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On The Scene

Volume 6, Issue 3

EMS committed to infection prevention

Slyvia FordInfection prevention is crucial for the safety of patients and EMS professionals – and too often goes unchecked. First responders are at risk every day for exposure to infectious materials, diseases and bioterrorism, but only 49% of EMS exposures are reported to employers.

Infection prevention starts with changing your own behavior and is best achieved in a three-pronged approach.

  • Hand hygiene: Hand washing is the most important way to prevent the spread of disease. Always wash your hands before putting on personal protective equipment and after touching contaminants, removing gloves and between patient contacts.
  • Personal protective equipment (PPE): Treat every patient as if they have an infectious disease. PPE – gloves, gown, mask, eye protection, face shield – is the last line of defense to prevent occupational exposure to blood or body fluids. Take the time to put on the necessary PPE.
  • Environmental decontamination: Develop procedures for routine care, cleaning and disinfection of environmental surfaces and equipment. Properly dispose of used patient-care equipment and sharps in specified and puncture-resistant containers while in the field.

Report exposures immediately

Exposures significantly underreported:

An estimated 22% of EMS professionals surveyed by the National Institute for Occupational Safety and Health were exposed to blood at least once in the past year.

  • 29% of exposures to broken skin are reported
  • 72% of needlesticks are reported
  • More than 50% of exposures are not reported

Take all exposures seriously and report them, no matter how they occur or how minor they seem. If an exposure occurs in the field, clean the area thoroughly, provide first aid if appropriate and report it to your designated infection control officer (DICO) immediately.

The DICO will determine the severity of the exposure and work with the hospital to determine next steps. Postexposure prophylactic medications, if necessary, should be started within a few hours of exposure, so prompt reporting is vital. Don’t wait until after a shift.

Know prevention protocols

Familiarize yourself with your department’s Exposure Control Plan and immunization program. Additional prevention regulations are available in the Guide to Infection Prevention in Emergency Medical Services at apic.org.

The University of Kansas Hospital partners with EMS providers to offer educational services for infection prevention. To schedule a course at your facility, contact Dan Hudson, EMS liaison, at dhudson@kumc.edu or 913-588-0824.

- Sylvia Ford, MS, RN, CIC

Know the deceptive signs of sepsis

Dustin PierceSepsis is a silent killer that cleverly hides behind other diseases. It is the third leading cause of death in the U.S., with 20,000 cases annually in Kansas alone. Though treatable, 500-plus people in the U.S. die from sepsis every day because it is difficult to diagnose. As first responders, EMS professionals are essential to quickly identify potentially septic patients.

Likely targets: Sepsis is caused by the body’s reaction to an infection. While anyone can develop sepsis, those most vulnerable include infants, the elderly and patients with an infection or compromised immune system.

Looks can be deceiving: Family on the scene may not understand the symptoms and causes of sepsis, so ask questions and observe the signs.

  • Is the patient inexplicably tired, disoriented or dizzy?
  • Do they have a disease or infection that might lower their immune system?
  • Has the patient had surgery recently?
  • Have they been around anyone sick recently?
  • Do they fit the Systemic Inflammatory Response Syndrome (SIRS) criteria?

Act and notify the hospital immediately: If you suspect a patient meets the criteria for sepsis, notify the hospital immediately. For every hour treatment is delayed, the mortality rate increases 8%. Recognition in the field is key.

To learn more about sepsis, visit kumed.com/sepsis. If you have any questions, contact Dustin Pierce at dpierce@kumc.edu.

- Dustin Pierce, RN, BSN

Meet the Olathe Fire Department

Olathe Fire DepartmentThe Olathe Fire Department was established in 1871 and internationally accredited in 2012 to provide emergency and nonemergency services to those who live, learn and work in Olathe, Kansas.

The department serves more than 130,000 residents as well as students of Mid-America Nazarene University and the Kansas State School for the Deaf. Operating from seven fire stations with eight fire trucks, they are staffed by 43 paramedics and 73 EMTs. The staff responds to more than 10,000 calls annually.

Emergency services include fire suppression, emergency medical care and specialty services like those provided by the Special Operations Group (SOG). SOG is composed of technical rescue (e.g., trench, confined space, swift water, breaching heavy objects and building collapse), hazardous materials and explosive ordnance disposal. Nonemergency services consist of community risk management, safety education, emergency management and building codes. The department is the only Kansas City metropolitan agency engaged in mobile integrated health.

To learn more, visit olatheks.org/fire.

Thanks for attending the TCD Symposium

TCD SymposiumEMS professionals from across the region made October’s The Time Critical Diagnosis: You’ve Got Mad Skills Symposium a success. Several physicians from The University of Kansas Hospital spoke at the conference and led afternoon skill simulation stations on Difficult Airway, Burn/Trauma Management, Complicated OB Deliveries, and Stroke Assessment and Management.