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EMS News in Focus
by Arthur Hsieh

Infection control and EMS: On the front lines

With the winter flu season upon us, now is a good time to do more than a cursory cleaning

By Arthur Hsieh

EMS providers are exposed to a variety of infectious diseases, on a daily basis. It would make sense that we should treat the back of our ambulances as rolling patient examination rooms, and take the time and care to clean them after every patient contact. After all, they do that in emergency departments, right?

Unfortunately, most of us don’t do much more than a cursory cleaning, even after a messy call. We might quickly wipe down the gurney mattress, or wipe off the parts of the gurney itself. Even fewer of us will take a mop to the floor on a daily basis, or wipe down the cabinets, bench seats, grab handles, or the ambulance cab routinely.

Years back, I was working on a patient while transporting to a hospital. The ambulance wasn’t really wll designed ergonomically — a whole different story &mdash and as a result, I kneeled on the floor of the unit while tarting an IV. My partner had to come to a quick stop, which resulted in me pitching forward slightly, striking my elbow on the floor of the ambulance. The contact was so brief, I didn’t even think twice about the incident. We completed the transport without further incident, and I forgot about it for the rest of the shift.

When I woke up the next morning, I could feel that my arm was sore. At first I thought I had strained my elbow; I took some ibuprofen and didn’t think too much more about it. But, by the end of that day’s shift, it was fairly stiff and my elbow felt a bit raw. It turned out I had received a minor scrape on my elbow, which established a staph infection that rapidly blew up into a major infection. It took IV antibiotics and a week off from work to resolve it.

Prior to that incident, I didn’t do too much in terms of disinfecting the unit. I‘m fairly religious about it now — not paranoid, but I certainly don’t want to have that happen to me again. The APIC report provides solid information about the pathogens EMS providers are exposed to, and the appropriate level of pre-and post-exposure response. Infection control is not a sexy topic, but it affects all of us on a daily basis. With the winter flu season upon us, it’s a good time to step up our game and keep those bugs from coming home with us.

About the author

EMS1 Editorial Advisor Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Contact Art at
The comments below are member-generated and do not necessarily reflect the opinions of or its staff. If you cannot see comments, try disabling privacy and ad blocking plugins in your browser. All comments must comply with our Member Commenting Policy.
Daniel Gerard Daniel Gerard Monday, December 23, 2013 5:04:44 PM Good job Art.
Alan W. Rose Alan W. Rose Monday, December 23, 2013 7:57:07 PM I used to work in an ED. Seriously you jest. Clean rooms? Usually just a wipe down of the mattress, handrails,cords. If the patient was infectious, housekeeping would be called in to do a full cleaning. Many times I've delivered patients to the ED with bloody trash on the floor and blood stains on the bed. Everybody needs to do a better job. No not a better job, we need a revolution in cleanliness. There is a reason why hospitals are a massive source of infection. The old lessons learned have been lost.

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