a finger because 3 of them are pointing back at you

I don't think anyone is debating whether or not she should be vaccinated. I think the problem is crying about a 2 day wait. Yes, she should be vaccinated immediately, but it's not like they're telling that she will be waiting a month to be vaccinated. It sucks, but at the end of the day it doesn't quite reach the level of picking up your ball and going home.