The answer is simple, infection control are the practices that we use to minimize our risk of exposure. Why would we want to take chances when there is so much bad stuff out there? I’m sure we all know of at least one person in our line of work that will not utilize BSI or standard precautions for any reason. I know several of those people, the risk takers of EMS, the ones that think “it’s won’t happen to me”. These are the ones who say “if I was going to get something I would have gotten by now”.

    I don’t know about you, but to me that is a very scary way to think. Yes those of us involved in public service are sometimes a few fries short of a happy meal, but don’t let yourself get burned. We are taught from the beginning stages of EMS to “lookout for number 1”. That number 1 being you, do not intentionally place yourself in danger when it comes to infection control. As far as myself, I have a wonderful Wife, great children, and fantastic grand children. I want to be around for them and even more I do not want to take anything home to them. So let’s take a look at what infection control is all about.

It is a system of procedures and practices designed to keep us safe as well as our patients. This includes:
1) Knowledge of diseases and how they are transmitted, this includes your initial and annual training and updates
2) Prevention, this includes HBV vaccine and yearly TB screening
3) The exposure control plan for your agency, to include the proper paperwork for exposures
4) A post exposure plan needs to also be in place
5) Proper counseling needs to be available for provider’s following an exposure

Now let’s explore the above five items in a little more detail.

1) If you do not know or understand how disease is transmitted or the disease process itself you will not be able to adequately protect yourself. You must know which disease is bloodborne or airborne, you must know the mode of transmission, you need to be properly trained in this subject. Many providers think that this is one of the most boring and useless subjects in EMS. True it is not an edge of your seat class, but it is something that is required by law. You must have training in this once hired usually within ten days followed by annual updates. The length of the class varies depending on the agency. I know of some agencies that require eight hours of initial training and four hours of annual update. Some of these agencies give a test and if you do not pass, you repeat the training. That is just how important this training is.

2) The HBV vaccine has made this terrible virus almost entirely preventable. This is something that all of us need. Many school systems have this as a required part of the immunization of children now. There is also talk from the federal Government about making this a requirement for all healthcare workers and responders. The annual TB (PPD) now called Tuberculin Skin Test (TST) is another fantastic tool for us. Some people are unable to get this test because they have previously tested positive, but they can still be checked. These providers need to get a chest x-ray if they develop any symptoms. Some agencies require a chest x-ray when an exposure occurs. These two items (HBV vaccine & PPD) should be offered by your employer free of charge. My suggestion is protect yourself.
 
3) Know your agency/employers exposure control plan, this is another way you can protect yourself. Know the plan and the proper paperwork that you need to complete. If this plan is part of your local protocols learn it and practice it. You also need to know the federal regulations pertaining to infection control and become familiar with the Ryan White Law. In these days of internet access there is no excuse for not being familiar with not only federal regulations, but infection control as well. It is all at our finger tips.

4) Know your post exposure plan, this is very important so you know what your rights are within your agency. Do not let yourself get bullied, know your rights. By knowing not only the post exposure control plan but also knowing your agencies exposure control plan are ways of protecting yourself.

5) Exposure incidents can be a very stressful event. There are times when you may need to seek counseling. My suggestion is do not use your CISD team for this type of counseling. Use a trained councilor, someone that can help you get through this event. Your CISD team normally does not have this type of training. Do not be afraid or embarrassed to contact a councilor, this is nothing to be ashamed of. It is true that we all have co-workers that will tease us, but it is not their body or health that is in question, it is yours.

    In future columns we will be taking an in depth look into the regulations from OSHA and the CDC, as well as the Ryan White Law. In the meantime take yourself on a mission of discovery and explore your agencies plans.

    In closing this is something that all of us must take seriously. Yes the training can be boring, and some agencies give you the same information year after year without any updates. When it comes to training you need these updates, you need to know about emerging diseases and new ways to protect yourself as well as any new regulations.

    Remember, it is the only body you will ever have so you need to take care of it.