Exposure ?

[triemal04]

Actually I believe that there is a legitimate need for gloves on every call but they might not need to stay on for the entire call. I think that until you know there are NO bodily fluids or infectious disease hazards then gloves are on. ONce you determine in your "AWESOME" field evaluation and examination that there is no hazard, then you can consider taking the gloves off. I have done that myself.

This is just going to go around in circles, so I'll ask one more time and then throw in the towel.

In your day to day life, do you glove up before you shake hands or otherwise touch someone else's skin? Or before you pick up an object that someone else was touching just prior to you and may have left...something...on?

[MariB]

Ruff-

As far as fluids then I think we are on the same page. Where we differ is that you have made it sound very much like you should have gloves on for every call, and every time you touch a patient...no matter what. That is what I take issue with because...to be blunt...it's bullshit.

It's just another one of those things that get's beaten (as someone else put it, which is a very accurate term for it) into everyone's head until nobody actually stops and THINKS about it. And then when some heretic dares to <gasp> question the gospel, they are immediately reviled and get the equivalent of being burned at the stake.

No, I'm not. I'm argueing because you very clearly don't understand what you are talking about.

Do you really actually think that every patient knows what is wrong with them and tells the facility they are at? Do you really think that every facility tests every patient for every possible infectious disease? Do you really think that every facility actually knows what is wrong with every patient they send out? Fuckin' A...

no , you don't. You are jumping around all over the place

Listen closely. I wear all ppe for every 911 response, personal choice and also policy. If it wasn't policy, I still would. Because of reasons I gave.

As for transfers. For heart pts, closed fractures, no obvious body fluids and no contact precautions given beforehand, why would I? I will wash my hands after. You have stated yourself you don't need them for every pt. I have a good idea from pt history given if they have a diagnosed condition needing them, however certain transfers do not need them! Why would a heart pt doctoring at this facility need them with no body fluids present?

C diff pts, certain pneumonia pts, mrsa pts etc we have contact precautions.

Not everyone here is an idiot.

Aw shucks...

I'm not trying to win anything though. If someone makes a personal decision that they will wear gloves on every call, or there are extenuating circumstances (like your constantly cracked skin or other damage to their hands) that is one thing. My only point is that there is no legitimate NEED for gloves on EVERY call.

yet you just told me I don't know what I'm talking about because I wear them on 911 responses but not on all transfers with no wounds or bleeding... nice

[ERDoc]

I think there is a difference between taking PPE seriously and making a blanket policy of using it on all pts. PPE should always be taken seriously, but it doesn't mean it needs to be used on all pts, it just needs to be used properly. I can't argue the logic of wearing it into a pt's house when you first arrive. We don't wear them on every pt in the hospital and no, there no magical disinfecting that occurs when an ambulance comes through the door. We practice appropriate infection control procedures, which means wash in, wash out. Several people on here have brought up MRSA. You all realize that we all have MRSA living on and in us since we are in the medical field as do our families, right? We all have our anecdotes that change the way we doing things, such as Ruff. I wouldn't blame someone who has had his experience from using gloves on all calls.

[MariB]

As for mrsa, swab was negative so far from the nose as if 2 weeks ago for my daughter who is also on our team.

I don't see anything wrong with using gloves for all initial pt contacts. But then again, I don't know what I'm talking about according to him

[Just Plain Ruff]

This is just going to go around in circles, so I'll ask one more time and then throw in the towel.

In your day to day life, do you glove up before you shake hands or otherwise touch someone else's skin? Or before you pick up an object that someone else was touching just prior to you and may have left...something...on?

no I don't do that Triemal but they are not calling 911 because they are sick or injured and therefore I'm more worried about the ones calling 911 than the one who shakes my hand.

But if I"m approacing a patient for the first time, then hell yeah I'm going to wear gloves. I'll make the determination after my exam and discussion with the patient on whether continued gloving is warranted.

You aren't going to be swayed to my side, I don't expect you to but you are sure as heck not going to make me change my habits no matter how Crazy you think that any of us here who wear gloves on every call.

My friend waiting on a liver transplant wishes he wasn't as non-chalant about gloves when he was exposed.

[triemal04]

no , you don't. You are jumping around all over the place

Listen closely. I wear all ppe for every 911 response, personal choice and also policy. If it wasn't policy, I still would. Because of reasons I gave.

Ok, so you wear gloves for all 911 calls because of a personal choice, because it's policy, and apparently because it takes a long time for you to put gloves on. I'm not going to argue against your personal choice, just that there isn't a real need that exists.

As for transfers. For heart pts, closed fractures, no obvious body fluids and no contact precautions given beforehand, why would I? I will wash my hands after. You have stated yourself you don't need them for every pt. I have a good idea from pt history given if they have a diagnosed condition needing them, however certain transfers do not need them! Why would a heart pt doctoring at this facility need them with no body fluids present?

And certain 911 patients also do not need them. If you want to make a personal decision (that somehow only applies to 911 calls...guess those diseases are different than the ones on a transfer) or fall back on the "it's policy" arguement, that's ok. I'll leave it alone. I just hope you realize that the patient who has XXX and calls 911 is no different that the patient with XXX that is being transferred from a facility; both have the same issue, both present the same risk (whatever that may be) and both may not be aware of it. To think that you need to wear gloves for one and not the other is asinine, and hypocritical. And for the record, my point here is that if you think you need gloves for 911, you oughta be wearing them for a transfer (even if you don't actually need them for either).

C diff pts, certain pneumonia pts, mrsa pts etc we have contact precautions.

Not everyone here is an idiot.

yet you just told me I don't know what I'm talking about because I wear them on 911 responses but not on all transfers with no wounds or bleeding... nice

[MariB]

I know a lot more about the pt on the transfer , I know they aren't bleeding or pooping or vomiting.... goodness. You don't get it

[triemal04]

I know a lot more about the pt on the transfer , I know they aren't bleeding or pooping or vomiting.... goodness. You don't get it

You are absolutely right. You don't get it at all.

[MariB]

You are absolutely right. You don't get it at all.

I better just quite ems now since I'll never be as smart as you.

[EMS4Life11]

EMS4LIFE, here is some guidelines from the CDC website. Read the section under "Definition of Health-Care Provider and Exposure", specifically read the second paragraph of that section.

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5011a1.htm

ERDoc, here are some guidelines from the CDC website. Read Risk for Occupational Transmission of HCV. It clearly says in black and white Transmission rarely occurs from mucous membrane exposures to blood, and no transmission in HCP has been documented from intact or nonintact skin exposures to blood.