Re: Are we making our patients ill?

[Guest guest]

Don't you know by now that the worse place you can be when you are sick is a

hospital?

BEB

E. Bledsoe, DO, FACEP

Midlothian, Texas

All outgoing email scanned by Norton Antivirus and guaranteed " virus free "

or your money back.

Are we making our patients ill?

> A recent article in the Dallas paper indicated that the number of

> in-hospital bacterial infections has gained epidemic proportions,

resulting

> in many documented deaths. The number one source of antibiotic resistant

> bacterial infection seems to be the hospital. Among other things, the use

of

> stethoscopes on multiple patients without sterilization was mentioned as a

> means of contamination.

>

> Nothing in the article mentioned prehospital, but a letter to the editor

in

> today's paper did, and stethoscopes were mentioned as the culprit. I

wonder,

> do any services in the state have a policy regarding sterilization of

> stethoscopes and other non-disposable items after a call?

>

> Regards,

> Donn

>

>

>

>

>

>

[Guest guest]

Actually, this sort of follows the logic of " road rage. " Newspapers

started reporting it more, so the AAA published a study on how fast it's

increased, based on the number of incidents reported. This study fueled

more reporting, which led to an even faster rise in " road rage. "

Much the same with nosocomial infections and/or those of iatrogenic

origin. They're being reported more, so obviously they're " on the

rise. " <grin>

Mike

> Are we making our patients ill?

>

>

> A recent article in the Dallas paper indicated that the

> number of in-hospital bacterial infections has gained

> epidemic proportions, resulting in many documented deaths.

> The number one source of antibiotic resistant bacterial

> infection seems to be the hospital. Among other things, the

> use of stethoscopes on multiple patients without

> sterilization was mentioned as a means of contamination.

>

> Nothing in the article mentioned prehospital, but a letter to

> the editor in today's paper did, and stethoscopes were

> mentioned as the culprit. I wonder, do any services in the

> state have a policy regarding sterilization of stethoscopes

> and other non-disposable items after a call?

>

> Regards,

> Donn

>

>

>

>

>

>

[Guest guest]

Yeah, man, people DIE in hospitals at a SIGNIFICANTLY higer rate than in

the general public!

Mike

> Re: Are we making our patients ill?

>

>

> Don't you know by now that the worse place you can be when

> you are sick is a hospital?

>

> BEB

>

> E. Bledsoe, DO, FACEP

> Midlothian, Texas

>

> All outgoing email scanned by Norton Antivirus and guaranteed

> " virus free " or your money back.

>

> Are we making our patients ill?

>

>

> > A recent article in the Dallas paper indicated that the number of

> > in-hospital bacterial infections has gained epidemic proportions,

> resulting

> > in many documented deaths. The number one source of antibiotic

> > resistant bacterial infection seems to be the hospital. Among other

> > things, the use

> of

> > stethoscopes on multiple patients without sterilization was

> mentioned

> > as a means of contamination.

> >

> > Nothing in the article mentioned prehospital, but a letter to the

> > editor

> in

> > today's paper did, and stethoscopes were mentioned as the culprit. I

> wonder,

> > do any services in the state have a policy regarding

> sterilization of

> > stethoscopes and other non-disposable items after a call?

> >

> > Regards,

> > Donn

> >

> >

> >

> >

> >

> >

[Guest guest]

--- " Dr. Bledsoe "

wrote:

> Don't you know by now that the worse place you

> can be when you are sick is a

> hospital?

>

> BEB

>

> E. Bledsoe, DO, FACEP

> Midlothian, Texas

Of course it is...There's sick people in the

hospital...you could catch something. lol

phil

__________________________________________________

[Guest guest]

The EMT curriculum(at least in Texas)does stress BSI

precautions, but there is not even a passing mention

of sterile technique, untill at least Intermediate

level.

Even BSI precautions are not taken on the ambulance.

