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

[tniuqs]

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.

Point taken:

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.

Thing is sometimes you have to stir the pot a bit to get results and this swine flu panic generated over the long term will go a very long way to educate the non believers for all vaccines IMHO. I think tom5706 makes a very good point, you can't knee jerk response demanding an immediate yank a licence for an news interview to enlighten only, can you?

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

I just believe in free speech we so need more leaders in EMS like her, I would bet shes on the road today is my bet !

On to the hand washing vs other methods to keep this thread on an educational track:

Efficacy of Soap and Water and Alcohol‐Based Hand‐Rub Preparations against Live H1N1 Influenza Virus on the Hands of Human Volunteers

M. Lindsay Grayson,1,2,3

Sharmila Melvani,1

Julian Druce,4

Ian G. Barr,5

Susan A. Ballard,1

Paul D. R. Johnson,1,3,4

Tasoula Mastorakos,5 and

Christopher Birch4

1Infectious Diseases Department, Austin Health, 2Department of Epidemiology and Preventive Medicine, Monash University, 3Department of Medicine, University of Melbourne, and 4Victorian Infectious Diseases Reference Laboratory, Melbourne Health, and 5World Health Organization Collaborating Centre for Influenza, Melbourne, Australia

Background.Although pandemic and avian influenza are known to be transmitted via human hands, there are minimal data regarding the effectiveness of routine hand hygiene (HH) protocols against pandemic and avian influenza.

Methods.Twenty vaccinated, antibody‐positive health care workers had their hands contaminated with 1 mL of 107 tissue culture infectious dose (TCID)50/0.1 mL live human influenza A virus (H1N1; A/New Caledonia/20/99) before undertaking 1 of 5 HH protocols (no HH [control], soap and water hand washing [sW], or use of 1 of 3 alcohol‐based hand rubs [61.5% ethanol gel, 70% ethanol plus 0.5% chlorhexidine solution, or 70% isopropanol plus 0.5% chlorhexidine solution]). H1N1 concentrations were assessed before and after each intervention by viral culture and real‐time reverse‐transcriptase polymerase chain reaction (PCR). The natural viability of H1N1 on hands for >60 min without HH was also assessed.

Results.There was an immediate reduction in culture‐detectable and PCR‐detectable H1N1 after brief cutaneous air drying—14 of 20 health care workers had H1N1 detected by means of culture (mean reduction, 103–4 TCID50/0.1 mL), whereas 6 of 20 had no viable H1N1 recovered; all 20 health care workers had similar changes in PCR test results. Marked antiviral efficacy was noted for all 4 HH protocols, on the basis of culture results (14 of 14 had no culturable H1N1; ) and PCR results ( ; cycle threshold value range, 33.3–39.4), with SW statistically superior ( ) to all 3 alcohol‐based hand rubs, although the actual difference was only 1–100 virus copies/μL. There was minimal reduction in H1N1 after 60 min without HH.

Conclusions.HH with SW or alcohol‐based hand rub is highly effective in reducing influenza A virus on human hands, although SW is the most effective intervention. Appropriate HH may be an important public health initiative to reduce pandemic and avian influenza transmission.

Comparative efficacy of hand hygiene agents in the reduction of bacteria and viruses

American Journal of Infection Control, Volume 33, Issue 2, Pages 67-77

E.Sickbert-Bennett, D.Weber, M.Gergen-Teague, M.Sobsey, G.Samsa, W.Rutala

Background

Health care-associated infections most commonly result from person-to-person transmission via the hands of health care workers.

Methods

We studied the efficacy of hand hygiene agents (n=14) following 10-second applications to reduce the level of challenge organisms (Serratia marcescens and MS2 bacteriophage) from the hands of healthy volunteers using the ASTM-E-1174-94 test method.

Results

The highest log10 reductions of S marcescens were achieved with agents containing chlorhexidine gluconate (CHG), triclosan, benzethonium chloride, and the controls, tap water alone and nonantimicrobial soap and water (episode 1 of hand hygiene, 1.60-2.01; episode 10, 1.60-3.63). Handwipes but not alcohol-based handrubs were significantly inferior from these agents after a single episode of hand hygiene, but both groups were significantly inferior after 10 episodes. After a single episode of hand hygiene, alcohol/silver iodide, CHG, triclosan, and benzethonium chloride were similar to the controls in reduction of MS2, but, in general, handwipes and alcohol-based handrubs showed significantly lower efficacy. After 10 episodes, only benzethonium chloride (1.33) performed as well as the controls (1.59-1.89) in the reduction of MS2.

Conclusions

Antimicrobial handwashing agents were the most efficacious in bacterial removal, whereas waterless agents showed variable efficacy. Alcohol-based handrubs compared with other products demonstrated better efficacy after a single episode of hand hygiene than after 10 episodes. Effective hand hygiene for high levels of viral contamination with a nonenveloped virus was best achieved by physical removal with a nonantimicrobial soap or tap water alone.

Oddly enough both these papers present somewhat opposing findings, but note well the non enveloped virus and from my background an 70/30 or 60/40 blend of alcohol based antibacterials rupture the cell wall of the bacterium. So next on my little research project is does this release the virus attached to RNA/DNA ?

[JPINFV]

Looking at the second study, my question would be what the definition of "significant." For example, transporting with lights and sirens "[statistically] significantly" decreases transport time, however it is rarely "[clinically] significant."

[tniuqs]

Looking at the second study, my question would be what the definition of "significant." For example, transporting with lights and sirens "[statistically] significantly" decreases transport time, however it is rarely "[clinically] significant."

