|
Lt. Timothy R. Thompson covers Infection Control topics.
About the columnist:
Lt. Timothy R. Thompson has been involved in EMS since 1977. He currently serves as a Medical Quality Officer for the Washington DC. Fire & EMS Department. He also serves as an instructor of BLS, ALS and Infection Control programs for the department.
You may contact through his web site or submit feedback with the link below. |
 |
Co -Author Denise A. Thompson, EMT/B
Denise has several years in EMS as an EMT/B and currently holds certifications in Maryland, Washington DC., and Virginia. She has served in both the private and public sector. Currently she is the backbone of all the training we do and has assisted with all programs. Denise, along with husband Timothy and Stepson Michael belong to the Chester Gap Fire Department in Virginia.
Clean it up !!!!
By: Timothy R. Thompson, NREMT/P
Denise A. Thompson, EMT/B
This month we are going to address the issue of housekeeping, something that many providers seem to forget about. And I don’t just mean keeping your duty station clean, but everything around you. How many times have you reported for duty and had to clean up after the off going shift, if you have my luck it’s happened several times. So what are your housekeeping duties:
· Unit
· Supplies & equipment
· Duty station
· Scene
Unit: Do you really know what was in the unit on the previous shift, probably not. Your unit needs a thorough cleaning inside and out, top to bottom, front to back. Over the years there have been many changes in how we should clean our units. Back in the day (before sharps containers) I’ll bet you can’t guess what the bench seat was used for. If you said to stick used/dirty needles in it you are correct. And there are still providers out there that do that. When you clean the inside of your unit at a minimum you need to do a light decon, this includes the cabinets, control panels, onboard suction and oxygen hook up. You also need to clean every seat and the ceiling and give the floor and door well a good scrubbing, and yes the seat belts need attention as well.
Don’t forget the front of your unit, just because you don’t put patients up front does not mean you don’t have to clean it. Think about this, you have a trauma victim and you have your gloves on. Now you start your transport and you are driving but you did not take off your gloves. What have you done to the front of the unit? You have just destroyed it, you were using the siren and lights, steering wheel, signal and shift levers, radios and many more things. The inside of the door is also contaminated. This just shows that the front needs just as much care as the back when it comes to cleaning. Do you know that the previous shift kept it clean, no you do not.
When you clean the outside of your unit use your soap as you normally would but also add a little disinfectant in the water. We want to make sure all of the nasty stuff is gone. Don’t just wash over door handles and mirrors, clean inside of every crevice. How many times do you open unit doors and compartments without gloves before you clean it. Sure we check our unit when we get to work, that is a must since you have to be ready for service. When you check your unit wear your gloves. Once you find you have what you need start the cleaning process. The way I used to do this was I would check the supplies while my partner washed the unit, then I would begin cleaning the back and when my partner was finished washing he/she would begin cleaning the front.
The biggest pet peeve of my Wife Denise is the cleanliness of the unit. If you want a clean unit just ask her how to do it. She will clean every nut, bolt, screw and just about anything you can think of. By the time she is done you will think you have a brand new unit. Part of our job is to keep the patient safe, how can that be done if our unit is not clean. Without the unit being clean all of your patients are transported together, not physically but parts of every transport are left behind. Do you want your family transported in a filthy unit, I sure don’t.
Supplies & equipment: This by far is one if not the most important. These are the items you use to treat your patients, if they are not clean what have we possibly done to the patient. I have seen over the years the use of contaminated equipment, mostly because the crews are too lazy to take care these items. Many times providers use blood stained blood pressure cuffs on patients. “Back in the day” we used wooden spine boards, these boards would become stained with blood and body fluids. Not only would these boards have stains they would become splintered creating a bigger hazard for us as well as the patient. Let me ask you, how long does the HBV last outside of the body? If you said seven days you are correct. So that should tell you what a big risk that is. Then we as providers were given a false sense of security with the plastic and composite spine boards. They clean up easy, right. Sure, but only if you get into every crack and scratch. These boards become nicked and damaged over time and need to be thoroughly cleaned.
But don’t just think of these items, think of everything you use on your patient and everything you use to transport (carry) your patient. All of this needs attention, how many times have you seen a stair chair put away dirty and used on the next patient. Odds are you have seen it a lot. All straps and safety belts need decon as well, these are all too often forgotten. Next time you are at your duty station take a look at everything on your unit and try and remember the last time it all had a complete cleaning.
Duty station: Please do not neglect your station, this is your home for several hours at a time. If you have a Bio hazard waste section in your station keep it neat and only place soiled items in it, not food trash. Call for regular waste pick ups, do not let it pile up before you get rid of it, bad smells have been known to come from this waste. Keep your restroom and kitchen clean, do not allow the cook/s to fix the meal until they have washed up. And please keep your feet off of the furniture and tables, just remember where you have been. Do you want to eat your meal from a table that just had vomit filled bloody shoes on it. NOT ME.
Scene: This is by far the easiest. Last unit on the scene CLEAN IT UP. Don’t leave anything behind, we sure don’t want the little ones to pick up dirty gloves and try to use them like balloons. Do a complete survey of the scene before you leave and bag all of the nasties and trash. As a Manager this was the topic of many neighborhood complaints, units would leave this contaminated material on the scene. So please think of the communities that you serve and clean up after yourself.
So with all this said please take this seriously, it is not just our own lives at stake, we must think about the people and communities that we serve. Do you want to do a “Dog and Pony” with a dirty unit and contaminated equipment, I sure hope not. Do you want your family and friends treated and transported by a breading ground for disease, not me.
So please people, from us to you keep your job clean
NOTE: If you have any IC horror stories I would love to hear them and maybe use them in future articles. Also if you have any topic suggestions please send them to me via email.
iccorner@hotmail.com