Well informed EMT

Your text, most likely, goes into quite a bit of detail on communicable diseases. The information is important and a well informed EMT has a better chance of protecting himself. Remember we are trying to eliminate "ignorance" (as mentioned above, on this page.) As you familiarize yourself with the different diseases, notice how many of them are "fluid borne" (carried by fluid.) Especially those diseases that seems to be of more "recent" concern, like AIDS and Hepatitis. Following the guidelines of Body Substance Isolation (BSI) will help protect you from, and "isolate" you from body fluids, secretions, and other substances that might be carrying infection. There is no way that you can know if a body substance is a "carrier." For that reason, is it smart to assume that all body substances are infected and do everything possible to avoid them. The use of appropriate "personal protective equipment" (PPE) starts by evaluating the scene into which you are about to enter. If the scene is a relative "quiet" one, gloves may be the only equipment needed to protect yourself. If the scene is likely to become more "violent," as it might with "impending child birth" where fluids a likely to be projected into the air, it might be necessary to add eye protection, gowns, and masks. There are two other concepts that we have included in this discussion, that we consider to be part of "PPE" and they are "hand washing" and "immunity."

Protect yourself

Neither is classically considered to be a "piece" of personal protective equipment, but both are very important to the health, well-being, and ultimately, the usefulness of any healthcare provider, and both, properly practiced will be very effective in "protecting" the provider from personal infection and the transmission of that infection to others. Proper hand washing has been identified as the simplest and most effective way to control personal infection and disease transmission. Familiarize yourself with the proper technique for hand washing, and utilize it before and after every patient, before and after any event that might expose you to infection, before and after meals, before and after se......OOPS!...We got carried away. Appropriate proactive immunization has become the "standard of care" for all healthcare providers and its usefulness needs no further explanation here.

Your own body, when healthy, has an intricate system of protection, but you need to be attentive to your personal health habits, and do everything possible to protect your health. As mentioned above, it is not only embarrassing to "sneeze" in face of patient, it indicates that your health is in a state of compromise and that you are at greater risk of infection. Proper use of personal protective equipment, including but not limited to, donning and removing gloves, donning and removing gowns, donning and removing masks, and being fitted for a HEPA respirator, is something that is better left to actual classroom discussion and demonstration. The proper disposal of these items is something that common sense dictates.

All healthcare facilities have very strict controls over the disposal of infectious waste, and strict adherence to those controls is expected from everyone. Hazardous scenes are around every corner. From the "hazards" mentioned above, to fires, electricity, weather conditions, terrain, violent patients, and hazardous materials, the EMT is constantly bombarded with situations that threaten his/her well-being. In addition to the protective equipment mentioned above, some other pieces of equipment are offered. In some areas medical providers are wearing body armor. Although it is not common practice for medical providers to involve themselves in scenes involving firearms, some providers have felt better "protected" in the urban setting using this new technology. Firefighting turnout gear not only provides some protection from the hazards of fire, but will provide limited protection from environmental elements. Today's turnout gear provides a barrier to fluids (including water, rain, body fluids, chemicals, and some hazardous materials,) and is very useful in cold weather environments. Helmets and goggles provide head and face protection in environments where falling objects or projectiles might pierce the skin. Heavy turnout gloves provide a very limited degree of protection from accidental brushes with charge wires, and a somewhat better level of protection from hot/cold surfaces. If the scene is one which includes loud noises, consider some type of ear protection.

Even if the noise is not painful, sound levels well above the level that destroys the small "hair-like" structures in the inner ear, can occur. Electricity is a hazard that must be anticipated without being seen. The likelihood that a provider, who is inattentive, at a scene where wires (any kind of wires) are involved, will ultimately be electrocuted, is very high. The likelihood that a provider, who is inattentive, will ultimately be struck by lightning at a scene where weather conditions are an issue, is equally as high. Attention to the environment in which you are working is vital to your well-being. Issues regarding violent patients, and hazardous materials will be discuss at length in later sections of this site.

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