If I had the money to not just get abstracts for every dang medical website I would read the entire study ... but the short answer I have no idea what significant is, in fact who funded the study thats even more of a query to me.

cheers

[HellsBells]

So whats the difference cause virus's are not as big as a threat ..... no I don't buy it for a millisecond, nice try though During WW1 more died from Spanish flu than in combat (just a little comparison to blow that comparison out of the water)

A specious argument, as prior to World War II civilian attrition almost always outpaced soldier casualities (Return of The White Plague).

If you somehow believe that wearing a mask gloves and glasses is adequate or you believe that your training on any EMS level is adequate for infectious disease control for aerosolized particles and decon of truck .... please think again.

There is no fail safe method for 100% prevention. However N95 masks, goggles, gowns and gloves will greatly reduce the risk. I agee that having the H1N1 vaccine would be ideal, But how do we know thats what the pt has? What if its TB? Is the gown and mask good enough for those pts? Or should we refuse to transport them too?

I applaud this woman for taking a stand and speaking out on this issue. All health care workers should be among the first to be vaccinated. However, for her to bleat about refusing to treat a sick pt because there is a 2 day delay is a little childish; particularly since she might get one call in the interm.

[tniuqs]

http://www.absoluteastronomy.com/topics/World_War_I_casualties

I stand corrected I should have said death due to WW1 (all) many returning by sea were burred at sea, no records of those but I sure wish my grandfather was still around to explain just how bad it was, he would have been in uniform pounding on the Parliament door saying WTF did you not learn anything ?

The total number of casualties in World War I, both military and civilian, were about 37 million: 16 million deaths and 21 million wounded. The total number of deaths includes 9.7 million military personnel and about 6.8 million civilians.

Check the link in the France portion for link to Spanish Flu also an H1N1 subtype "suspected also" to produce a cytokine storms, thanks Vent medic this is why when the victims do get really sick ARDS is the result.

Now based on the statistic gathering and record keeping at that time (far different than today I would HOPE) estimates vary from 40 to 100 MILLION, even deaths as far as the arctic.

Now lets look to the VAST difference in world wide travel today.

We are now seeing new emerging techniques in the delivery of the vaccine even throughout our own provinces, honestly from infectious disease point of view the immediate STOP in AB amassing huge groups in confined areas for long periods just may turn out one of the most effective, but really how will we ever know as the tracking and reporting issue is raised.

Just how, say for example my case I am following MDs orders being informed to sequester myself in isolation in my home, so am I H1N1 or just another form of influenza, would you like to visit and do some swabs (thats if you have been vaccinated for all that is) as that would be my best advice.

What makes me most insane (ok more) is that a possible EMS model delivery of vaccine has not even been considered an option?

Hells bells we can roll 1000 MTCs into the Oilpatch in a freaking heartbeat, but are basically excluded and or ignored in many places. <insert noises of slapping head heard>

http://www.emtcity.com/index.php/topic/16779-are-you-assisting-in-innoculations/

So please answer the poll ... my grandfather just might be proud that I will be trying to think out of the box, and do some door knocking myself, ok so here goes my soap box stand again, if EMS is to be considered a true part of the HEALTH CARE system then why are we not playing a way bigger part in this possible pandemic.

Actually EMS in Canada is by definition just SICK CARE.

[spenac]

Interesting discussion and links. Of course I have to laugh at a post using wiki as a reference, sorry.

I still say she should lose her certification. We everyday accept that we are at risk of catching communicable disease. If we started refusing any and all calls that put us at even a slight risk of sickness, harm or death we would not ever respond. I agree health care providers should be first on list to get it but to refuse patient care because of slight delay is BS. I would also bet that she is also someone that does not use her mask, gowns, gloves when she contacts patients that may be contagious. I would also bet she wears those contaminated clothes home to share with her family. So give me a break defending her. A leader that makes a threat like she did deserves punishment, and IMHO that equals taking certification away.

Had she used any brains she could have stirred the people up with comments like we will be there but we fear that in the early stages we may not know we are sick thus placing the patients we cherish and live to serve in grave danger. Now the citizens would be concerned for themselves and these wonderful taxi umm EMT's. So now not only will you get your shots first you can go beg more money from the community.

Edited November 1, 2009 by spenac

[tniuqs]

Breaking news:

McDonald's has been gone bankrupt in ICELAND ... we can only hope

cheers

[chaser]

Yet another shining star in Jersey's volunteer EMS System....

...

I applaud this woman for taking a stand and speaking out on this issue...

I never trust vaccines that just come out, it takes years to see side effects from them to start appearing. She seems to be the type to throw everyone else in front of a bus to save her own ass. Major? Makes sense. Selfish and self promoting. Hope Karma steps in. It's sad she feels she is too important to wait two days. What a pompous ass, and like Spenec said, there is always something out there to catch. It might be this flu, or something else. Who hasn't been coughed, bled, sneezed, or barfed on?

Let her step in and be the the guniney pig!

[Richard B the EMT]

Someone asked about "disposable thermometers". Here is a link to one of the suppliers of one brand of disposable thermometers.

http://www.woundcareshop.com/tempadotby3m.aspx?gclid=CLbElZ3q6p0CFdx05QodDXCLLg

It's a strip in individual packaging, kind of like a "band-aid", that turns dots from one color to another if the temperature goes over a set point. Each dot is a degree, or part of a degree, represented.

[Chief1C]

I'm not a fan of the disposable thermometer. We have a box of "Temp Dot" thermometers. They're sharp, inaccurate-IMO; though inexpensive. If we can use the same BP Cuff on every patient, while disinfecting it between each, we can use digital thermometers. A separate device, or probe; for each "area of measurement" of course..