Action Items for Disease Prevention

Thinking about your PPE actions ahead of time will pay off

Mandated or not, personal protection equipment (PPE) can protect us from a variety of hazards; in EMS the standard body substance isolation PPE can protect us from everything from anthrax to hepatitis. Often times the value of body substance isolation or personal protective equipment is under realized… as is the value of a good infection control program.  Most responders think of personal protective equipment as masks, gloves, eye wear, and gowns. But our personal protection is more than  a “thing” we put on… our best personal protection is our action. Far too often responders don't think about their personal protective equipment until they have to use it so we decided to include a few tips in today's post.

Action number one: get vaccinated.

No matter which side of the mandated vaccine debate you happen to be on, vaccine is a top preventative measure. Vaccines are proven to be safe and effective. Not only do they provide the individual with protection from specific diseases, vaccination also provides herd immunity to a given population. That is,  a community that is vaccinated and protected against disease also protects those who have not developed immunity. Herd immunity is vital to those with compromised immune systems and even to some healthy groups such as schoolchildren.

Action number two: it's not all about vaccine

Okay, this was really not an action is a mindset… so pay attention anyway. Pharmacological measures such as vaccine are fantastic at preventing disease. However, the downfall is that they are not always readily available. As we saw with the swine flu situation 2009, vaccine production is time-consuming and with most vaccine production occurring overseas, delivery of vaccine is susceptible to breaks in the logistical chain. Additionally, deployment of pharmacological measures (oral medications as well as vaccine) can be challenging. Because of the shortcomings, it's important for everyone to understand the role of non-pharmaceutical interventions in disease spread control. The non- pharmaceutical interventions include; hand washing, respiratory etiquette, appropriate social isolation.

Action number three: hand hygiene.

Above all medications and science; hand hygiene (the simple act of washing your hands) is rated as the number one means for preventing the spread of disease. The use of warm water and soap for washing hands for between 15 and 30 seconds is a major component in effectively stopping disease spread in any population.

Action number four: respiratory etiquette.

Respiratory etiquette means covering your cough and your sneeze and any other secretions you discharge from your mouth or nose. Covering your cough and sneeze is a mainstay of respiratory etiquette and helps prevent droplet transmission of disease. Droplet transmission is a major mode of transmission for Type A influenza. And don't be afraid to wear a mask. That is, don't be afraid to put a mask on yourself or on the patient if they have a cough or sneeze. Placing a mask on the patient goes a long way to containing the source of the droplets and respiratory secretions at the source… placing a mask on you significantly decreases your intake potential of those droplets and respiratory secretions. And yes, you can place a standard surgical mask over an oxygen delivery device such as a nasal cannula or non-rebreather mask. And no, it does not have to be an N. 95 mask. The centers for disease control and prevention noted that standard surgical masks were sufficient to prevent droplet transmission in the setting of many respiratory illnesses including Type A influenza.

Action number five: appropriate social distancing.

Simply stated, appropriate social distancing means staying home when you're sick. That's not just staying home from work; this also includes staying out of public areas when you're ill. It does us no good to have someone stay home from work and/or school only to go to the local shopping mall or otherwise be out in public. I realize this is not a popular topic with many employers (emergency service or civilian employers) but the fact remains that people who are ill with gastrointestinal problems or respiratory illness should not be in a position to spread that disease whenever possible.

And finally, action number six: clean your work environment. Simply wiping down flat surfaces in your work environment will go a long way to preventing your exposure to disease and the spread of many illnesses. Cleaning your work environment means wiping down flat surfaces and other areas of your response vehicle. Many commercially available cleaning materials will do the trick… you don't have to get too fancy. Wiping down the dashboard, the steering wheel, and the microphone will go a long way to preventing illness amongst your crew and your patient. Don't forget your office environment either. A quick wipe on telephones and computer keyboards as well as other surfaces will prevent disease spread as well.