Emergency medical services equipment hygiene practices

Area of Science:

• Emergency Medicine
• Infection Control
• Public Health

Background:

• Accepted equipment hygiene standards are crucial for preventing pathogen transmission in emergency medical services (EMS).
• Previous assessments of EMS hygiene practices, particularly concerning decontamination protocols, are limited.

Purpose of the Study:

• To evaluate the adherence of emergency medical services (EMS) systems to established equipment hygiene and decontamination standards.
• To identify deficiencies in current EMS decontamination practices.

Main Methods:

• A mail survey was distributed to the physician medical directors of EMS systems in the 125 most populous U.S. cities.
• Response rates and reported practices regarding equipment decontamination policies, quality assurance, and specific cleaning agents were analyzed.

Main Results:

• Of 85 responding EMS systems, 86% had decontamination policies, but only 44% had associated quality assurance programs.
• While 93% used alcohol or commercial disinfectants (A/CD) for noncritical items, only 41% supplemented this with soap and water.
• For laryngoscope blades, 59% used A/CD alone, and only 37% used soap and water with A/CD, falling short of high-level disinfection standards.

Conclusions:

• EMS systems in major U.S. cities demonstrate inadequate adherence to accepted equipment hygiene standards.
• The frequent omission of soap and water pre-cleaning before disinfection may compromise the efficacy of decontamination.
• Current practices for items contacting mucous membranes, like laryngoscope blades, often do not meet recommended high-level disinfection standards.