C S Goodman1, D C Cone. 1. Emergency Services, Brookhaven Memorial Hospital Medical Center, Patchogue, New York 11772, USA. cgoodman@bmhmc.org
Abstract
OBJECTIVE: To determine whether emergency medical services (EMS) systems adhere to accepted equipment hygiene standards. METHODS: Mail surveys were sent to the physician medical directors of the EMS systems of the 125 most populous cities in the United States. RESULTS: Eighty-five surveys (68%) were returned. Seventy-three (86%) of the responding services have a policy addressing equipment decontamination, and 32 of these (44%) have an accompanying quality assurance program. Seventy-nine (93%) utilize either alcohol or a commercial disinfectant (A/CD) on noncritical items when visibly contaminated with blood. However, only 32 of those agencies (41%) use soap and water in addition to A/CD. Another nine (11%) exchange contaminated items at the hospital, one (1%) uses other methods, and two (2%) respondents did not know. Seventy-six (89%) of the responding agencies perform endotracheal intubation. Of the 54 that decontaminate their own blades, 20 (37%) use soap and water in addition to A/CD, 32 (59%) use A/CD alone, and two (4%) use soap and water alone. CONCLUSION: Adherence to accepted hygiene standards among EMS systems in our most populous cities is poor. Many systems do not use soap and water prior to A/CD. Failure to do so may minimize the effectiveness of disinfection. Several systems use A/CD or soap and water alone, neither of which meets current standards for high-level disinfection recommended for items that will come in contact with mucous membranes, such as laryngoscope blades.
OBJECTIVE: To determine whether emergency medical services (EMS) systems adhere to accepted equipment hygiene standards. METHODS: Mail surveys were sent to the physician medical directors of the EMS systems of the 125 most populous cities in the United States. RESULTS: Eighty-five surveys (68%) were returned. Seventy-three (86%) of the responding services have a policy addressing equipment decontamination, and 32 of these (44%) have an accompanying quality assurance program. Seventy-nine (93%) utilize either alcohol or a commercial disinfectant (A/CD) on noncritical items when visibly contaminated with blood. However, only 32 of those agencies (41%) use soap and water in addition to A/CD. Another nine (11%) exchange contaminated items at the hospital, one (1%) uses other methods, and two (2%) respondents did not know. Seventy-six (89%) of the responding agencies perform endotracheal intubation. Of the 54 that decontaminate their own blades, 20 (37%) use soap and water in addition to A/CD, 32 (59%) use A/CD alone, and two (4%) use soap and water alone. CONCLUSION: Adherence to accepted hygiene standards among EMS systems in our most populous cities is poor. Many systems do not use soap and water prior to A/CD. Failure to do so may minimize the effectiveness of disinfection. Several systems use A/CD or soap and water alone, neither of which meets current standards for high-level disinfection recommended for items that will come in contact with mucous membranes, such as laryngoscope blades.