Not on My Watch

Virus.

“Do no harm” is a tenet of Emergency and traditional medicine, yet sometimes we can be our own worst enemies. Such is certainly the case with Healthcare Associated Infections (HAIs), which affect 1 in 20 hospital patients a year and cost an estimated $4.5 billion annually1. An HAI is any infection that occurs while a person is in the care of a medical institution, and while it most commonly occurs in a hospital facility, there is no reason EMS providers should not do their part in reducing the chances of this condition occurring. A major drive to educate the industry about the dangers of HAIs is the “Not on my Watch” campaign sponsored by Kimberly-Clarke. Their website (http://www.haiwatch.com/) offers tools and educational opportunities to help eliminate this threat.
 

  So what can EMS providers do to combat this situation, and how does it relate to our equipment? Well it just so happens that cross contamination, that is dirty and/or contaminated equipment coming in contact with a non-contaminated patient, is the most prevalent cause of an HAI2. Patients probably have more direct contact with our equipment then they do with the provider. They sit in our ambulances, lay on our stretchers or backboards, get monitored by our BP cuffs and stethoscopes and when we interact with them we are (or should be) wearing gloves. We should be wearing gloves because they can reduce contamination by 70-80 percent3.
 
  In addition, your equipment should always be thoroughly cleaned after each call. I’m sure you’ve seen it, when someone was rushed and didn’t want to clean a piece of equipment because it “didn’t look dirty” or because the patient “wasn’t bleeding”. This is dangerous thinking because the fact that the contaminant is not visible does not mean it’s not there. There is a high chance of cross contamination even when a piece of equipment is not visibly “dirty”. Therefore, every piece of equipment that comes in contact with a patient should be thoroughly cleaned with an alcohol wipe or other approved cleaning solution. Used stretcher linens, blankets, and pillows should be left at the receiving hospital for proper cleaning and/or disposal. New, clean gloves, should be used when cleaning and preparing the equipment/ambulance for the next call.
It bears repeating that the importance of proper hygiene, hand washing and glove use is one of the most important aspects of preventing cross contamination. Not only do these things prevent cross contamination and potential HAIs, they also prevent you, the responder, from coming home with anything.
 
More info about Healthcare Associated Infections and the steps to mitigate them can be found at: http://www.haiwatch.com/
 
 
Sources:
1- http://www.bd.com/hais/pdfs/HAIs_Bckgrndr.pdf
2- http://www.haiwatch.com/CrossCont.aspx?Region=US
3- http://airforcemedicine.afms.mil/idc/groups/public/documents/afms/ctb_109778.pdf

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