Emergency medical services oxygen equipment: a fomite for transmission of MRSA?

2018 ◽  
pp. emermed-2018-207758
Author(s):  
Cody Vaughn Gibson
Keyword(s):  
Staphylococcus Aureus ◽  
Emergency Medical Services ◽  
Prehospital Setting ◽  
Medical Services ◽  
Cross Contamination ◽  
Nacl Solution ◽  
Emergency Medical ◽  
Storage Area ◽  
Oxygen Equipment ◽  
Patient Infection

ObjectivesThe primary purpose of this study was to determine if methicillin-resistant Staphylococcus aureus (MRSA) was present on the surface of oxygen cylinders and regulators used in the prehospital setting and secondarily to assess other surfaces for MRSA within the ambulance compartment, as a comparison.MethodsOn 17 March 2018, the surface of oxygen cylinders and regulators located in ambulances at an emergency medical services (EMS) station in North Alabama (n=9) and at an offsite oxygen cylinder storage area (n=70) were swabbed using sterile cotton-tipped applicators saturated in an 0.9% NaCl solution. These cotton-tipped applicators were then streaked across the surface of HardyCHROM MRSA plates, followed by incubation at 36°C for 24 hours. The growth of pink or magenta colonies was considered a positive indication for the presence of MRSA. The motivation for assessing oxygen cylinders at the offsite storage area was to outline the persistence of MRSA on stored oxygen cylinders.ResultsOf nine oxygen cylinders tested in the ambulances, nine had MRSA colonisation (100%). MRSA was also present on 67 of 70 oxygen cylinders (96%) tested at the offsite oxygen cylinder storage area.ConclusionOxygen cylinders appear to act as a fomite for MRSA. The development of universal disinfection protocols for oxygen equipment could help reduce the risk of patient infection due to cross-contamination.

Emergency Medical Services System Changes Reduce Pediatric Epinephrine Dosing Errors in the Prehospital Setting

PEDIATRICS ◽  
2006 ◽  
Vol 118 (4) ◽  
pp. 1493-1500 ◽  
Author(s):  
A. H. Kaji ◽  
M. Gausche-Hill ◽  
H. Conrad ◽  
K. D. Young ◽  
W. J. Koenig ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Prehospital Setting ◽  
Medical Services ◽  
Emergency Medical ◽  
System Changes

scholarly journals Elder Abuse Identification in the Prehospital Setting: An Examination of State Emergency Medical Services Protocols

2018 ◽  
Vol 66 (5) ◽  
pp. 962-968 ◽  
Author(s):  
Brooke L. Namboodri ◽  
Tony Rosen ◽  
Joseph A. Dayaa ◽  
Jason J. Bischof ◽  
Nadeem Ramadan ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Elder Abuse ◽  
Prehospital Setting ◽  
Medical Services ◽  
Emergency Medical

Methicillin-Resistant Staphylococcus Aureus Nasal Colonization Prevalence among Emergency Medical Services Personnel

2013 ◽  
Vol 28 (4) ◽  
pp. 348-352 ◽  
Author(s):  
Alaa Al Amiry ◽  
Richard A. Bissell ◽  
Brian J. Maguire ◽  
Donald W. Alves
Keyword(s):  
Staphylococcus Aureus ◽  
General Population ◽  
Emergency Medical Services ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Medical Services ◽  
Nasal Colonization ◽  
Methicillin Resistant ◽  
Emergency Medical ◽  
Emergency Medical Services Personnel ◽  
Mrsa Colonization

AbstractIntroductionThe prevalence of Methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization among Emergency Medical Services (EMS) personnel is not well studied. Methicillin-resistant Staphylococcus aureus colonization can be a health hazard for both EMS personnel and patients. The aim of this study was to quantify the prevalence of MRSA colonization among EMS personnel. This study will help the scientific community understand the extent of this condition so that further protocols and policies can be developed to support the health and wellbeing of EMS personnel.Hypothesis/ ProblemThe hypothesis of this study was that the prevalence of MRSA colonization among EMS personnel is significantly higher than among the general population.MethodsThis was a cross-sectional study. A total of 110 subjects were selected from two major US Mid-Atlantic fire departments. Methicillin-resistant Staphylococcus aureus colonization was detected by nasal swabbing. Nasal swabs were inoculated onto a special agar medium (C-MRSAgar) with polymerase chain reaction testing performed. One-sided binomial distribution at the StudySize 2.0 Web calculator was used. Using the Web calculator, p (H0 proportion) = 1.5%; a difference (H1-H0) ‘Δ’ = 4.53% can be detected at α = 5% and power = 80% with N = 110.ResultsSamples were collected from 110 volunteers. Seven samples were positive for MRSA, resulting in a prevalence of 7/110 or 6.4% (95% CI, 1.8%-11%; P < .0003) compared with a 1.5% prevalence of MRSA colonization among the general population.ConclusionThere is evidence that EMS personnel have a higher prevalence of MRSA colonization than the general population. This can be a risk to patients and can be recognized as an occupational hazard.Al AmiryA, BissellRA, MaguireBJ, AlvesDW. Methicillin-resistant Staphylococcus aureus nasal colonization prevalence among Emergency Medical Services personnel. Prehosp Disaster Med. 2013;28(4):1-5.

Involuntary Commitment in the Prehospital Setting

1992 ◽  
Vol 7 (2) ◽  
pp. 139-143
Author(s):  
James G. Adams ◽  
Jody Gerard ◽  
Vince P. Verdile ◽  
Paul M. Paris
Keyword(s):  
Emergency Medical Services ◽  
The United States ◽  
Base Station ◽  
Prehospital Setting ◽  
Emergency Medical Technician ◽  
Medical Services ◽  
Involuntary Commitment ◽  
Emergency Medical ◽  
Behavioral Emergencies ◽  
Suicidal Patients

AbstractIntroduction:Suicidal patients who refuse prehospital transport pose a difficult problem for emergency medical services. A survey was conducted in an attempt to assess the current strategies for involuntary transport of such patients.Methods:The medical directors of 135 of the largest EMS systems in the United States were mailed a questionnaire requesting descriptions of the operating procedures for dealing with suicidal patients who refuse transport.Results:Fifty-nine of 130 questionnaires (45%) were returned. Seventeen emergency medical services (EMS) systems (29%) serve populations of less the 250,000, while 41 (69%) serve populations greater than 250,000. Cumulatively, respondents represent an excess of 2.1-million EMS responses per year, of which 0.5%-10.0% involve behavioral emergencies. Eleven of the 59 responding systems (19%) have urritten, explicit policies guiding the management of suicidal patients who refuse to be transported. Involuntary commitment proceedings are initiated in the prehospital setting in 25 of the 59 services (42%). Of these 25, the initiation of commitment proceedings is performed by the following (more than one may apply to a given system): 11 (44%) by base-station physicians, six (24%) by the emergency medical technician (EMT), 23 (92%) by a police officer, and five (20%) by family or friends. Ten of the 59 systems (17%) require a mental health delegate to authorize commitment. Two physicians can mandate involuntary commitment in one of the responding systems. Of the 25 systems that actually perform involuntary commitment in the prehospital setting, seven (28%) have established policies. Of the 34 systems which do not perform involuntary prehospital commitment, four (12%) have policies to guide the care of suicidal patients who refuse care.Conclusion:Suicidal patients commonly confront emergency medical services, yet many systems lack explicit policies for dealing with such patients. Widely varied strategies are used to authorize transport of patients who are suicidal and refuse to be transported.

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