I have seen apalling things like blood pressure cuffs

soaked in blood gingerly replaced in the emergency

bag, therefore contaminating all its contents.

Once, my preceptor handed me a blood soaked needle to

conduct an FSBS test. I was not even wearing gloves at

that time.

What is really cheesey is that everyone wears the same

stethoscope (hanging in the back of the ambulance),

without cleaning it out.

Nurses in the hospital are no better. The more they

have been around, the less they have fear of catching

or giving anything to anyone.

__________________________________________________

[Guest guest]

I have provoked groans time after time by haranguing my students about

practicing good infection control. I have had students actually leave the

program rather than remove their nose, tongue and eyebrow rings before going

to clinicals, leave off makeup, not wear rings or other jewelry, clean their

stethoscopes and scissors and other serially used items between calls, wash

their hands or use the available disinfectant properly, and learn not to pick

their noses, rub their eyes and bite their fingernails while at work.

Even worse, most of them haven't a clue how to avoid contaminating

everything from Bugtussle to Muleshoe when working a patient with body fluids

flying. I require them to triple glove, so that they can shuck one pair if

it becomes bloody or contaminated and then be able to enter the truck without

smearing gradoo on everything. Then I make them shuck the second pair after

they place the patient on the hospital gurney so that they remain gloved

while they disinfect stretcher, steth, and so forth.

It seems not to have occurred to most of them that the stretcher is

contaminated with the patient's everything, and when they shuck their gloves

in the ER and then grab the stretcher barehanded to roll it back outside and

replace it in the truck (you notice I didn't include decontaminating it

because that's seldom done) they have just contaminated themselves just as if

they hadn't worn gloves to begin with. DUH!

There are other obvious advantages to multiple gloving, one of which is when

the Tegaderm or tape latches onto your glove while you're trying to secure

your IV you can just shuck that pair of gloves and don another pair over the

others and continue. You're not left barehanded. Same for getting a rip or

tear in a glove. At least having another pair or two on minimizes the risk

of getting stuff down to the skin with a glove failure.

All this takes zilch amount of time to employ.

Does anybody else take this approach with students or employees?

Gene G.

Gene Gandy, JD, LP

4250 East Aquarius Drive

Tucson, AZ 85718

home and fax

cell

wegandy@...

[Guest guest]

Just a thought...

We have none for years about hospitals and infections, but where is this WE

stuff coming from [now, that something negative is out... EMS is apart of the

medical community?].

Just a thought...

[Guest guest]

I do. But I did learn from the best,Gene Gandy. And I try to teach our future

employees the importance of minimizing the risks of

contamination.....Sincerely, Bettina

[Guest guest]

I strongly suggest multi-gloving at the least

indication that the incident will be messy.

Also, we respond to a nursing home in which

several of the patients have contracted MRSA or

some other contagious malady. If we have any

information that the patient to whom we are

responding is one of those (the nursing home

staff is not always " forthcoming " with this

information), I prefer most of the crew to stay

outside the room, in the hall, and pass only the

necessary supplies and equipment to the person

doing the hands-on patient care. This follows

the logic of the HazMat community: Don't

contaminate anybody or anything that's not

absolutely necessary.

Of course, if we need to get everybody into the

room for appropriate patient care, then everybody

goes. However, it's surprising how often we can

do everything that needs to be done with one or

two people while the other two or three stand by

outside. We've received some weird looks from a

couple of the EMS crews (invariably crews who

don't know us) until we explain the situation to

them and they determine that everything is done

that needs to be done at my level.

This, of course, prevents the whole

" decontamination " issue by preventing

contamination in the first place.

stay safe - phil

- I require them to triple glove, so

> that they can shuck one pair if

> it becomes bloody or contaminated and then be

> able to enter the truck without

> smearing gradoo on everything. Then I make

> them shuck the second pair after

> they place the patient on the hospital gurney

> so that they remain gloved

> while they disinfect stretcher, steth, and so

> forth.

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